Abstract: Toothaches have received widespread attention and commentary dating back to ancient times, appearing in Egyptian texts from over 3000 years ago and the writings of Hippocrates, Aristotle, and Galen. Scientific studies of the innervation of dental pulp and dentin date back to at least the 1800’s, yet our understanding of the basis for tooth pain is still limited. Standard treatments for toothache continue to be drastic and irreversible, including removal of the dental pulp or extraction of the tooth. While the trigeminal sensory innervation of the tooth pulp is commonly the origin of toothache pain, it is also indispensable for normal function and physiology, and should be retained as an integral part of the repaired tooth. Repair or regeneration of the dental pulp and its innervation could represent the next step in restorative dentistry, but a better understanding of the roles of the tooth’s sensory nerve supply and the mechanisms underlying its development and repair is needed.