Sensitive Teeth
A lot of people will say that they have sensitive teeth. This means that you feel twinges of pain or discomfort in your teeth in the following situations
- drinking or eating cold foods and beverages
- drinking or eating hot foods and beverages
- eating sweet food
- touching the teeth with other teeth or the tongue
There are two types of tooth sensitivity and they are
Dentinal sensitivity occurs when the dentin layer or the middle layer of the tooth is exposed. Normally, the dentin layer is covered by enamel above the gum line and by cementum below the gum line. Dentin is made up of tiny openings called tubules and inside each tubule, there is a nerve branch that comes from the tooth's pulp, the centre or core of the tooth. When the dentin is exposed, extreme temperature and pressure can affect these nerve branches causing sensitivity.
Dentinal sensitivity can affect one or more teeth and it occurs then the outer protective layers of enamel or cementum are removed. Here are some of the causes which lead to the exposure of dentin
- brushing your teeth too hard will wear away the enamel layer
- poor oral hygiene will lead to tartar build up and may leach minerals from the tooth
- wear and tear of the tooth over time
- cavities that are left untreated
- old fillings with cracks o leaks
- receding gums that expose the roots of the teeth. Receding gums are caused mainly by periodontal diseases or by brushing too hard
- gum surgery which leads to the exposure of the tooth's roots
- excessive tooth whitening in people who have tooth roots that are exposed
- eating of acidic foods or drinking of acidic beverages which may cause erosion of tooth minerals and protective layers
Pulpal sensitivity is a reaction to the pulp of the tooth. The pulp of the tooth is made up of several blood vessels and nerves and is located at the centre of each tooth. Pulpal sensitivity tends to affect only one tooth. Causes of pulpal sensitivity include
- decaying teeth
- infected teeth
- a recently filled tooth
- excessive pressure from the clenching or grinding of the tooth
- cracked or broken teeth
If you experience a sharp pain when you bit then you may have a cracked tooth, a cracked filling, or a broken filling.
What are the symptoms of sensitive teeth?
Dentinal and pulpal sensitivity normally involve reactions to temperature and pressure. The sensitivity to cold drinks or foods is the most common of all symptoms. The teeth are sometimes sensitive to hot temperatures as well. If one tooth changes from cold sensitivity to hot sensitivity then the tooth's nerve may be dying. In cases like this, a root canal treatment is needed.
What is the diagnosis for sensitive teeth?
Your dentist will look at your dental history and your mouth will be examined. Your dentist will ask about your oral habits. If you grind or clench your teeth then this may contribute to sensitivity. Your dentist will look for tooth decay, deep metal fillings, and exposed root surfaces. Your dentist may use an explorer, a metal instrument with a sharp point, to test your teeth for sensitivity.
A tooth can be sensitive to cold temperatures for several weeks after a filling is placed. The metals in amalgam or silver are able to conduct cold temperatures very well thus, transmitting it to the pulp easily. Bonded, tooth-coloured fillings require etching the tooth with acid before a filling is placed. In some of these cases, the etching removes enough enamel to make the tooth sensitive. Advances in bonding make teeth less likely to be sensitive. Your dentist or endodentist can conduct tests in order to see if you need root canal treatment.
How long will your teeth be sensitive?
If your tooth feels sensitive after a silver filling is placed then you can expect the sensitivity to go away in a couple of weeks. Some of the sensitivity may not go away over time and may indicate the need of a root canal.
Sensitivity in more than one tooth may disappear after a short while or it may continue and persist. This depends on the cause of the sensitivity. Each and every case is unique. Some people will have sensitive teeth for a month or two while others will have the condition for the rest of their lives.
How do you prevent your teeth from becoming sensitive?
You can reduce dental sensitivity by
- brushing twice a day and flossing everyday
- using a soft toothbrush
- brushing gently
- brushing up and down instead of from side to side
- using a fluoride toothpaste
- using a fluoride mouthwash
- using products that has the seal of approval from the American Dental Association
- getting treatment for bruxism or the grinding or clenching of your teeth
You can reduce pulpal sensitivity by
- having a root canal treatment
You should not delay root canal treatment because this may result in further problems in the future.
How should you treat sensitive teeth?
Dentinal sensitivity is treatable no matter what its cause. First, your dentist or your oral hygienist will clean your teeth. If your teeth are too sensitive then your dentist will use a local anaesthetic before the cleaning. Nitrous oxide can also be used.
After your teeth are cleaned, your dentist will apply a fluoride varnish to protect your teeth. This will reduce sensitivity temporarily and will also serve to strengthen your teeth. Your dentist may apply an in-office treatment for your teeth's sensitivity. They block the openings in your teeth, also known as tubules, in order to reduce the sensitivity of your teeth.
Fluoride toothpastes and fluoride mouth rinses at home can help reduce the sensitivity of your teeth. There are also toothpastes in the market that are made specifically for sensitive teeth.
You should talk to your dentist about which fluoride rinses you must use. Some of the over-the-counter rinses are acidic while others are not. You must select a fluoride mouth rinse that uses neutral sodium fluoride.
Pulpal sensitivity can be treated with a root canal. When the tooth's nerve is damaged or is dying then this is the most appropriate treatment. If the sensitivity is due to a new amalgam or silver filling then it should go away after several weeks. In some cases, this new filling may be too high and may cause sensitivity. Your dentist can polish this filling in cases like this. If the sensitivity is caused by the grinding and clenching of your teeth then the sensitivity must decrease after treatment.
When should you call a professional?
If the sensitivity in your teeth lasts for longer than a few weeks then you should contact your dentist. If you have a scheduled cleaning then you should talk to your dentist about the sensitivity of your teeth and the possible causes. Most cases of tooth sensitivity are treatable especially if early dentinal sensitivity is suspected.
What is the prognosis of sensitive teeth?
The outlook for treating sensitive teeth is different for each and every person. Some people only have short-term tooth sensitivity while others deal with the condition for several years.