Sensitive teeth can be a troubling issue for patients at one time or another. The causes are typically varied, but fortunately, can usually be treated. In this article we’ll discuss some causes as well as some possible solutions if you are experiencing teeth that are painfully sensitive.
The portion of the tooth above the gumline is comprised of an inner core of hard tissue called dentin. It is surrounded by a protective layer of white enamel. Dentin can turn darker as one gets older, resulting in a gradual yellowing of the teeth. Below the gumline is the root, which unlike the top part of the tooth, has no enamel covering. The significance of this fact is that dentin is full of small pores and tubules that connect to the nerve. It is theorized that the disturbance of the liquid in these tubules elicits a sensation of pain. When the protective covering of enamel is worn away exposing dentin or when the dentin on the roots become exposed, these areas thus may become sensitive. This is called dentinal hypersensitivity.
A tooth with dentin hypersensitivity will hurt when cold or hot liquids contact the affected area, or when cold air hits the tooth.
Causes of hypersensitivity may include brushing too vigorously, or uncontrolled clenching and grinding of your teeth. The diet may also play a factor in hypersensitivity. Acidic foods as well as drinks dissolve the enamel and expose the dentin. Examples might include citrus drinks such as orange juice or lemonade, or even carbonated drinks such as soda pop.
Other causes of hypersensitivity include systemic diseases such as bulimia or acid reflux, which again produce acids that wear away protective enamel. Abrasive polishing agents in toothpaste may also produce symptoms.
What can be done to reduce sensitivity? Proper identification of the cause is essential to solve the problem. A dentist will examine and identify possible causes of hypersensitivity. We can place protective fillings and coatings such as hema-based desensitizers or prescribe products for home use. If the sensitivity is caused by a crack, we may place a filling or crown to protect the tooth, or make a mouthguard if the sensitivity is caused by clenching or grinding. If you have pain that does not go away readily or wakes you up at night, the nerve may be irreversibly affected, so it is best to visit the dentist before it becomes unbearable.
In closing, I have found another little-mentioned cause of dentinal hypersensitivity that is easily remedied, namely medium bristled toothbrushes. It is my belief that this type of toothbrush should be relegated only to such tasks as scrubbing sinks. I would advise all of my patients to use soft bristled brushes since the medium bristled brushes tend to aggravate root exposure and gouge grooves into the roots. Aggressive brushing also will damage your gums, so proper technique is crucial.
Dr. Mar can be reached a t (623) 536-6845 if you have questions. His office is located at 5220 N. Dysart Road, Suite #144.
About the Author: Dr. Nelson Mar graduated from the University of Nebraska Dental School in 1995 with a Doctor of Dental Surgery degree. He completed an Advanced Education in General Dentistry residency at the University of Oklahoma Dental School in 1996, and was awarded a Geriatric Fellowship at the University of Texas Health Sciences in San Antonio. He became a Fellow in the Academy of General Dentistry in 2002 and is a member of the American Dental Association and Central Arizona Dental Association.