What causes an intensely painful and persistent toothache? And what is the remedy?

The chief enemy of teeth is decay. Despite the fact that the outer two layers of a tooth, enamel and dentin, are the strongest materials in the body, they are composed of mineral crystals embedded in a protein mesh. Enamel is solid, whereas dentin has a porous body structure. Tiny canals run from the enamel through the dentin and to the pulp chamber, the inner part of the tooth that houses connective tissue, blood vessels and nerves that are sensitive to heat, cold and pressure.

The canals hold extensions of the pulp that respond to heat, cold, pressure and sweets. They can also convey cavity-causing bacteria. The bacteria ferment sugars and starches and in doing so make acid. The more sugar and starch we eat the more numerous the bacteria become and the more acid they make. This acid eats through the enamel of the tooth. A crack is made in the enamel and the bacteria find the door open into the fortress of the tooth. They get into the enamel, reach the pulpy dentin and begin to dig into that. A severe tooth-ache may begin if they inflame the pulp, triggering the body to counter with infection-fighting blood cells. The blood vessels in the pulp then dilate to accommodate the extra blood and the pulse drives yet more blood into them, in turn compressing the inflamed pulp, squeezing the nerve fibers and causing pain. The root cause, of course, is the lack of dental care.

The basis of dental hygiene is healthy food. Anyone who munches cakes and sweets all day can never have strong teeth. Neither can anyone who either freezes his or her teeth by eating ice-cream and iced drinks or who heats them by drinking very hot soup or tea. Sudden rises and drops in temperature are harmful to teeth. It’s also necessary to wash away the bits of food left between the teeth, so they do not start fermenting and making acid.

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