Is the sipping of hot coffee or the eating of cold ice cream sometimes a painful experience for you? If your answer is YES, you may have a common problem called sensitive teeth.
Tooth sensitivity is tooth or teeth discomfort that is provoked by hot, cold, sweet, or acidic foods and drinks, or breathing in cold air. The pain can be sudden, sharp, and shoot deep into the nerve endings of your teeth.
There are two very different types of sensitivity:
Dentinal Sensitivity. This occurs when the middle layer (dentin) of a tooth is exposed to the outside. Dentin is usually covered by enamel above the gum line and by cementum (bone like connective tissue covering the root of a tooth) below the gum line. There are tiny openings called tubules in the dentin. Inside each tubule there is a nerve branch that comes from the tooth’s pulp (the nerve center of the tooth). When the dentin is exposed, these nerve branches can be affected by hot, cold, or certain foods. This causes tooth sensitivity.
When the outer protective layers of enamel or cementum wear away the dentin becomes exposed to the outside. This can affect one tooth or multiple teeth. Dentin exposure can be be caused in a variety of ways. These can include:
1. Aggressive brushing. The enamel layer can be worn away from brushing too hard.
2. Plaque build up. The presence of plaque on the root surfaces can cause sensitivity.
3. Tooth wear that occurs over time from chewing and brushing.
4. Untreated dental cavities.
5. Gingival recession. When the gums recede they expose the tooth’s roots. Receding gums often are caused by periodontal diseases or by aggressive brushing. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.
6. Periodontal surgery (gum surgery) that exposes the tooth’s roots.
7. Tooth whitening.
8. Frequently eating acidic foods or liquids.
Pulpal sensitivity. This is a reaction of the tooth’s pulp. The pulp consists of a mass of blood vessels and nerves in the center of each tooth. Sensitivity of the pulpal tissue tends to affect only one tooth. Causes of this type of sensitivity can include:
1. Dental cavities or infection.
2. Placement of a recent filling.
3. Excessive pressure from grinding or clenching your teeth.
4. A cracked or broken tooth.
If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release your bite is a sign of a cracked tooth.
You dentist will be able to diagnose the type of sensitivity you have. You want to rule out pulpal sensitivity as that requires more extensive treatment. If it is decided you have dentinal sensitivity then we will suggest a few options for you. The most conservative way is by use of a sensitivity toothpaste. I recommend Colgate Sensitive Pro-Relief which I believe to be the best on the market today. I have found it to be the most effective in eliminating or limiting the symptoms of tooth sensitivity. Other options include use of a fluoride varnish or a bonded desensitizing agent that we would apply in office. As well as use of an at home fluoride rinse.
In severe cases of hypersensitivity that is persistent and cannot be treated by other ways, your dentist may recommend endodontic (root canal therapy) treatment to eliminate the sensitive teeth issue.
If you or a loved one is experiencing either type of sensitivity, the best approach would be to schedule a dental appointment for further evaluation.