Tooth Sensitivity

Ouch! Tooth sensitivity can cause mild to severe tooth pain with cold or hot foods and beverages, cold air, or sweets. In fact, one of the most common complaints we receive from our patients is tooth sensitivity. Although cavities are often the cause, they are not the most frequent and definitely not the only cause. 

The tooth itself has nerve endings just like any other part of your body. Although teeth are hard and strong, able to chew and tear the toughest foods for many years, they have a sensitive core that is full of nerve endings. Anything that disrupts or wears down the protective cover will expose the nerve endings and causes tooth sensitivity. Especially vulnerable is the root portion of the tooth, next to the gum. It has a thin mineral layer protecting thousands of tiny tubules leading to your tooth’s center where the nerve is. These tubules (or channels) allow sensation— for example, hot, cold or sweet food — to reach the nerve in the tooth. This can result in pain. If gums have receded, exposing more root surface and the thin protective layer is worn down, more tooth sensitivity will occur. 

Causes of tooth sensitivity
The outer shell of the tooth is a hard enamel layer. Under this is a slightly softer more porous dentin layer that covers the nerve core (pulp) of the tooth and contains the many fine tubules where nerve endings are located. These layers can be destroyed or weakened by the following resulting in more nerve endings being exposed and therefore more sensitivity or pain.

• Cavities

• Tooth fractures or cracks

• Tooth grinding or clenching 

• Aggressive brushing technique

• Acidic food or drink such as lemon, pop, vinegar

• Tooth whitening treatments, toothpaste or mouthwash 

• Acid reflux (GERD) or frequent vomiting 

• Some genetic disorders 

In general anything that causes mechanical wear or chemical erosion (acid attack) will cause tooth sensitivity. One of the most common causes of tooth sensitivity is aggressive brushing technique. Any toothbrush, manual, battery operated or electric has the potential to scrub too hard and damage teeth if pressing too hard. Aim for softer bristles when looking for a toothbrush either manual or electric and avoid pressing too hard when brushing.

Helpful suggestions to help prevent or reduce tooth sensitivity

• Careful brushing technique
  Using a soft-bristle toothbrush with gentle pressure. Most electric toothbrushes  have pressure sensors. If you brush too hard, they turn off. Try to avoid a scrubbing side to side motion with a harder bristle brush. 

• Wearing a nightguard
  If grinding or clenching is suspected to protect teeth from excessive wear. 

• Avoiding acidic foods or beverages
  Especially lemon or citrus in general, and carbonated drinks (pop, even mineral water). Sports drinks are also acidic in addition to containing high quantities of sugar. Do not brush teeth at least an hour after an acidic exposure. 

• Desensitizing toothpaste 
  Can sometimes help improve sensitivity. There are a variety of products available over-the-counter. 

• Fluoride or desensitizing varnishes can be applied by your dental professionals to reduce sensitivity. These can help strengthen the tooth surface and reduce pain. 

• Bonding/filling material can occasionally be used to cover worn down exposed tooth surfaces. 

• Surgical gum graft
  Can be done to replace lost gum tissue coverage on exposed roots and reduce sensitivity.

• Root canal 
  Is required if the nerve inside the tooth is permanently damaged or is infected. 

• Avoid whitening toothpaste or mouthwash, they are not very effective in whitening teeth, they only remove superficial stain and can be abrasive. Speak to your dental professionals about the use of whitening products for guidance on how to reduce sensitivity while using them.

• Regular dental visits.