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No. 1 Nov. 18-Dec. 18, 1998
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by: Dr. Gary Molina, DMD
    You had your glass of cold water after a sumptuous meal, or a cup of hot tea during office break, and suddenly an excruciating pain bolts towards your brain.
    You're wondering what in the world is going on when by just a bite on a chocolate bar, you feel pain somewhere among your teeth.
    You sat on your office table, and with a doomed face, disinterested with the commotion going around you, swear that you would knock down anyone who will disturbed you. You can't almost lift a pile of papers, and you feel as if your
    I have laid out a couple of situations above wherein pain sensations are felt through the tooth. Although the pulp is protected and covered entirely by hard substances (Enamel and Dentin), pain sensations then depend on the present physical state and conditions of these hard coverings. Enamel cracks can be a positive pathway for extreme temperatures (cold or hot) to trigger sensations on the tooth. Enamel cracks can be initiated by exposing the tooth to extreme temperatures,
"It is a unique feature of tooth receptors to recognize only as pain whatever stimuli it receives, may it be heat, cold, or pressure."
whole body aches because of a single painful tooth.
    Everyone could have experience any of those, and your dentist probably had already done the appropriate treatment. But with all those painful experiences, you deserve the fair chance of knowing the "how-does-it-happened" side of the story. I figured out that it is just so appropriate to understand the anatomy of a tooth as our referral point. If we are going to slice a tooth vertically and view it on its side, this is how it looks like:

    If you have visited the page on Oral Anatomy, (I hope you did already) the figure above will look familiar. Inside the core of a tooth is the pulp chamber where blood vessels and nerves come in through the apex. It is the pulp that nourishes and provides the sensory function of the tooth.

like drinking cold water immediately after sipping on a hot coffee.
    Another condition of the Enamel covering that causes sensations is abrasion, commonly found on the cervical portion of the tooth crown. Cervical abrasions are usually caused by improper toothbrushing method, which is applying excessive force during toothbrushing using toothbrush with an improperly hard bristle.
    Enamel hypocalcification also predisposes the tooth to painful sensations.
Such conditions of enamel above are mentioned (separate from dental caries) because to most people, these are not so visible and are usually not recognized as tooth defects, and cause confusions especially when sensations are already felt by the patient. It is really imperative to have them checked at once by your Dentist, before such conditions progress into a dental caries.
    But what about the next layer of covering, the Dentin? If we will try to slice a portion of the tooth and try to enlarge, we will be introduced to these part of the dentin:

 
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