Why It’s So Hard to Tell Which Tooth Has the Ache
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By Laura Sanders, Science News
- April 16, 2010 |
- 6:27 pm |
- Categories: Brains and Behavior
When it comes to a toothache, the brain doesn’t discriminate. A new imaging study shows that to the brain, a painful upper tooth feels a lot like a painful lower tooth. The results, which will be published in the journal Pain, help explain why patients are notoriously bad at pinpointing a toothache.
For the most part, humans are exquisitely tuned to pain. The brain can immediately distinguish between a splinter in the index finger and a paper cut on the thumb, even though the digits are next-door neighbors. But in the mouth this can be more difficult, depending where and how intense the ache is.
“We don’t know much about tooth pain,” comments dentist and neuroscientist Alexandre DaSilva of the University of Michigan in Ann Arbor, who was not part of the new research. The new study is one of the first to address the puzzle of toothache localization, he says.
In the study, researchers led by Clemens Forster of the University of Erlangen-Nuremberg in Germany analyzed brain activity in healthy — and brave — volunteers as they experienced tooth pain. The researchers delivered short electrical pulses to either the upper left canine tooth (the pointy one) or the lower left canine tooth in the subjects. These bursts of electrical stimulation produced a painful sensation similar to that felt when biting into an ice cube, Forster says, and were tuned such that the subject always rated the pain to be about 60 percent, with 100 percent being the worst pain imaginable.
To see how the brain responds to pain emanating from different teeth, the researchers used fMRI to monitor changes in activity when the upper tooth or the lower tooth was zapped. “At the beginning, we expected a good difference, but that was not the case,” Forster says.
Many brain regions responded to top and bottom tooth pain — carried by signals from two distinct branches of a fiber called the trigeminal nerve — in the same way. The V2 branch carries pain signals from the upper jaw, and the V3 branch carries pain signals from the lower jaw.
In particular, the researchers found that regions in the cerebral cortex, including the somatosensory cortex, the insular cortex and the cingulate cortex, all behaved similarly for both toothaches. These brain regions are known to play important roles in the pain projection system, yet none showed major differences between the two toothaches. “The activation was more or less the same,” Forster says, although he adds that their experiments might have missed subtle differences that could account for why some tooth pain can be localized.
Because the same regions were active in both toothaches, the brain — and the person — couldn’t tell where the pain was coming from. “Dentists should be aware that patients aren’t always able to locate the pain,” Forster says. “There are physiological and anatomical reasons for that.”
DaSilva agrees that the brain’s inability to tell top-tooth pain from bottom-tooth pain “pairs really well with what we see in the clinic.”
Understanding the pathway from tooth to brain may help researchers devise better treatments for acute tooth pain, such as cavities or infections, and more-chronic conditions, DaSilva says. One such condition is phantom pain that persists in the mouth after a tooth has been removed.
Image: assbach/flickr
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Wow, I hope the participants in this study were well compensated, I can’t imagine too many things I would enjoy less than having my teeth zapped.
I’ve been pretty lucky with my teeth, never had an major problems and never been in any real pain, but I can damn sure tell the difference between my upper and lower teeth hurting, does that make me super human? Or just like everyone else not involved in this study?
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@tony, you’ve never had major tooth pain, yet you can tell where the pain is coming from?
Forster is merely restating what is obvious to any practicing dentist.
OMG there is nothing worse than a tooth ache. Oweee.
JImbo
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Those who don’t ‘go’ to their dentist, “run”! to their dentist
OMG hiçbir şey bir diş ağrısı daha kötüdür. Oweee.
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Jimbo…
srsly… do something about the spam in the comments. Every article on Wired seems to have spam comments!
The reason you can’t tell which tooth is bothering you most is because dentist are Gold Diggers first. That means they like to choose their patients like they do their stocks, picking a core of blue chip stocks first. There is a chemical dentist can use to cause the root to stand out simply by dabbing it on the tooth itself to make it stand out. It takes 10 seconds, but dentist never use it. The other thing is I use Advair for my asthma and on chilli days like today after a heavy month of Advair usage my roots ring out like notes being played on a piano, and then there’s Psoriasis and Psoriasis arthritis thanks to your friendly neighborhood dentist who’s family runs a car import facilty and who forgot to mention not to breathe near the exhaust pipe.
I’m getting a little tired of this! I didn’t know you were going to give me electric shocks! I’ll tell you what the effect is. It’s pissing me off!
I’m terrified at what dentist are doing to me. I demand it to stop now! I’m afraid I’ll grab one by the ballz and squeese until I can’t feel anything I’m so angry with them. I don’t like being lied to and told it’s for your own good, or trust me, or a bright idea, especially when no one can tell if I’ll die before I get old. I can’t find a dentist who isn’t playing around with the idea of torturing me, and it’s making me over eat and down right miserable. Dentist know better than to do what they’re doing, and one dentist recently lied about identifying a cavity under a cap (which they can’t do)and then planed the tooth so low I had nerve damage. To top it off the crown seperated and all they want to do is keep toying with the tooth until it’s pulled or the root is removed. All I want to do is squeese their balls so hard none of them will have kids to grow up to be like them. I hate the back stabbing going on and I can’t sleep and I’m over eating, and they haven’t said a word except to say they’re broke. I have a wife a kid to worry about and I’m now wondering if they’re making plans for them as well. I’m not buying into this crazy crap dentist are pulling on me, they aren’t doing me any favors, and I don’t like being hurt and pushed around.
I got a thumb nail and a fat toe nail coming unplugged because of Advair. Steroids really do stink. Society is disappointing, on the one hand civilian employers are saying we don’t have to tell you anything about work related hazards. On the other side which I’ve been membered to is the military and civilains are saying why didn’t you warn everyone about a pending attack? The military is saying you worry about your people and we’ll worry about our own. And if the military knew atomic bombs were to be set off in a dozen cities they still wouldn’t tell you because you aren’t military. I don’t want to hear anymore tears out of anyone as your world vaporizes before your eyes, it’s just the way we are, and neither side is right.
I went 5 years without any Advair and have a stock pyle of it. Sitting at the pc relieves alot of those constricting asthma attacks as I can get wrapped up in a game to over come my asthma. You can’t drive or watch tv and get the same results, and of course the internet is now more primary to our well being than transportation, tv and radio. The government should be behind maintaining our internet like it does our roads. I’m sure many people who are diseased and injured finding the internet to be more helpful than the medication. Advair isn’t making any money off me inspite of the fact that a tire store and home redecorating store employees put chemicals in my lawn mower to make my asthma worse. If I should lose a hundred pounds I could bury the proverbial hatchet for another decade by not needing my Advair. I just have to take it oneday at a time. I hear stuff lik I hope I die before I get old but remember that being online makes one feel young again.
My son is going to school online and is two elective classes shy of getting his BS in computer science, and he’s acing computer techology classes which will be over in a year. The point is he does less than I do, all he does is sleep and eat infront of his pc like a junior Tesla. If those guys can stand being online 24/7 so can I. Most of the time my teeth are normal, but I get various body achs from my kidneys to shoulders. Teeth roots I can stand I think even when they’re inflamed and I was stupid telling my doctor I had problems which led to 3 root canals because it wasn’t the throbbing kind of pain, just noticeable is all. It could of been just a decaying tooth, I don’t think anyone looked, they just acted on what I told them. Well as soon as I stop going to the bathroom so much I’m out to change my car oil.
@woodyeagle - classic.
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