The Interaction Between the Central Nervous System and Dental Tissues: Hypothetical Dental Interoception Inferred From Skeletal Interoception

BACKGROUND: The circuit of interoception, through which the nervous system monitors internal physiological states and maintains tissue homeostasis, has been well characterized in bone. However, whether a comparable interoceptive mechanism exists in the other mineralized tissue-teeth-remains unknown. OBJECTIVES: This review uses skeletal interoception as a comparative framework to examine whether analogous sensory-regulatory mechanisms may operate in dental tissues. We summarize the neuroanatomical basis of dental innervation, the peripheral cellular mechanisms by which the pulp-dentine complex and periodontal ligament-alveolar bone complex sense and transduce local tissue states, and the reciprocal neural and effector responses that may contribute to dental homeostasis. Based on current evidence, we propose 'dental interoception' as a hypothetical conceptual framework for understanding neural-cellular regulation in teeth and their supporting tissues. METHOD: The literature search was conducted in the PubMed and Web of Science databases, with a focus on how dental cells sense local tissue-state changes and communicate with the nervous system, as well as the direct regulation on odontogenesis-related cells by the nervous system. RESULTS: Current evidence suggests two potential modules of dental interoception: a pulp-dentine module that monitors intradental tissue states and supports pulp repair and reparative dentinogenesis, and a periodontal ligament-alveolar bone module that senses tooth load and regulates occlusal adaptation and alveolar bone remodelling. These modules involve pulpal cell-trigeminal nerve communication, reciprocal neural regulation of pulpal vascular, immune, stem-cell and reparative responses, and periodontal mechanoreceptor-guided remodelling. However, whether they form a complete peripheral-central-peripheral feedback loop remains unresolved. CONCLUSION: The bidirectional regulation between the nervous system and dental tissues is fundamental for maintaining dental homeostasis. Mapping the full circuitry underlying this interaction will be essential to establish dental interoception as a coherent physiological concept.