We think that
our works will cause widespread interest to both experts and non-experts in this
field. This is because numerous people suffer from tooth thermal pain in daily
life and dentistry. However, we know little about the mechanism why cold
stimulation evokes sharper and more shooting pain sensations in human teeth than
hot stimulation. Although thermal pain sensation has been attributed to the
activation of thermo-sensitive nociceptors (e.g., for skin
tissue), it may not be exactly the case when tooth pain evoked by thermal
stimulation is considered. It has been experimentally established that hot
stimulation causes an inward flow (toward tooth pulp chamber) of dentinal fluid
in dentinal microtubules whereas cold stimulation causes a reverse flow, and
that intradental nociceptors (within dentinal microtubules) are not “equally
sensitive” to mechanical activation (shear stress) by inward and outward
dentinal fluid flows. To explain theoretically such different responses in
intradental nociceptors, we proposed in this study the models that combine a
computational fluid dynamics (CFD) model, which describes the fluid mechanics in
dentinal microtubules, with a modified Hodgkin-Huxley (H-H) model, which
describes the discharge behavior of intradental neurons. The simulation results
agreed well with existing experimental measurements. The proposed models were
further employed to provide mechanistic insights into the long-standing
questions regarding the phenomenon that cold stimulation causes more rapid
transient pain sensations than hot stimulation. The models developed here could
enable better diagnosis in endodontics which requires an understanding of pulpal
histology, neurology and physiology, as well as their dynamic response to
thermal stimulations used in dental practices.