Why do teeth become sensitive?
A tooth is made up of essentially three layers:
- Pulp: the soft part of the tooth that contains sensitive nerve endings and blood vessels.
- Dentin: The largest part of the tooth. It is hard, but not as hard as dense as enamel, as it contains thousands of very long and very fine fluid-filled tubules. The fluid in these tubules can move and directly stimulate the nerve endings in the pulp.
- Enamel: The outer covering of most, if not all of the exposed surface of the tooth.
Tooth decay, some foods or drinks (usually the acidic kind like vinegars, citrus juices, pop,) excessive bushing, and even teeth grinding or clenching may damage the protective enamel layer. Once the underlying dentin is exposed, the fluid in the tubules moves around too much when exposed to some irritants and then the nerve endings fire and that hurts! At some depth under the gum line, the enamel thins out to nothing, and that is where the gums serve to cover and protect the sensitive dentin layer. If the gums are receded, the dentin is exposed and once again, the pain returns.
Some dental treatments can contribute to or cause tooth sensitivity
Usually the effect is temporary.
- Bleaching or whitening – no matter what technique is used, these materials sometimes get into the dentin tubules and make teeth rather irritable for many whitening patients. Usually the effect can be offset by applying fluoride treatments after bleaching applications or by using a less potent concentration of bleach.
- Gum surgery – especially the kind that is designed to eliminate or reduce gum pockets. Although there are treatments to help patients handle the sensitivity, the risk of this side effect is far less a concern than the likelihood of tooth loss if the gum surgery is not done!
- Scaling or polishing – occasionally a patient complains of sensitivity during cleaning procedures performed by a dentist or a dental hygienist. Often this is a minor issue, but occasionally local anesthetic is required.
What you can do about tooth sensitivity?
- Brush your teeth gently. We should all use soft-bristled toothbrushes, and mildly abrasive toothpaste. Some newer rotary brushes have built-in sensors that let you know when too much pressure is being applied. I highly recommend these for patients whose teeth are sensitive or who have receded gums.
- Moderate your diet. Don’t overdo it with sour or acidic food and juices. If you do consume these types of foods, wait at least half an hour before brushing your teeth.
- Keep up with your oral hygiene. Remember this is your best defense against plaque formation and subsequent tooth decay and/or gum disease.
- Use a toothpaste that is specially formulated to help prevent and relieve tooth sensitivity. Your dentist or dental hygienist can help you select one to try. Make sure that the brand you choose contains fluoride.
- Get professional treatment for eating disorders and stomach conditions that causes frequent vomiting as the acid in vomit is likely to harm your teeth, not to mention being harmful to your general health.
Treatment at the dental office
- Of course your dentist will look for any cavities and the remove all tooth decay and repair the teeth accordingly.
- Areas of exposed and sensitive dentin can be desensitized with topical fluoride gels and varnishes. In the more troublesome cases, I have had excellent results using acrylic resins.
- While it is rare, some sensitive teeth will not respond to treatment or they may even worsen in severity. In these cases, the removal of nerve tissue can be painlessly removed and sealed off. This procedure is referred to as root canal treatment or endodontics.
- The dentist may diagnose Bruxism (clenching or grinding your teeth at night) and accordingly, prescribe appropriate treatment such as an appliance.
Steven Deskin is a Brantford Dentist in general practice.