Tooth sensitivity and pain can vary from mild to extreme and it is important to understand the cause in order to treat it effectively. Dentists regularly get quizzed from patients who are concerned they have serious issues that are contributing to their discomfort. Fortunately, true tooth sensitivity is easy to treat and often manageable without significant or expensive intervention.
It is of course, important to ensure that your issue is not an early sign of something more serious such as tooth decay, a crack or an exposed nerve. In these scenarios it is likely dental treatment is required to resolve the issue.
Your teeth have nerves and blood vessels inside them that were important for their formation. Throughout life they serve an ongoing purpose of warning you about consuming foods that may be too hot or too cold, but when exposed to the outer environment, can become painful and infected.
If you experience sensitive teeth when you consume something cold or hot, or when you breathe in cool air, it usually indicates a problem. In most cases the nerve is not exposed or infected, but the root of the tooth is exposed to the outside environment. The root of your tooth is normally covered by gum and jaw bone, meaning that only the enamel of the tooth is visible above the gumline. The enamel provides a hard and well insulated shell to chew on, and to protect the rest of the tooth.
If the gum and jaw bone recede then the root of the tooth ( made of more porous dentine) becomes visible. It is this dentine that transmits the temperature sensation into the nerve of the tooth. In most cases the sensitivity is short acting and fades once the stimulus is removed.
The receding of the gum and subsequent exposure of the root of the tooth is typically caused by heavy brushing or by other forms of advancing gum disease also known as periodontal disease. To prevent tooth sensitivity it is recommended that you only ever use a soft toothbrush and avoid heavy handed scrubbing. It is this heavy brushing that wears away the gum and over time, wears down the hard tooth. The same outcome is possible if you don’t brush effectively and leave an excess of plaque and build up. The bacteria and scale that form at the gumline result in the gum and bone being infected and shrinking away.
The goal is to brush gently yet thoroughly to remove the plaque without damaging the tooth or gums. Your brush should last 2-3 months, so if you find it worn out and shaggy after only a few weeks then you may be pressing too hard. Using an electric brush with a pressure sensor is also a handy way for those with sensitive teeth to avoid doing damage.
If the root of your tooth is exposed, it commonly results in a short lasting twinge when stimulated. If the gum is worn down, it cannot be regrown, so it becomes important to try and seal over the exposed root to help insulate it. In cases where the root is worn out due to damage, it can be filled by the dentist.
So how do we seal over the exposed root?
You will be aware of desensitising toothpastes that are commonly available at supermarkets or chemists. They all work in a similar fashion, which is to provide a microscopic barrier over the root in order to block the porosity and reduce the ability of the stimulus to reach the nerve.
With regular use, the barrier is often all that is required to reduce tooth sensitivity. One way to speed up the effectiveness of desensitising toothpaste is to rub it directly into the affected areas with your finger and leave it on overnight without rinsing. Dentists also have other products or glazes they can place over exposed roots that do not respond to over the counter toothpastes.
Sensitive teeth can also occur if the enamel layer on the tooth becomes too thin. The same principle applies as it does in the gum recession situation because the porous dentine becomes exposed as the enamel is worn away. Enamel is dissolved by consuming excess acidic food, drinks and stomach reflux. Toothpastes for sensitive teeth will be somewhat effective in this situation, however, it is important to remove the cause, and in some cases have the damaged areas repaired.
Tooth sensitivity also occurs in the early stages of more serious issues. Therefore, having your teeth inspected regularly by a dentist, or when the problem occurs is critical to ensure your issues are resolved appropriately. If you have tooth decay or a crack it may progress into a toothache where the nerve becomes infected. Once this has happened, teeth require more extensive and expensive repairs.
Sensitive teeth are a common problem. The correct diagnosis and treatment means it can be managed with good ongoing success. Being able to enjoy your favourite foods and drinks without pain is all part of improving satisfaction and quality of life.