How the salt solution may work to stop & cure toothache:
on causes of dental and gingival pain
I believe the warm salt water to work in the following manner: having a toothache to my knowledge means the nerve is being attacked by caries and/or other bacteria travelling into the nerve's environs via a "softened" tooth (which has lost its healthy natural hardness due to a lack of minerals in its crystalline latticework allowing bacteria to travel through the “gaps” towards deeper-lying tooth areas. In fact, tooth enamel when healthy is the hardest tissue in the human body!).
In other words, the pain is caused by bacterial infection settling and spreading in a weakened area. The salt water rinse (probably the stronger the brine the better) works in two ways: first via osmosis, pulling out molecules and offending bacteria from the gums surrounding the nerve (and possibly the weakened tooth itself), second by the salt both directly killing these problem-causing bacteria on contact, and them being flushed out by repeated rinsing.
To add other interesting perspectives on possible causes of tooth as well as gum pain proposing an additional explanation why salt water can be so effective in immediately relieving dental pain, here are some of the definitions offered by dentist “Paul Revere” (a pseudonym) in his 1970 “alternative dentistry” book “Dentistry and Its Victims” excerpted from the chapter discussing “Dental Pain and Its Control”:
“Though the pulp is the most common source of dental pain, it is not a nerve. (But when people say "the nerve", they mean the pulp.) A condition of slight irritation of the pulp is called pulpal hyperemia. A hyperemic pulp usually displays sensitivity to cold, and it may be sensitive to the pressure of biting or the action of food juices, especially sugary or acid juices. Hyperemia may be episodic; the symptoms often disappear entirely for long periods of time, returning for briefer episodes. I have had patients whose hyperemia returned twice a year, at the change of seasons, year after year. Most of us have known days when it was impossible to take something cold into our mouth... without experiencing dental pain.
Pulpal inflammation, or pulpitis, produces more acute pain than that which results from pulpal hyperemia. The inflammation may originate in any of several causes: trauma, as from a blow or dental drilling; irritation, because of decay and, possibly, a resulting invasion by bacteria; toxic effects of poorly insulated filling materials; or changes in temperature. Any tissue, including the pulp, tends to swell when it becomes inflamed. But unlike other tissues, which are usually free to expand, the pulp is confined in inflexible walls of dentin.
As the inflamed pulp swells, it builds up terrific pressures inside the tooth. It is these pressures which are the direct cause of the most severe dental pain. And it is here, of course, where the osmotic effect of salt water comes into play, exerting an immediate dehydrating pull on the area concerned, thereby decreasing its internal pressure. It seems clear to me, however, that more than a simple “milking” effect is involved since repeated salt water rinses [if followed up with a tooth-regenerating diet can initiate a long-term cure for the “decayed” tooth, likely as mentioned due to the thorough killing off of offending bacteria.
The gums may be a source of great pain, particularly if there is infection present. Pain in the gums results from infectious lesions, developing wisdom teeth, and irritations such as dentures sores. There are many other causes of mouth pain; the important thing to know is that it is invariably a warning of a real ailment that should be corrected. I have neer seen a cause of what I could honestly call psychosomatic dental pain. Although on occasion dental pain can be very difficult precisely to locate and correct, such pain is very real and rarely, if ever, psychosomatic in origin.”
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