Can’t Exactly Tell Which Tooth is Aching?

Your Brain and Your Tooth Ache

Most people are so tuned in to pain they exactly know where it hurts – a knife cut in the middle finger or a splinter caught under the thumb nail, even if the fingers involved are near each other. It is not so readily easy with toothache in the mouth. A new study from the University of Erlangen-Nuremberg in Germany is one of the first to address the puzzle of toothache localization.

Researchers analyzed brain activity in healthy volunteers as they experienced tooth pain. They delivered short electrical pulses to the upper left canine tooth or the lower left canine tooth in the subjects. These bursts of electrical stimulation produced a painful sensation similar to that felt when biting into an ice cube and were tuned such that the subject always rated the pain to be about 60%, with 100% being the worst pain imaginable.

The researchers used fMRI to monitor changes in activity when the upper tooth or the lower tooth was electrocuted. Many brain regions responded to top and bottom tooth pain in the same way, for the signals came from two branches of the trigeminal nerve . The V2 branch carries pain signals from the upper jaw, and the V3 branch carries pain signals from the lower jaw. Regions in the cerebral cortex behaved similarly for both toothaches. These brain regions are known to play important roles in the pain projection system, yet none showed major differences between the two toothaches.

Though the stimulation was more or less the same, the experiments might have missed subtle differences that could account for why some tooth pain can be localized and some can’t. The person couldn’t tell where the pain was coming from, so dentists should be aware that patients aren’t always able to locate the pain source. There are physiological and anatomical reasons involved.
These findings are consistent with what dentists see in practice – the brain is unable to tell top-tooth pain from bottom-tooth pain.

Understanding the pathway from tooth to brain may help researchers devise better treatments for acute tooth pain, such as cavities or infections, and more-chronic conditions, such as phantom pain that persists in the mouth after a tooth has been removed.

Understanding Tooth Pain Locations in Bellingham

Are you experiencing tooth pain and can’t exactly tell us which or where? No worries. It’s a common enough dilema. Come to us in Bellingham for a consult and let us look you over and help.