Synonyms
Toothache
Introduction
The neck of the tooth is the upper part of the root of the tooth, which connects to the crown of the tooth covered by the enamel. While the crown is protected by the enamel, the neck of the tooth is usually covered by the gum. The gums protect the neck of the tooth from external influences. If this protection is lost and the neck of the tooth is exposed, pain may occur due to mechanical or chemical influences.
Causes at a glance
These causes can lead to pain in the neck of the tooth:
- Caries, especially in the area of the tooth neck
- Untreated gum inflammation (gingivitis)
- Untreated periodontitis (inflammation of the periodontium)
- Wrong tooth brushing technique (too much pressure, wrong “scrubbing”)
- Wedge-shaped defects
Causes in detail
The cause of an exposed tooth neck is either the receding gums due to periodontitis (inflammation of the periodontium) or the age-related gingival recession. Periodontological operations to flatten deep gum pockets also lead to the exposure of the neck of the tooth because the upper gumline is removed (gingivectomy). Another cause is improper brushing habits, mainly through “scrubbing” in combination with too firm contact pressure and a highly abrasive toothpaste.
In this case, the gums may also recede and the root surface may be eroded. The dentine in the cervical region of the tooth is traversed by numerous root canals containing nerve fibers in which stimuli are transmitted to the tooth pulp. By exposing the cervical area of the tooth, even through incorrect brushing habits, these tubules are opened and a connection to the irritations causing the irritation is established.
Because of the painfulness, less brushing is done and the accumulation of plaque leads to a vicious circle with the consequence that sensitivity increases and cervical caries develops. Inflammation of the gums (gingivitis) or the periodontal apparatus (periodontitis) is often wrongly described as cervical inflammation. However, a bacterial inflammation of the periodontium, a periodontitis, leads to destruction of the periodontium, which in the worst case can lead to loss of the tooth.
Gingivitis, in turn, is an inflammation of the gums, which manifests itself with swelling and redness in the affected areas. Inflammation of the dental neck can colloquially mean inflammation of the dental pulp, a so-called pulpitis. An inflammation of the dental nerve in the pulp is very painful.
It comes to sudden attacks of pain. The pain can occur on contact with food or spontaneously during the night and lasts longer than caries tooth pain. In general, it is always advisable to consult a dentist if the neck of the tooth is painful.
It is necessary to counteract the spread of the inflammation to ensure the preservation of the tooth. While tooth decay mainly affects the chewing surfaces or the spaces between the teeth, cervical caries affects the root of the tooth. If the gums have receded and the neck of the tooth is exposed, caries can form locally very quickly at the neck of the tooth.
The outermost layer at the neck of the tooth is not enamel, but the much more sensitive dentin. This dentin is in direct contact with the pulp, the pulp of the tooth, where the nerves and blood vessels are located. This is why patients experience spontaneous and prolonged pain on contact with cold, hot, acidic or spicy foods.
In case of cervical caries, it is always best to visit a dentist directly. If cervical caries is not treated, there is a risk that the caries will spread to the periodontium. In this case, it can lead to inflammation, e.g. periodontitis, or in the worst case to the loss of the tooth. Therefore, comprehensive oral hygiene with exposed tooth necks is essential.
