Dentist Questions Dentist

Can you have tooth pain without an infection?

I am a 32 year old male. I wonder if you can have tooth pain without an infection?

10 Answers

Yes. Tooth pain can be caused by many reasons unrelated to infection because even though the outer layer are protected by a mostly mineralized surface called enamel the inner part is technically a living organ made up of modified bone called dentin, a ligament attaching the tooth to the bone called the periodontal ligament, and nerve tissue with a blood supply called the pulp. If the tooth is fractured this can cause pain as the fracture can be sensed throughout the living dentin. As the gum recedes off of the roots such as what can be cause by trauma from a toothbrush the exposed dentin can also cause pain or sensitivity to hot or cold. And on occasion biting on ice or super hot foods can injure the nerve thereby triggering a death of the pulp without infection. This is caused a sterile necrosis.
Only if it is upper tooth, because the sinus is infected and puts pressure. Otherwise it’s just infection if it is a big pain. By what you have pain exactly? What type of pain it is?
Yes. Usually this can happen if the tooth is cracked.
Yes, receding gingival tissue around tooth exposes root of tooth.Teeth can be very sensitive.
Yes. Most common is a tooth fracture or pain in the tissues around
If the gums recede, the exposed root can be very sensitive. If you have bitten hard and a tooth has a crack, that can be extremely painful.
Yes. There are many reasons. Have it examined.
Yes, but that is often right before an infection will arise.



Tooth pain usually arises from trauma, inflammation or infection. You may also have pain to temperature, specifically, cold. If that goes away seconds after the tooth warms up, nothing is usually wrong, but it can be a major irritation that can last for years, making ice cream and cold drinks difficult to endure. That may be caused by pulp that is unusually close to the surface or even root exposure caused by gum recession.



Let's take a simple injury. You accidentally bang your front tooth on a glass or a bottle. The tooth may hurt for some time, because the trauma has caused inflammation to the supporting (periodontal) ligaments of the tooth, much like twisting your ankle. If that is all that is affected, it will heal.



But if there is inflammation in the pulp of the tooth- the nerve and blood vessels- that is a different story. The pulp just fits in the root canal with no room to spare, so if it gets severely inflamed and swells too much, it has no place to go. It essentially strangulates itself, beginning the process of dying. The pain from inflammation may eventually subside as the nerve finally dies, but a different pain will occur some time later. Then, the dead and dying tissue inside the tooth putrifies, forming pus, and pressure is generated. Once that pressure seeks the path of least resistance- the end of the root- that pus will begin to build up under the tooth causing bone and jaw pain. Often bacteria from the mouth can get involved and infection progresses.


The same thing can happen when a tooth is restored with a filling or crown. Tooth decay can cause severe inflammation in the pulp from the bacterial toxins, and the process of drilling out that decay or reshaping a tooth for a filling or crown can cause terminal inflammation of the pulp. Fixing a tooth can result in pain, and, ultimately, infection. That doesn't happen often, but it's always a possibility.



Generally speaking, if a tooth reacts severely to hot or cold, it is probably inflamed and may ultimately get infected- not like overall sensitivity to temperature changes with cold foods.



If a tooth hurts spontaneously and severely with no provocation (your typical "toothache"), it is almost certainly infected. The same is true of a tooth that hurts to pressure or biting.


So, when a tooth hurts, if you're lucky, it's nothing but an irritation. If you're not lucky, it is only the beginning of the process leading to more pain- and infection.


Michael A. Conrad, DDS, PC
Yes, you can have pain without an infection. You have to get an exam and X-ray with a dentist.
Yes