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"Toothache?" I asked, not too gently. "You deserve it. A woman of your age, who would rather go around with an exposed nerve in her head than have the tooth pulled! It would be over in a moment."
The above is from 'Circular Staircase' by Mary Roberts Reinhart. (1908)
The expression itself is not an idiom or slang, and I can't simply understand the meaning of this sentence at all.
When a tooth is badly broken, sometimes there is little no dentine left to cover the nerve inside the tooth, and it becomes very sensitive to temperature or to pain. That is what the speaker is referring to.
