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You might be wondering why your toothache is worse at night when you are trying to sleep. Although there are many types of toothaches, the irreversible toothache is the one that is common to disrupt your sleep at night. It is irreversible because the nerve has been inflamed beyond repair. This is different than the transient reversible tooth sensitivity than may result from gum recession or after dental work.
The Science behind it: the ideal gas law:
-The “number of moles” and “gas constant” do not change
When we are asleep, our body temperature rises. When this happens, pressure and volume inside the nerve chamber and canals is proportionally increased. Because the chamber and nerve canals of your teeth cannot expand, a throbbing pain ensues. It will feel like a pulsating, throbbing pain, and you will want to pull your tooth out (please don’t do it by yourself!). At some point, the inflamed nerve will be so infected by bacteria that it may create a draining abscess (AKA gumboil).
Before treatment can occur, a proper diagnosis should be made—what caused the toothache? For example, was it caused by a small bacterial decay/cavity in between the teeth? Or was it caused by a large non-repairable fracture of the tooth? The correct assessment and diagnosis will dictate the proper course of treatment. If the structure of the tooth cannot be saved, extraction with tooth replacement options, such as a dental implant, may be warranted. If the structure of the tooth can be saved, your dentist/prosthodontist may suggest de-nerving the tooth (root canal therapy) followed by a full coverage crown to protect the remaining tooth structure.
It never hurts to get a second opinion! Don’t be rushed into a tooth extraction or root canal therapy, without considering all your restorative options. Feel free to call Dr. Huang, a dual-board certified prosthodontist, for a second opinion. Then you really will be able to sleep better at night.