The
most common natural inciting agents which are responsible for causing
pain are hot and cold foods as well as liquids. Consumables with a rich
concentration of sugar in it such as toffee and chocolate also can cause
pain when munched upon-especially so when teeth are having cavities.
A mechanical stimulus e.g passing a finger
nail around the neck of a tooth can induce pain. It is left entirely to
the pain threshold of a patient who eventually decides to pay a visit
to a dental clinic trying to seek a line of treatment that restores his
dental health.
It follows that with intact or
undeteriorated enamel tucked around the tooth mostly around its incisal
or occlusal surfaces as well as cervical margins the chances of intense
pain arising out of what has already been mentioned so far will be
minimized if not remote.
It is therefore vital that the entity of
the tooth be maintained and preserved. To those who believe that they
are performing a great cleansing act by vigorously brushing their teeth
in the same way they employ a polishing brush to shine their shoes fail
to realize that such an aggressive battering with the bristles applied
horizontally to the long axis of teeth erodes the enamel gradually
exposing the sensitive portion of the tooth, the dentine. With the
thickness of enamel wearing out sensitivity becomes a common complaint
of these patients.
In a random survey of 25 patients who
visited the Dental clinic, 14 of them used the ‘assault technique’.
Hitting the enamel forcefully without even trying to surmise the cause
of semi-lunar concavities on the facial surface of their front teeth
they had continued in the same vein until the day their dentist educated
them about the genesis of their cavities. None of the 14 patients ever
bothered to look themselves in the mirror when they brushed their teeth.
Even the remaining 11 patients were not
free of blemishes. Only 5 out of these had, after more than three visits
to a dental clinic started brushing correctly. While 6 out of this lot
used the mixed rotational and horizontal method, suffice to say that
unless there is a honest effort made by those committed to safeguarding
the integrity of their enamel around their teeth sooner than later,
sensitivity is bound to surface.
A question that is often asked by a
patient: “What happens if I take very hot coffee and immediately
afterwards bite into an ice cream cone?” When one eats ice cream pain
and sensitivity occurs in the lower anterior teeth. The crowns of these
teeth are comparatively small which would imply that contact with any
cold food or drink produces a greater fall in temperature than would
occur in larger teeth. The distance from the outer surface of enamel to
the pulp is less that in the other teeth.
Hence for a given cold stimulus the
thermal gradient is greater in lower teeth. With this the temperature
across the tooth structure from outside to inside falls faster. The
thermal gradient is the difference between the outside temperature and
the inside temperature divided by the distance between.
Pain occurs when the ice cream is bitten
and continues for a shorter time afterwards, outlasting the stimulus for
a few seconds because the dentine has been cooled and requires this
short time to return to its normal temperature. As the person continues
to eat ice cream the pain becomes less. This is because temperature of
the tooth gradually approaches that of the ice cream, so that the
thermal gradient decreases.
In a similar way pain may occur from
drinking hot liquids. This is even more likely if a person drinks hot
coffee soon after taking a cold dessert. The dentine becomes colder
than normal. Application of heat to the outer surface therefore produces
a larger temperature gradient through the tooth. The rapid swing in
temperature causes pain.
The simple solution of the problem is to
avoid such severe temperature changes. This would prevent the occurrence
of the shifts of thermal gradient and contribute toward maintaining the
health of the pulp, which harbours blood vessels and nerve fibrils.
*****************
A man goes shopping and sees a Thermos
flask. He asks a sales assistant what it does. “It keeps hot things hot
and cold things cold,” replies the assistant. He buys one and takes it
to work the next day. “Look at this,” he says to his workmate. “It’s a
Thermos flask. It keeps hot things hot and cold things cold”. “What have
you got in it?” asks his friend. “Two cups of coffee and a choc ice,”
comes the reply.
The best bet is to enjoy your ice-cream if
you have intact enamel. Allow about 15 to 30 minutes to elapse after
one has munched an ice-cream. Let the temperature come back to normal
before indulging in a drink that is scalding.
One could choose to have either hot or
cold item first. What is essential is the definitive time allowance
between two food items which are at extreme temperatures. It is for the
patient to choose and follow the instruction of his dentist and maintain
the intactness of enamel around the surfaces of his teeth.
Kgupta52@hotmail.com
SOURCE:
THE GUARDIAN
