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Tooth Sensitivity: Causes, Remedies & Treatment

sensitive teeth, tooth pain
Credit: Jan Mika | Shutterstock

Tooth sensitivity is a common dental problem that involves discomfort or pain in teeth when encountering certain substances and temperatures. At least 40 million adults suffer from sensitive teeth in the United States.

Probably the most common symptom of tooth sensitivity is teeth being sensitive to cold. This may include cold drinks and foods, ice cream, or even taking a breath of cold air. Those with sensitive teeth may also experience pain from consuming hot, sweet, or sour foods or drinks. Some people experience tooth sensitivity from brushing or flossing their teeth.

The pain is often sharp and sudden, but it is temporary. You may be able to feel pain shoot into the nerve endings of your teeth. Fortunately, sensitive teeth can be treated and the condition can improve.

Causes of tooth sensitivity

In healthy teeth, enamel protects the underlying layer of dentin, which is softer than enamel. The tooth roots are protected by gums. But if the enamel is worn down or if the gum line has receded, then the dentin becomes exposed. The dentin contains thousands of microscopic tubules, or channels, leading to the tooth’s pulp. When exposed to the elements, these dentinal tubules allow heat, cold, acidic, or even sticky substances to reach the nerves inside the tooth, causing pain.

Some factors that contribute to sensitive teeth may include:

  • Brushing too hard or using a hard-bristled toothbrush. This can wear down enamel, causing dentin to become exposed, or encourage gum recession.
  • Gum recession. This often happens in people suffering from periodontal disease, and it exposes the dentin.
  • Gingivitis. Inflamed and sore gum tissue can result in exposure of the tooth’s root.
  • Cracked teeth. These can become filled with bacteria from plaque and cause inflammation in the pulp of the tooth. In more severe cases, it may lead to abscess and infection.
  • Teeth grinding or clenching. This can wear down enamel.
  • Tooth-whitening products. These contain harsh chemicals to remove stains, but can also remove the enamel.
  • Toothpaste with baking soda and peroxide
  • Age. People between ages 25 and 30 are most likely to suffer from tooth sensitivity.
  • Plaque build-up
  • Long-term use of mouthwash. Some over-the-counter mouthwashes contain acids. If you have exposed dentin, the acids can make existing tooth sensitivity worse and also further damage the dentin layer. There are neutral fluoride mouthwashes available that might be a better option.
  • Acidic foods. These can encourage enamel reduction.
  • Dental procedures. Teeth may be sensitive after professional cleaning, root planing, crown replacement, and other tooth restoration procedures. Usually the pain will disappear in four to six weeks.

Tooth sensitivity after filling

As with other dental procedures, tooth sensitivity after having a cavity filled or a filling replaced is common. The tooth decay that causes cavities irritates the tooth, and the filling procedure, while necessary, can further irritate the tooth. Fortunately, tooth sensitivity after a filling should improve on its own within a few weeks. It may last longer, as much as a few months, but as long as the tooth sensitivity shows gradual improvement, there should be nothing to worry about.

If the tooth sensitivity persists, however, it may indicate that the tooth is suffering from a prolonged infection. This happens if the tooth decay was close to the tooth’s pulp and, while under the irritation of the filling procedure, the tooth became infected from the bacteria that are naturally present. This is a rare situation but if it is the case and the irritation persists, you may need a root canal.

Sometimes after a filling, teeth become sensitive when biting down. This can be fixed with a simple bite adjustment.

If you had a composite filling put in, you may experience tooth sensitivity when chewing. There is no pain when the teeth are clenched together, however. This tooth sensitivity is usually fixed by adjusting the bite or replacing the filling with another composite.

Treatment

Depending on your level of tooth sensitivity, you may try various over-the-counter or dentist-recommended treatments. Regardless of what you opt for, maintaining good oral hygiene is key to helping sensitive teeth.

The following are some at-home treatments:

  • Desensitizing toothpaste. There are several brands of toothpaste for sensitive teeth available. Your dentist may recommend one or you may have to try different brands until you find the product that works for you. Be sure to use fluoridated toothpaste for sensitive teeth, not tartar-control toothpaste. Try spreading a thin layer of the desensitizing toothpaste on the exposed tooth roots before bed.
  • Use a soft bristled toothbrush
  • Avoid highly acidic foods
  • Use a fluoridated mouthwash daily
  • Avoid teeth grinding. You may consider getting a mouth guard.

The following are some dental procedures that may reduce tooth sensitivity:

  • Bonding, crowns, or inlays. These may fix a tooth flaw or decay that is causing sensitivity.
  • Fluoride gel or varnish
  • Dentin sealers. These are applied to the exposed root surface, but they are not a permanent fix.
  • Surgical gum graft. This will protect the root and reduce sensitivity if the gum tissue has eroded from the root.
  • Root canal. This is a last-resort treatment for severe tooth sensitivity that has not been helped by other methods.

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