Abstract
The term dental pain refers to dentinal pain associated with sensory activation of the dentine as a result of caries lesion or trauma and pulpal pain associated usually with inflammatory reaction of the pulp tissue. The mechanism of pain generation and transfer is complex and in interactions with the central mechanism of pain and sensation. This chapter focuses on the suspected mechanisms involved in dental pain.
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References
Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976–82.
Liu XX, Tenenbaum HC, Wilder RS, Quock R, Hewlett ER, Ren YF. Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners. BMC Oral Health. 2020;20(1):220.
Anderson DJ, Hannam AG, Mathews B. Sensory mechanisms in mammalian teeth and their supporting structures. Physiol Rev. 1970;50(2):171–95.
Brannstrom M. The elicitation of pain in human dentine and pulp by chemical stimuli. Arch Oral Biol. 1962;7:59–62.
Byers MR, Narhi MV. Dental injury models: experimental tools for understanding neuroinflammatory interactions and polymodal nociceptor functions. Crit Rev Oral Biol Med. 1999;10(1):4–39.
Olgart LM. The role of local factors in dentin and pulp in intradental pain mechanisms. J Dent Res. 1985;64:572–8.
Magloire H, Maurin JC, Couble ML, Shibukawa Y, Tsumura M, Thivichon-Prince B, et al. Topical review. Dental pain and odontoblasts: facts and hypotheses. J Orofac Pain. 2010;24(4):335–49. Epub 2011/01/05
Chung G, Jung SJ, Oh SB. Cellular and molecular mechanisms of dental nociception. J Dent Res. 2013;92(11):948–55. Epub 2013/08/21
Aminoshariae A, Kulild JC. Current concepts of dentinal hypersensitivity. J Endod. 2021;47(11):1696–702.
Byers MR, Kish SJ. Delineation of somatic nerve endings in rat teeth by radioautography of axon-transported protein. J Dent Res. 1976;55(3):419–25.
Byers MR, Neuhaus SJ, Gehrig JD. Dental sensory receptor structure in human teeth. Pain. 1982;13(3):221–35.
Okumura R, Shima K, Muramatsu T, Nakagawa K, Shimono M, Suzuki T, et al. The odontoblast as a sensory receptor cell? The expression of TRPV1 (VR-1) channels. Arch Histol Cytol. 2005;68(4):251–7.
Ushiyama J. Gap junctions between odontoblasts revealed by transjunctional flux of fluorescent tracers. Cell Tissue Res. 1989;258(3):611–6.
Matthews B, Sessle BJ. Peripheral mechanisms of orofacial pain. In: Lund JPLG, Dubner R, Sessle BJ, editors. Orofacial pain from basic science to clinical management. Chicago: Quintessence; 2000. p. 37–46.
Armstrong D, Dry RM, Keele CA, Markham JW. Observations on chemical excitants of cutaneous pain in man. J Physiol. 1953;120(3):326–51.
Anderson DJ, Naylor MN. Chemical excitants of pain in human dentine and dental pulp. Arch Oral Biol. 1962;7:413–5.
Brannstrom M. Dentin sensitivity and aspiration of odontoblasts. J Am Dent Assoc. 1963;66:366–70.
Narhi M, Jyvasjarvi E, Virtanen A, Huopaniemi T, Ngassapa D, Hirvonen T. Role of intradental A- and C-type nerve fibres in dental pain mechanisms. Proc Finn Dent Soc. 1992;88(suppl 1):507–16.
Lee K, Lee BM, Park CK, Kim YH, Chung G. Ion channels involved in tooth pain. Int J Mol Sci. 2019;20:2266. Epub 2019/05/11
Hossain MZ, Bakri MM, Yahya F, Ando H, Unno S, Kitagawa J. The role of transient receptor potential (TRP) channels in the transduction of dental pain. Int J Mol Sci. 2019;20(3):526.
Fried K, Sessle BJ, Devor M. The paradox of pain from tooth pulp: low-threshold "algoneurons"? Pain. 2011;152(12):2685–9.
Pigg M, Nixdorf DR, Law AS, Renton T, Sharav Y, Baad-Hansen L, et al. New international classification of orofacial pain: what is in it for endodontists? J Endod. 2021;47(3):345–57.
Byers MR, Narhi MVO. Nerve supply of the pulpodentin complex and response to injury. In: Hargreaves KM, Goodies HE, editors. Seltzer and Bender’s dental pulp. Chicago: Quintessence; 2002. p. 151–79.
Hargreaves KM, Seltzer S. Pharmacologic control of dental pain. In: Hargreaves KM, Goodies HE, editors. Seltzer and Bender’s dental pulp. Chicago: Quintessence; 2002. p. 205–25.
Goodis HE, Bowles WR, Hargreaves KM. Prostaglandin E2 enhances bradykinin-evoked iCGRP release in bovine dental pulp. J Dent Res. 2000;79(8):1604–7.
Lee PR, Lee JH, Park JM, Oh SB. Upregulation of toll-like receptor 2 in dental primary afferents following pulp injury. Exp Neurobiol. 2021;30(5):329–40.
Pietrobon D, Moskowitz MA. Pathophysiology of migraine. Annu Rev Physiol. 2013;75:365–91.
Rodd HD, Boissonade FM. Comparative immunohistochemical analysis of the peptidergic innervation of human primary and permanent tooth pulp. Arch Oral Biol. 2002;47(5):375–85.
Itoh K. The distribution of nerves in human deciduous and permanent teeth. Arch Histol Jpn. 1976;39(5):379–99.
Benoliel R, Elishoov H, Sharav Y. Orofacial pain with vascular-type features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84(5):506–12.
Penarrocha M, Bandres A, Penarrocha M, Bagan JV. Lower-half facial migraine: a report of 11 cases. J Oral Maxillofac Surg. 2004;62(12):1453–6.
Rodd HD, Boissonade FM. Substance P expression in human tooth pulp in relation to caries and pain experience. Eur J Oral Sci. 2000;108(6):467–74.
Hughes SR, Williams TJ, Brain SD. Evidence that endogenous nitric oxide modulates oedema formation induced by substance P. Eur J Pharmacol. 1990;191(3):481–4.
Lundy FT, Linden GJ. Neuropeptides and neurogenic mechanisms in oral and periodontal inflammation. Crit Rev Oral Biol Med. 2004;15(2):82–98.
Awawdeh LA, Lundy FT, Linden GJ, Shaw C, Kennedy JG, Lamey PJ. Quantitative analysis of substance P, neurokinin a and calcitonin gene-related peptide in gingival crevicular fluid associated with painful human teeth. Eur J Oral Sci. 2002;110(3):185–91.
Trowbridge H, Kim S. Pulp development structure and function. In: Cohen S, Burnse RC, editors. Pathways of the pulp. 7th ed. St Louis: CV Mosby; 1996.
Martinho FC, Chiesa WM, Leite FR, Cirelli JA, Gomes BP. Antigenicity of primary endodontic infection against macrophages by the levels of PGE(2) production. J Endod. 2011;37(5):602–7. Epub 20110305
Kokkas AB, Goulas A, Varsamidis K, Mirtsou V, Tziafas D. Irreversible but not reversible pulpitis is associated with up-regulation of tumour necrosis factor-alpha gene expression in human pulp. Int Endod J. 2007;40(3):198–203.
Bae YC, Yoshida A. Morphological foundations of pain processing in dental pulp. J Oral Sci. 2020;62(2):126–30.
Madison S, Whitsel EA, Suarez-Roca H, Maixner W. Sensitizing effects of leukotriene B4 on intradental primary afferents. Pain. 1992;49(1):99–104.
Sessle BJ, Bradley RM, Dubner R, Matthews B, Moller E. Dental neuroscience. New Dent. 1979;10(4):32–8.
McGrath PA, Gracely RH, Dubner R, Heft MW. Non-pain and pain sensations evoked by tooth pulp stimulation. Pain. 1983;15(4):377–88.
Brown AC, Beeler WJ, Kloka AC, Fields RW. Spatial summation of pre-pain and pain in human teeth. Pain. 1985;21(1):1–16.
Virtanen AS, Huopaniemi T, Narhi MV, Pertovaara A, Wallgren K. The effect of temporal parameters on subjective sensations evoked by electrical tooth stimulation. Pain. 1987;30(3):361–71.
Tal M, Sharav Y. Development of sensory and reflex responses to tooth-pulp stimulation in children. Arch Oral Biol. 1985;30(6):467–70.
Avery JK. Structural elements of the young normal human pulp. Oral Surg Oral Med Oral Pathol. 1971;32(1):113–25.
Hu JW, Sharav Y, Sessle BJ. Effects of one- or two-stage deafferentation of mandibular and maxillary tooth pulps on the functional properties of trigeminal brainstem neurons. Brain Res. 1990;516(2):271–9.
Chiang CY, Park SJ, Kwan CL, Hu JW, Sessle BJ. NMDA receptor mechanisms contribute to neuroplasticity induced in caudalis nociceptive neurons by tooth pulp stimulation. J Neurophysiol. 1998;80(5):2621–31.
Chattipakorn SC, Sigurdsson A, Light AR, Narhi M, Maixner W. Trigeminal c-Fos expression and behavioral responses to pulpal inflammation in ferrets. Pain. 2002;99(1–2):61–9.
Sessle BJ. Peripheral and central mechanisms of orofacial pain and their clinical correlates. Minerva Anestesiol. 2005;71(4):117–36.
Kobayashi M, Nakaya Y. Anatomical aspects of corticotrigeminal projections to the medullary dorsal horn. J Oral Sci. 2020;62(2):144–6.
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Haviv, Y., Leibovitz, S., Sharav, Y. (2023). Dental Pain, Mechanism of Action. In: Fuks, A.B., Moskovitz, M., Tickotsky, N. (eds) Contemporary Endodontics for Children and Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-031-23980-9_3
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DOI: https://doi.org/10.1007/978-3-031-23980-9_3
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