London - We all know that you can sprain an ankle or strain your back, but did you know you can sprain a tooth as well?
Like the ligaments that connect bones in the body, the periodontal ligaments that hold teeth in place are prone to strains or sprains.
If you suffer a sharp knock to your teeth or bite on something hard, you can damage these ligaments and get a “sprained tooth” — which can be very painful.
The tiny ligaments surrounding the teeth are buried under the gum and are visible only under a microscope, says Professor Damien Walmsley, scientific adviser to the British Dental Association.
“The ligaments attach on to the tooth and bone — they are like little ropes forming a sling to hold the tooth in place,” says Professor Walmsley.
Their primary purpose is to allow the tooth to have some give.
Dr Margaret Kellett, director of the Leeds Dental Institute, says: “If they were not there, when you exerted force and bit down there would be no way for the tooth to move. The force when you bite down goes against the opposing tooth and, without flexibility, it would squash the surrounding blood vessels in and around the root of the tooth. The tooth would then lose its blood supply and die.”
Flexibility also prevents teeth from chipping, a problem people sometimes have with implants —replacement teeth that are firmly screwed into the jaw bone, and which are not flexible because there are no ligaments.
During pregnancy, every ligament in the body loosens — including the periodontal ligaments, says Dr Kellett. This is why expectant mothers may find their teeth become more wobbly than usual.
When someone loses a tooth during an accident, it is because the ligaments have torn. But most tooth sprains occur because people grind their teeth in the night.
“Lots of people clench and grind their teeth when they are asleep and this can cause tooth pain because of tooth sprain,” says Dr Kellett.
“During the day your teeth have at most 15 minutes of contact, but at night if you do grind your teeth that can be more like three or four hours of contact. On top of that you use around three or four times more force as you bite down when you’re asleep than you do during the day because the natural feedback mechanism that moderates the bite when you are awake does not work when you are asleep. This strong force can cause damage to the ligament fibres.
“The ligament can accommodate this extra force for only so long before it starts to become stretched and strained.
“It becomes thicker and more fibrous and irritates the nerve inside the tooth, which leads to pain.”
Other causes of tooth sprain include biting into something unusually hard, such as a seed or unexploded popcorn, or getting a new filling or a crown that sits too high, as this can put extra strain on the ligaments.
It can be hard to tell the difference between toothache caused by tooth decay and a tooth sprain.
“With tooth sprain, the pain tends to be very specific to one tooth,” says dentist Dr Richard Guyver, who works for the Envisage Dental Surgery in Emsworth, Hampshire.
“With tooth decay the pain is caused by the nerve inside the tooth dying and as it goes through this process it becomes overactive.
“However, the nerve inside the tooth is not very good at causing specific pain — often people are unsure exactly which tooth hurts.
“However the nerves around the ligament are much better at being specific.”
A dentist normally tells the difference by taking an X-ray and ruling out other causes, such as an infection, says Dr Kellett.
The good news is that normally the ligament will heal itself within a matter of weeks. “If an adult tooth is knocked out completely it should be put back in the gap in the mouth as quickly as possible. The ligaments are good at healing back around it and so can seal the tooth back into place,” says Dr Guyver.
If you suspect tooth strain, try swapping to a diet of soft food for a while to ease the strain.
A dentist can also analyse your bite and see if excess load is being put on one area. Sometimes fillings or crowns need to be trimmed to rectify the issue. Wearing a mouthguard can also help if night grinding is the problem. - Daily Mail