Millions of Americans suffer from sensitive teeth. It can affect your diet, preventing you from eating or drinking things you love. Sensitivity can even be so severe that it hurts to breathe in cold air. Most people with sensitive teeth experience discomfort when exposed to cold foods, drinks, or air. Some also have painful sensations the various areas of the teeth come into contact with sweets.
There are two general categories of the causes of sensitive teeth. In the first, the nerve within the tooth is healthy, but a lack of enamel allows it to “feel” sensations it should not. In the second, the nerve within the tooth is unhealthy and overreacting to relatively normal stimuli.
When the nerve inside a tooth is healthy, and it is sensitive to cold or sugary sensations, that means it is feeling something it should not feel.
Enamel forms a hard outer shell over each tooth, and it insulates the nerve within against these sensations. It protects the softer and more vulnerable underlying tissues from both the thermal and mechanical forces of normal eating and drinking. One important aspect of enamel is that it only covers the “crown” of the tooth, or that portion which protrudes out of the gums in a healthy mouth. It does not cover the roots.
The most common cause of sensitive teeth with a healthy nerve is receding gums, which expose the roots of the teeth. Because roots do not have a protective enamel coating, they allow the sensations of cold and sweets to easily pass through the larger pores on root surfaces, reaching the nerve within.
In addition to gum recession with root exposure, any loss of enamel on the crown of the teeth can cause sensitivity. This can occur through acid erosion, wear and tear from heavy clenching or grinding, or mechanical abrasion through poor toothbrushing techniques. Any portion of tooth not covered in enamel is a site at risk for sensitivity.
If the nerve within a tooth is unhealthy, meaning it has active inflammation or infection, it will likely be overly sensitive to normal stimuli. The two most common causes of inflammation or infection in a tooth’s nerve are cavities and cracks. A cavity is a bacterial infection of the hard structures of a tooth. Over time, the bacteria penetrate into the tooth, working their way toward the nerve. The toxins they produce lead to inflammation in the nerve. When the bacteria reach the nerve, the nerve itself is infected.
A cracked tooth causes pinching and inflammation of the nerve. Eventually, cracks allow bacteria from the mouth inside the tooth. The response of the nerve is the same as that of a deep cavity. An inflamed or infected nerve becomes sharply sensitive to cold, lingering for longer than the time required to “warm up” the tooth back to normal mouth temperature.
Great question!
Not everyone must see a dentist when the teeth are sensitive. As we described above, you can experience sensitive teeth with both healthy and unhealthy nerves. The sensitivity caused by unhealthy nerves is a symptom of a progressively worsening dental problem. So you have to determine whether the nerves in your teeth are healthy or unhealthy.
If you have seen your dentist consistently and followed through with any necessary dental treatments, you can assume that your nerves are healthy. If you have not seen a dentist in quite some time, you cannot make that assumption. You must rule out the possibility of dental diseases as the cause of your sensitivity. Make an appointment for an evaluation with x-rays to ensure that you are not suffering from large cavities or cracked teeth, which require dental treatment.
Our drugstore and grocery store shelves are filled with oral care products, and many claim to fight sensitivity. There are two ways to help reduce the symptoms of sensitive teeth, and there are specific ingredients to accomplish this.
Sensodyne is the most popular anti-sensitivity toothpaste, and it contains an important ingredient for calming down the nerve inside the tooth. The active ingredient, Potassium Nitrate, actually has a slight numbing effect on the nerve, so that it does not feel those cold sensations to the same level of intensity. To achieve relief with this type of ingredient, you must use the product consistently for a minimum of two weeks.
The second way to fight sensitivity is through a process called remineralization. Softened or weakened tooth structure allows the nerve within to feel more of the sensations of the oral cavity. We can re-harden those structures (enamel and its underlying dentin) by using products that remineralize them. The most common ingredient you will find for remineralization is fluoride. Your dentist may prescribe a toothpaste or gel with a high concentration of fluoride.
There are several newer ingredients gaining in popularity for remineralization, including nanohydroxyapatite (nHa), arginine, and amorphous calcium phosphate (ACP). It can be difficult to find these products over-the-counter, but many are available through online retailers. Many of the products containing these remineralizing agents do NOT contain fluoride, so you should discuss these options with your dentist before abandoning fluoride products. A great, US-based company making a nanohydroxyapatite toothpaste is Boka. You can apply arginine to your teeth using unique, chocolate-flavored chews from BasicBites. ACP is available in a prescription-only paste called MI Paste, sold by many dentists.
For some people suffering from sensitive teeth, these products only barely take the edge off. If you and your dentist have ruled out dental disease, and the recommended products are not helping, it is time to discuss treatment options with the dentist.
If the underlying cause of the sensitivity is exposed roots, there are various ways to cover those roots and re-insulate the tooth. This may involve gum surgery or dental materials placed over the roots. Ask your dentist which options can relieve your sensitivity and help you enjoy a normal diet again.
Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our board certified dentists. We will assess your specific situation to determine the best course of action, so that you can achieve relief from your sensitivity as soon as possible.
