Why is dental pain so excruciating?

Why, both from a physiological & evolutionary point of view?

What is it about the ‘design’ of your teeth that make them some incredibly sensitive and give them the potential for such strong pain?

And is there any evolutionary reason for it? Obviously your teeth are vital to your survival, but until about 150 years or so ago it was rare for a person to significantly outlive them anyway.

WAG - maybe the pain is because there is such a high concentration of nerves in your gums just below your teeth, and maybe the adaptive advantage of that is to prevent us from eating anything too hot or too cold? i.e. we’d feel the pain before swallowing whatever it is, and decide not to.

Total guess here:

Evolutionary reasoning: Teeth were probably used as a weapon back in pre-tool times. Anyone who had faulty teeth and couldn’t hunt (post 25 years old back then) was a detriment to the tribe and therefore probably couldn’t eat as much food.

Maybe it kept the ones who couldn’t hunt from eating as much of the take.

And how would natural selection select against this person’s ability to survive? Evolution works at the individual (or gene) level, not species.

umm exactly how could people use teeth for weapons? You like bite a buffalo to death?

I could just see a neanderthal chasing a wildebeast with his mouth wide open :0 at that range wouldnt it be more prudent to whack an animal or somthing?

also, dental pain isnt THAT bad. PICC line insertion, now THAT smarts

=PK

Damaged skin grows back, but damaged teeth do not. How do you inform a young animal that some minor skin damage is OK, but it must be very careful not to damage it’s teeth? Use pain signalling.

Or from an evolutionary standpoint, the animals with overly sensitive teeth, the ones who didn’t go around biting rocks out of curiousity, those individuals tended to leave many more sensitive-toothed progeny behind.

As for humans and teeth, maybe the “tooth programming” happened long before we descended from trees. Or maybe it’s aimed more at the curious young who tend to try eating any small objects in the environment.

Maybe that varies by individual. After hurting himself once, my son asked me what the most painful things were that had ever happened to me. Every single one I could think of was in the dental chair, so I chose to say that I didn’t know, not wanting to make him frightened of the dentist.

yes amarone but have you had a PICC insertion w/out flouroscopy or pain meds? apparently the hospital was trying to cut back costs so i got no pain meds and the infusion team was doing it blind. it got stuck on a valve in my vein and they kept trying to force it through but it didnt go i had to go in a second time to get it done the right way (and this time i asked for the pain meds!)

=PK

As I have no idea what a PICC insertion is, the answer would have to be no.

I’m sure my position is complicated by the fact that standard painkillers seem remarkably ineffective on me. I never bother with OTC painkillers as I’ve never noticed any effect whatsoever.

Once as a student I made the mistake of going to a teaching dental hospital to save money. After 7 injections of local anesthetic, I had to report that no, my cheek still did not feel numb. So they injected the next one directly into the inside of my cheek. That hurt. Surely the idea is that your jaw should be so numbed that you feel it in your cheek? Anyway, they then proceeded to “treat” me. Boy, was that painful.

Some years later (the next time I plucked up courage to venture back to a dentist, actually), the dentist said he couldn’t give me any more local as I might overdose. He started drilling. I leaped off the chair, breaking his drill-bit in the process, leaving half sticking out of my tooth. He decided to give me another shot.

So does that help explain a little why my experiences are of somewhat painful events?

As I said, just a guess. Gene mutations work at an individual level, true. The process of evolution, however, works at the species level in that it causes the individuals who’s genes are ill equipped to survive to drop out of the gene pool. Individuals die, the species as a whole lives on and is better able to survive in its environment.

While that is true, it would not explain why dental pain is so extreme. If there are genes that cause this pain, they would only survive if the presence of these genes has an overall selective benefit - there has to be a plus side to the equation. Just giving selective disadvantage to the carriers does not have a beneficial effect. Weakening part of the species, and then kiling off that part of the species does not benefit the species as a whole unless there is an additional benefit conferred by those genes.

As an example, if their are genes that cause a heightened awareness of pain throughout the body, that may have an overall selective benefit - it could alert the carrier to danger to their body, allowing them to protect themselves. The downside would be that in areas with many nerves, such as the teeth, the pain becomes severe. But if the overall effect is a better rate of survival in danger situations versus a worse toothache, then the gene will survive.

However, the above example does not address why people have evolved to have greater levels of nerves in the teeth in the first place.

Minor Hijack. What I always wondered was why it never really hurt when your tooth got knocked out. It’s almost as if your body says in that picosecond, “Well there’s nothing we can do for this one boys, turn off the pain receptors.”

During my latest dental cleaning, the first in three or four years, five cavities were discovered. Normally, when I have a cavity drilled and filled, I don’t bother getting any novocain. I didn’t for the first two fillings, but on my second visit, the dentist stuck the needle in my mouth without asking. This was the only time I had it, and I found that it didn’t help very much and I hated having a numb mouth for the next four hours. For the third visit, when the fourth and fifth fillings were made, I told my dentist not to give me the novocaine. There was pain during the drilling and when the compressed air is shot into the cavity, but it’s not unbearable.

All of the other members of my family always refuse the novocaine also, so maybe tooth-pain-sensitivity is inherited.