How new research could help patients with persistent dental pain

By Dr Jamie Coulter, Clinical Lecturer at Newcastle University School of Dental Sciences


Dental decay is the most common non-transmissible disease worldwide and frequently results in an acutely painful condition commonly known as toothache. At this stage many patients seek care at a dentist resulting in either an extraction or root canal of the tooth. For many, this is where the story ends, but in an estimated 1.6% of cases the pain persists despite the tooth or nerve having been removed and, in some cases, this can persist long-term.


Whilst, this may seem like a small percentage, official figures estimate that three million root canals and extractions were performed in England on the NHS in 2022 to 2023, a figure which does not account for any treatment completed privately. Despite the widespread nature of these treatments our understanding of the processes behind the transition to persistent dental pain are poor with no preventative treatments available and only one third of patients with persistent dental pain showing an improvement over a seven-year period with the current gold standard treatments.


At Newcastle University School of Dental Sciences, we are committed to researching and improving treatments for facial pain in all forms and my own area of interest is in persistent dental pain. I have recently completed a PhD fellowship funded by the Newcastle Biomedical Research Centre which focused upon investigating novel pain pathways within dental pain. This utilised the close collaborative links between the School of Dental Sciences and Newcastle Dental Hospital which form part of Newcastle Health Innovation Partners. This partnership facilitated access to key clinical samples in conjunction with the advanced analytic techniques available at Newcastle University.


This research led to the identification of a strong association between toothache and a pathway not previously investigated within dental pain but associated with persistent neurological conditions. Such translational work has increased our understanding of toothache and the potential transmission to persistent dental pain but has also guided ongoing early-stage research testing novel therapeutics targeting this pathway to prevent or reduce the symptoms of persistent pain.


This will take time to determine the safest and most effective medication to address persistent dental pain, but in a condition with few effective options Newcastle School of Dental Sciences is uniquely placed to develop and trial such therapeutics as they become available due to our strong collaborative links.

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