Tooth Sensitivity: The Causes, Symptoms, and Solutions

Persistent dental discomfort should be evaluated by your dentist to determine the nature of your pain. Quite often, dental pain is a symptom of a hidden cavity or damaged tooth enamel. If your pain is not caused by structural damage or decay, you may be experiencing the symptoms of tooth sensitivity, particularly if your pain is triggered by hot or cold temperatures or contact with sweet or acidic foods.

Once you understand the many potential causes of tooth sensitivity, it's much easier to keep your condition from progressing, recognize the value of available treatment options, or avoid developing sensitivity in the future.

To understand the causes of sensitivity, it may be helpful to start with a review of tooth structure. The crowns of your teeth, the part above your gum line, is protected by a tough layer of enamel. This protective outer surface is the hardest substance in your body and allows your teeth to withstand a tremendous amount of wear.

The roots of your teeth, the part embedded in your jaw, are protected by a thinner, outer layer called cementum. While durable, cementum is not as resilient as enamel. Cementum is about as strong as bone.

These strong outer layers protect the innermost layers of your teeth, the dentin and pulp chambers. Dentin is substantially more porous than tooth enamel, a structure comprised of microscopic channels (dentinal tubules), that allow for the transmission of nutrients and pain signals.

When the protective barriers on your teeth are compromised, it's the dentinal tubules that allow heat, cold, sweet, and acidic foods to irritate nerves. This is the cause of your pain. There are several factorsthat could cause tooth sensitivity, consider the following:

• Damage to Tooth Enamel – While tooth enamel can withstand a significant amount of force, it is not impervious to wear. If your enamel is cracked or worn, it will no longer protect your teeth from painful stimuli. Tooth grinding (bruxism), a misaligned bite, overzealous brushing, and abrasive cleaning agents can wear down tooth enamel, leaving exposed areas susceptible to pain.

• Receding Gums – Ideally, the roots of your teeth are protected by your gums. When the roots of your teeth are gradually exposed because of a receding gum line or pockets forming between the teeth and gums, pain and sensitivity could soon follow. That's because the cementum protecting tooth roots is not as thick as enamel and can allow painful stimuli to reach dentinal tubules.

• Failed Dental Restorations – If you have had a tooth repaired because of decay or injury, the filling placed by your dentist forms a seal that protects your tooth from further damage. Nearly all dental fillings will need to be replaced eventually. Over time, fillings wear and the seal created by the restoration leak. A leaking filling can cause significant damage to the tooth structure surrounding the restoration and also allow painful stimuli to penetrate the dentin and trigger sensitive nerves in the pulp of your tooth.

• Tooth Whitening Products – The over-the-counter products commonly used to whiten teeth are known to cause tooth sensitivity. Many formulations of whitening toothpaste contain polishing agents that slowly abrade tooth enamel. Products containing hydrogen peroxide can irritate sensitive gum tissue and can even cause chemical burns. As the damage to tooth enamel increases, so does the frequency and severity of tooth sensitivity.

• Acidic Foods – Foods that are high in natural acids, or contain citric acid, can weaken tooth enamel. After eating acidic foods, your tooth enamel is a bit softer than usual, making your enamel more vulnerable to wear. It's now commonly advised to wait for 20-30 minutes before brushing after indulging in acidic food or drink. By waiting before brushing, you give your tooth enamel the opportunity to remineralize so that your toothbrush will not erode your tooth enamel.

If you are experiencing sharp, temporary pain as the result of eating, drinking, or brushing your teeth, it's important to visit your dentist. Most tooth sensitivity is caused by worn enamel or root exposure, but your dentist will want to rule out other possible causes for your discomfort and address your needs accordingly. For tooth sensitivity, your dentist may recommend one or more of the following treatmentsdepending on the severity of your symptoms:

• Fluoride Treatments – When applied topically, fluoride can strengthen and remineralize dental enamel. Reinforcing the integrity of tooth enamel is shown to reduce sensitivity. Your dentist might suggest using a prescription fluoride solution with a custom-fitted tray.

• Desensitizing Toothpaste – Desensitizing toothpaste will not reverse the cause of sensitivity but works quite well to alleviate symptoms. Desensitizing toothpaste will not numb your mouth. The active ingredients in a pain-relieving toothpaste work their way through the tubules in tooth dentin and block the transmission of pain signals.

• Bonding Problematic Surfaces – Your dentist may be able to desensitize your teeth by applying a composite resin, a compound similar to a tooth-colored filling, to protect exposed roots or areas of enamel that have worn. Bonding with composite resin will protect the dentin, pulp, and nerves from external temperatures and irritation.

• Root Canal – If tooth sensitivity is causing severe dental pain, your dentist might recommend root canal therapy, the same procedure used to preserve teeth affected by disease or infection. During a root canal, the nerves of the tooth are safely removed and replaced with an inert material. Root canal therapy is considered the most effective method of pain relief but may only be recommended if other options are unsuccessful.

• Gum Grafting – When sensitivity is caused by an exposed tooth root, your dentist might recommend a surgical gum graft. During the grafting procedure, a small piece of gum tissue is taken from your mouth and relocated to the affected area. Grafting protects exposed roots and can significantly reduce or eliminate sensitivity.

Protecting your teeth and gums from the hazards of dental plaque is essential for reducing your risk of tooth sensitivity or minimizing the symptoms. See your dentist regularly and schedule your professional cleaning as often as your dentist recommends. Regular dental exams allow your dentist the opportunity to detect early signs of damaged enamel or gum recession. To further reduce your risk of sensitivity, consider the following suggestions.

• Use a soft toothbrush at a 45-degree angle to your gum line
• Brush gently but firmly and be careful not to use unnecessary force
• Don't overuse home whitening products; ask your dentist about professional whitening treatments
• Wait a minimum of 30 minutesbefore brushing your teeth after consuming acidic foods to allow enamel to remineralize
• Drink through a straw when indulging in sugary or acidic beverages whenever possible
• If you clench your teeth, ask your dentist about a custom mouth guard
• Don't overuse alcohol-based mouthwash, or consider an alcohol-free alternative

Tooth sensitivity is just one of many potential causes of dental pain. Any persistent discomfort should be evaluated by your dentist. For general, pediatric, and cosmetic dentistry in Batavia, IL, contact the office of Ronald A Murphy, DMD. Dr Murphy and his staff are dedicated to providing a comfortable, relaxed environment, and flexible scheduling and extended hours can easily accommodate your scheduling needs.