Imagine taking a sip of ice-cold water, only to be met with a jolt of pain radiating through your teeth. Or wincing as the cool night air hits your molars on a brisk walk. If your teeth are sensitive, you likely deal with issues like these daily. Sensitive teeth, unfortunately, are far from uncommon. As dentists, we see it often enough to know the frustration it can cause, often leading people to neglect proper dental hygiene out of fear of discomfort. But it doesn’t have to be that way!
So, let’s crack the code on sensitive teeth so you can develop effective strategies to keep your smile sparkling without the pain of sensitivity.
What are the primary causes of sensitive teeth?
Sensitive teeth generally fall under two causes:
1. Loss of bone and tissue around a tooth - once this occurs, the roots of your teeth, which are usually covered by bone and tissue, are now exposed to acids, sugars and dramatic temperature swings. Your tooth roots don't like this! So they complain.
2. Damage to the tooth or nerve - this leads to increasing inflammation and increasing complaints from your nerve to your brain.
Fortunately, there are solutions to these problems! Lets explore some of the more common causes and how a dental team can help you get back to a comfortable smile!
Sensitivity caused by tooth root exposure
First, let’s talk about what causes root sensitivity in the first place. Beneath the hard enamel layer protecting your teeth lies a softer tissue called dentin. When your enamel wears down or tissues recede and expose the dentin on your root, microscopic channels called tubules open up. These tubules lead directly to the tooth’s nerve, making it vulnerable to temperature changes, acids, and even sweets. That sharp twinge you feel? It’s your nerve protesting.
Studies show that approximately 60% of adults have at least one area of root sensitivity by the time they reach mid-30's. So this is a very common issue.
The roots of your teeth are much less dense then the armored (enamel) part of your tooth and sensitivity can dramatically increase based on any of the following:
1. High acidity environment -
Many of the fruits or processed foods we enjoy have high levels of acidity. If these acids are not cleaned off our teeth after a meal, then they start to thin the root covering. This leads to increasing levels of sensitivity.
2. Clenching and grinding -
The teeth can actually bend slightly under tremendous pressure. This will eventually lead to small pieces breaking out of the root surface near the gumline (called abfraction). A night guard fabricated by your dentist can help minimize the destructive power of clenching and grinding.
3. Hard toothbrush bristles -
Hard and medium toothbrush bristles abrade the tooth and gum tissue. This gradual abrasion can wear away a tremendous amount of root surface over time, and cause tissue loss that exposes more vulnerable root surfaces. ALWAYS use a soft bristled toothbrush with slow gentle circles aimed at the gumline as you clean your teeth!
4. Bleaching with the wrong products
Low quality bleaching products have strong bleach and no desensitizers. This can dramatically increase your sensitivity for a period of time.
"Bleaching" toothpastes frequently have very high levels of grit in the toothpaste. This does remove some staining on the enamel surface, but it also abrades the softer root surfaces and can dramatically increase root sensitivity.
Talk with your dentist about bleaching products that can help you attain a bright smile without harming the root surfaces of your teeth
Steps to decreasing root sensitivity
1. Minimize all the scenarios we just discussed that increase root sensitivity.
2. Fluoride prescription toothpaste - this hardens the surfaces of your teeth and over time closes off the microtubule openings that lead to sensitivity. This is a gradual process that takes months of consistent use
3. Sensidyne - over-the-counter toothpaste that contains potassium nitrate, a chemical that numbs the nerve for short periods of time. Using this toothpaste in the morning, and the prescription fluoride toothpaste at night provides very strong relief over time.
4. Application of desensitizers at the dentist office
5. Placement of fillings overtop of extremely sensitive roots that aren't responsive to other treatments. This is usually done as a last resort based on the shorter lifespan of fillings in this region.
Sensitivity caused by damage to the tooth or nerve
There are other types of tooth problems that can initially mimic root sensitivity, but will develop into more severe problems. Lets explore what those are:
1. Cavities
A cavity is the breakdown of tooth structure because of bacterial acid that hasn't been cleaned off the teeth. This leads to increasing levels of sensitivity that last for longer and longer periods of time.
Solution - Filling or a crown. Teeth are terrible reporters, so by the time they let you know something is wrong, the problem needs quick attention to try and avoid much more involved and expensive treatment! Don't delay. At least let a dentist take a look and discuss your options.
2. Fracture of the tooth or root
A crack has worked its way deep into the tooth. If it goes far enough, the tooth can break in half. This leads to progressively worse sensitivity, and strong discomfort when you bite down on the tooth.
Solution - If the fracture is only part way into the tooth, the fractures can be removed and a crown used to hold everything together. If the fractures are deeper, the tooth has to be removed. If you are having significant pain to pressure on your teeth, see a dentist immediately as it could also be a serious infection at the base of your tooth.
3. A tooth nerve is dying
This can be caused by deep decay, trauma to the tooth, fractures, history of many fillings near the nerve, etc..
There are many different ways a tooth will complain about a dying nerve. If you have any of the following, see your dentist immediately:
a. Progressively worsening sensitivity to hot and cold
b. Pain that occurs spontaneously without any other stimulus
c. Pain to pressure on a tooth
d. Swelling around a tooth
Solution - If the tooth is savable we will complete a Root Canal treatment which removes the dying nerve and bacteria, and then seals everything back up. If it is not savable, then the tooth must be removed to prevent further infection of your body. Antibiotics are used to help the body if an infection is already present by the time you see your dentist.
Closing Thoughts
Remember, sensitive teeth don’t have to control your life or your dental routine. With the right practices and dental team, you can conquer discomfort and achieve a healthy, happy smile. So visit your dentist regularly, and embrace the journey toward a sensitivity-free future. Schedule your dental checkup today to discuss personalized strategies for gentle yet effective oral care. Your radiant smile awaits!