Preventing & Treating Tooth Sensitivity
Tooth sensitivity is a condition experienced by millions of Americans. For some, it is a temporary symptom of a problem easily diagnosed and treated. For others, sensitive teeth are a more chronic issue with a less obvious cause.
In this article, we will explore the various causes of tooth sensitivity and the different ways you and your dentist can treat the source.
What Causes Tooth Sensitivity?
We can best explain the causes of tooth sensitivity by discussing two broad categories. In a healthy mouth, teeth will not be sensitive to normal eating and drinking, which includes hot and cold temperatures as well as sweets. The natural design of teeth provides insulation and protection from potential hazards like temperature extremes. A layer of enamel insulates the entire exposed portion of a tooth. Bone and gum tissues protect the root surface.
The sensation of sensitivity comes from the nerve inside the hollow center of the tooth. The two overarching causes of tooth sensitivity involve abnormalities of these important anatomical structures.
Loss of Insulation
When healthy, the nerve within the hollow center of each tooth should not be able to “feel” sensations of cold, hot, sweets, etc…. However, when the healthy insulating structures are lost for any reason, the nerve can begin to feel sensations that it normally would not. Anything that weakens, cracks, or removes the enamel that insulates the nerve of the tooth can make that tooth sensitive. Also, anything leading to gum recession can make a tooth sensitive by exposing the root of the tooth. Here are a few things that can cause a loss of insulation.
• Decay - A cavity is a bacterial infection of the hard structures of a tooth. As bacteria infiltrates the tooth, they destroy enamel by softening it. Weakened, softened enamel does not insulate the nerve as well as it should.
• Cracked Teeth - Enamel is the hardest substance in the human body, but it can crack under heavy forces. A crack in the enamel allows sensations to reach the nerve that normally would not. In fact, isolated and consistent tooth sensitivity is a common symptom of a cracked tooth.
• Acid Erosion - Strong acids can cause a gradual thinning and loss of enamel through the process of chemical erosion. Significant erosion results from habits involving the exposure of enamel to extremely low pH, such as sucking on lemons and limes or medical conditions like severe acid reflux.
• Teeth Clenching and/or Grinding - Heavy clenching or grinding forces can slowly wear down enamel on the biting surfaces of the teeth. As the enamel becomes thinner, it provides less insulation for the nerve. Clenching and grinding also causes recession of the gums and bone around the teeth which provide insulation to the roots. Once roots are exposed by recession, sensitivity can occur.
• Improper Tooth Brushing Technique - Using a hard-bristled toothbrush or toothpaste that is very abrasive can slowly remove enamel or gum tissues through the mechanical process of abrasion. Many people think they are cleaning their teeth better and removing more stains by using abrasive products, but in fact, they are simply removing enamel and the supporting tooth structures. We recommend always brushing with a soft-bristled toothbrush.
Hyper-reactivity of Nerve
It is possible to have healthy enamel and surrounding tissues while still experiencing sensitive teeth. If this is the case, tooth sensitivity likely results from a hypersensitive nerve. The nerves within each tooth can become inflamed, causing them to “overreact” to normal stimuli, such as hot and cold temperatures.
Hypersensitivity of a nerve can be short-lived or chronic in nature. A wide variety of issues can lead to an inflamed nerve. Here are just a few of them.
• Injury/ trauma - If a tooth or teeth undergo trauma, the nerves inside often respond with inflammation. This can happen in instances of serious injury to a tooth or the long-term minor damage that accumulates from habits like clenching or grinding or previous sports injury.
• Dental treatment - Dental treatments are necessary to keep your mouth healthy. However, the act of the treatment itself can cause stress and strain, leading to temporary inflammation of the nerve. It is very common for teeth to be sensitive for a few days following reparative dental treatments.
• Teeth whitening treatments - The chemicals used in teeth whitening are wonderful for breaking down dark pigments in the teeth. Unfortunately, they also irritate the nerves. Temporary teeth sensitivity is a very common side effect of teeth whitening that should go away after you complete your whitening treatment.
• Inflammation in the maxillary sinus cavities - Some people experience tooth sensitivity in their upper molars and premolars during certain seasons. The underlying cause can be inflammation in the sinus cavity, which increases pressure on the nerves of the teeth. Sinus-referred sensitivity is also temporary and should improve as soon as the inflammation in the sinus cavities resolves.
What are the Symptoms of Sensitive Teeth?
The most common symptom of sensitive teeth is discomfort when exposing the teeth to cold temperatures. Some people feel a sharp zinging-type pain, while others notice a dull ache. The response is usually short, with the sensation going away after removing the cold temperature from the mouth.
Less commonly, people experience the same type of discomfort when exposing the teeth to hot temperatures. Some also experience sensitivity to sugary foods and beverages. For those with exposed roots, brushing and flossing can be uncomfortable.
Tooth sensitivity is often isolated to a specific tooth or area in the mouth, depending on the underlying cause. However, when all teeth feel sensitive to the same stimuli, a patient may have a more broad cause, such as heavy clenching or grinding during sleep.
How Can I Minimize My Tooth Sensitivity at Home?
Some people minimize the symptoms of tooth sensitivity by avoiding the things that cause discomfort. You can also use over-the-counter toothpastes with anti-sensitivity ingredients to help strengthen the enamel and calm down the nerves within the teeth. Anyone with sensitive teeth should avoid using whitening toothpastes, as these are abrasive and actually worsen tooth sensitivity over time. Ask your dentist if you may benefit from a prescription fluoride toothpaste to help with sensitivity.
It is important that you only use a soft-bristled toothbrush. Using a hard- or medium-bristled brush can actually worsen tooth sensitivity.
Many people have clenching or grinding habits that contribute to their tooth sensitivity, so commitment to wearing a professional nightguard is important to minimizing the symptoms of sensitivity.
Anyone with sensitive teeth should avoid acidic foods and beverages. Acid weakens and thins enamel, causing gradual loss of the tooth’s protective coating. Maintain a neutral pH in the mouth by drinking plenty of water and chewing sugar-free gum.
How is Tooth Sensitivity Treated?
Tooth sensitivity that persists after you try addressing it at home requires evaluation by your dentist. Your dentist can assess your unique situation to help discover the underlying cause of your tooth sensitivity. The first, and most important step is to undergo a thorough evaluation with dental x-rays and gum measurements to rule out any progressively worsening disease.
If disease is present, your dentist will recommend dental treatment to stop the progression and repair the damage. If disease is not present, your dentist will investigate to determine the specific cause of your sensitivity.
Treatment of tooth sensitivity with no dental disease present involves strengthening the teeth and reducing nerve inflammation. Your dentist can provide treatments such as desensitizing exposed roots with bonded root protection, filling material to cover exposed areas or broken tooth enamel, and fluoride varnish (enamel-strengthening) treatments, among others. You may also receive prescription oral hygiene products to use at home to fight sensitivity.
Tooth Sensitivity: Your Next Steps
Do you have sensitive teeth? Schedule a visit with your dentist for a comprehensive evaluation of your teeth and gums. Do not delay treatment hoping that the issue will resolve itself. We can help you address tooth sensitivity and make eating and drinking comfortable again!