Toothache due to nerve irritation
The oral cavity, including the teeth, is generally an extremely dense space with small branches of the fifth cranial nerve. The nerve fibers penetrate through small holes in the jaw from below into the root of the tooth and then lie inside the tooth, which is why it is very sensitive to the smallest foreign influences. If a tooth has been destroyed by caries, it must be removed or a dental root canal treatment with subsequent filling therapy must be carried out.
During this process, the files, instruments, drills, rinsing solutions and other necessary equipment used can cause mechanical, chemical and thermal irritation of the dental nerve. Especially in the case of a plastic filling an acid is used, which additionally irritates the tooth. The caries may have already penetrated so deeply that it has irritated the nerve itself. Both are then perceived as pain. In most cases, such an operation is performed under a local anesthesia of the nerve, which is why the toothache is only felt at home after the anesthesia has worn off.
Nightly toothache after filling
Many patients who complain of persistent toothache after a filling report an intensification of the symptoms during the night. In some cases the toothache after a filling is applied even occurs completely only at night. In fact, this perception of the affected patients is not based on pure imagination but can be explained scientifically.
In this context it is important to be aware that toothache is usually closely related to inflammatory processes within the oral cavity. Various inflammatory mediators are able to bind to pain receptors and thus mediate the perception of pain. The release of these inflammatory mediators is in turn promoted by strong blood circulation.
Since the blood circulation within the oral cavity increases at night due to the lying position, toothache after a filling is felt to be stronger during sleep. For the same reason, the toothache can also only be felt at night. A further explanation for the occurrence of toothache after a filling that only manifests itself at night is the fact that inflammatory processes are to a certain extent temperature-dependent. If the patient lies on the painful cheek for a longer period of time at night, overheating occurs within the tissue. As a result, the release of inflammatory mediators is increased and the patient only feels toothache at night.
