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Review
. 2017 Dec 15:10:2845-2851.
doi: 10.2147/JPR.S142539. eCollection 2017.

Dental pain induced by an ambient thermal differential: pathophysiological hypothesis

Anaïs Le Fur-Bonnabesse  1   2 , Céline Bodéré  1   2   3 , Cyrielle Hélou  2 , Valérie Chevalier  2   4 , Jean-Paul Goulet  5
Affiliations
Review

Dental pain induced by an ambient thermal differential: pathophysiological hypothesis

Anaïs Le Fur-Bonnabesse et al. J Pain Res. .

Abstract

Dental pain triggered by temperature differential is a misrecognized condition and a form of dental allodynia. Dental allodynia is characterized by recurrent episodes of diffuse, dull and throbbing tooth pain that develops when returning to an indoor room temperature after being exposed for a long period to cold weather. The pain episode may last up to few hours before subsiding. Effective treatment is to properly shield the pulpal tissue of the offending tooth by increasing the protective layer of the dentin/enamel complex. This review underscores the difference in dentin hypersensitivity and offers a mechanistic hypothesis based on the following processes. Repeated exposure to significant positive temperature gradients (from cold to warm) generates phenotypic changes of dental primary afferents on selected teeth with subsequent development of a "low-grade" neurogenic inflammation. As a result, nociceptive C-fibers become sensitized and responsive to innocuous temperature gradients because the activation threshold of specific TRP ion channels is lowered and central sensitization takes place. Comprehensive overviews that cover dental innervation and sensory modalities, thermodynamics of tooth structure, mechanisms of dental nociception and the thermal pain are also provided.

Keywords: atypical tooth sensitivity; dental pain; dentin hypersensitivity; pain; thermal allodynia.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Hypothesis of possible mechanisms underlying dental thermal differential allodynia. Abbreviations: DH, dentin hypersensitivity; NGF, nerve growth factor.
See this image and copyright information in PMC

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