牙疼问题及回答

牙疼问题：

I am having pain with the back teeth at the roots. It has been going on for a while. When I brush my teeth, whever the water is a little colder or hotter,my back teeth hurt. I felt it was from gum edges.
I once had x-ray and was told that i have severe bone loss and should have root cleaning. I did it once only with the back teeth. I also use mouthwash for a while. However, my friend told me mouthwash is not good so I stopped and use salty water instead. Now my gums look pretty healthy and no bleeding at all when brushing teeth. However, I am afraid the root nerves were exposed and probably caused the frequent pain. The pain started after I did the root cleaning.
Does anyone have the same experience or know what is going on? Does it mean it is pretty serious and what should I do?
Thank you very much!

王大夫回答：

你的问题如果讲起来是很复杂的，因为没有作检查，我就得将很多方面讲出来，而不能有针对性了。

在牙科主要的两种病：一是牙体病，一是牙周病，顾名思义即一个是发生在牙体本身，另一个是发生在牙的周围组织。

1． 牙体病多由龋坏，牙体畸型，隐裂，外伤，各种牙体上的改变，而让牙髓受到物理化学刺激而发生炎症，典型的牙髓病征就是冷热刺激痛（即吃过冷过热食品时牙痛）

2． 牙周病多是由牙周组织在结石。细菌的作用下，牙周的软组织连接受到破坏，牙槽骨吸收，牙周袋形成，继而牙松动脱落，有时感染通过牙体上的微管进入牙髓，而引起牙髓炎，牙就会出现冷热刺激痛。

综合上述，不难看出你是牙周病引起的牙髓炎（如果你能准确说出痛的位置的话，因为牙髓炎的痛经常不能定位，痛起来是一侧，所以不排出其它牙的问题上，须经医生用特殊仪器检查后才能真正确定），漱口水，清洁只能保持平时的清洁并不能起到治疗效果。就象你吃维生素还是要生病的原理一样。有牙周病的人千万不要错过每年两次的清牙。

现在你需要看医生，确定是这个牙的话，牙不松动且有保留价值的话，要根据情况先作 ROOT CANAL, 再作根部清洁，说不定还要上冠加固。不马上看医生，可能很快会痛得不可忍受，并诱发根部炎症，面部肿痛。

我不知道我的回答让你了解你的情况没有，有问题我们再聊。