Sensitive Teeth Symptoms

Chronically sensitive teeth can make mealtime an unpleasant experience. Hot and cold foods and beverages typically create immediate toothache discomfort in those affected. This discomfort can vary from mild irritation to shooting and intense pain.

Besides temperature, other factors can cause pain in sensitive teeth. These include sugary foods, sour/dehydrating foods, air pressure changes, and outside forces placed on the tooth.

Causes

• Sensitivity results when the hard outer layer of enamel on the upper part of the tooth is compromised, exposing the vulnerable layer of dentin underneath. Similarly, gum recession can lead to destruction of the protective cementum layer on the lower part of the tooth (the root), again exposing the underlying dentin.

  Physical cracks in the teeth, failed or cracked fillings, failed "crown and bridge" work, and periodontal (gum) disease can all lead to exposure of the dentin. Over time, poor brushing technique, bruxism (grinding of the teeth), clenching the teeth, acid reflux disease, and excessive consumption of acidic foods can also expose the dentin.

Mechanism

• The nerve or pain center of the tooth is the pulp, located in the center of the tooth. Once the middle dentin layer is exposed, the thousands of naturally occurring microtubules of which the dentin is composed provide a direct pathway from the inside of the mouth to the nerve.

  These microtubules are naturally filled with a liquid, plasma-like substance that conducts sensations from the exterior of the tooth straight to the nerve. The change in hydrostatic pressure in the microtubules due to extreme heat, cold, acidity or even sticky foods causes pain when this pressure is detected by the nerve.

Identification

• It is the responsibility of the dentist to diagnose abnormal conditions in the oral cavity (the mouth). However, if you suffer from sensitive teeth, you may be able to see visual evidence of the cause.

  For example, a partially or completely broken tooth is usually quite noticeable. Gum disease is also often obvious, especially in later stages.

  However, a dental X-ray or other form of investigative tool may be needed to diagnose hard-to-detect conditions such as a hairline tooth fracture.

Prevention

• Tooth sensitivity can be minimized or prevented. Avoid excessive force when brushing to decrease the chance of enamel wear. Floss daily with proper technique to keep the gums strong and healthy so the dentin of the roots remains unexposed.

  Regular dental check-ups are essential for early detection. Your dentist can identify risk factors such as a receding gum line before the problem becomes severe. The dentist may also prescribe a deep cleaning of the gums and can check fillings for defects.

  Avoid chewing non-food objects such as pipe stems or ice. This habit can lead to cracks or wear in the teeth that produce sensitivity.

Treatment

• Have any cavities (caries) identified by your dentist filled in a timely manner. Unchecked caries expose the dentin, and sometimes even the pulp, leading to tooth sensitivity.

  Your dentist may also recommend fluoride treatments to strengthen the tooth or the application of desensitizing agents to decrease the discomfort. For severely compromised teeth, the dentist may prescribe an endodontic root canal. During this procedure the nerve is removed from the tooth.

  Regular use of toothpaste designed for sensitive teeth can often alleviate the problem if not too severe. For exposed root surfaces, a surgical gum graft may be indicated to re-cover and protect the dentin of the roots.