Tooth pulp has a dense innervation and a rich vascular supply to maintain homeostasis and to preserve the integrity of the tissue. Function, trauma, and antigenic challenges make teeth and supporting tissues susceptible to tissue injury and inflammation, partially due to the lack of collateral blood and nerve supply and to their low compliance. This review focuses on dental nerve functions and adaptive changes in the pulpal nerve supply following inflammation and peripheral injury. Overviews of dental innervation and its development and of the peptidergic innervation of oral tissues are presented, followed by a discussion of peripheral and central changes after local insults to teeth and peripheral nerve injuries. The functional implications of these adaptive changes are considered.
Received 13 February 2009; accepted 3 September 2009.