Toothache caused by "excessive internal heat" usually refers to periodontal abscess or acute exacerbation of periodontal disease, whereas pulpitis involves an irreversible inflammatory reaction within the dental pulp inside the root of the tooth, and these two conditions are very different. Toothache from "excessive internal heat" related to periodontal swelling and pain refers to inflammation of the gums around the tooth. Pulpitis, on the other hand, involves inflammation of the nerves inside the tooth; thus, their specific locations are different. Toothache caused by "excessive internal heat" typically gives a feeling of the tooth being loose, but pulpitis results in localized tooth pain, which is difficult to pinpoint and can sometimes extend to include facial and head areas, presenting as radiating pain.