It may seem that teeth can become sensitive to heat or cold for no apparent reason, but this is far from being the case.
Tooth sensitivity, even if it seems to come and go intermittently and is fairly mild, will always have an underlying cause and should never be simply ignored or dismissed as a minor irritant.
Teeth are naturally hard in order to cope with biting and chewing but the hardness is limited to the topmost layer called enamel.
Beneath the enamel surface is a layer of dentin which supports the tooth structure. Dentin is also connected to sensitive nerve tissue in the inner pulp cavity and the roots of the tooth — and it is here, in the dentin, that sensitivity to heat and cold originates.
Tooth sensitivity, mild or severe, can usually be traced back to exposed dentin. Dentists commonly refer to the problem as dentin hypersensitivity.
Pain is often absent until triggered by eating or drinking hot or cold substances. In many cases pain in the tooth, or underlying gum, can also be caused by pressure, touch or eating spicy or acidic food.
This pain can have many underlying causes and can sometimes be easily treated by changing the way teeth are brushed and flossed, the type of toothpaste and mouthwash used or even by dietary changes.
Causes of Dentin Hypersensitivity
Tooth sensitivity occurs when the underlying layer of dentin is exposed because the protective enamel layer has been compromised. This can happen in numerous ways including:
- Tooth fracture, chip or break
- Worn down fillings
- Eroded tooth enamel
- Tooth decay
- Receded gums
- Gum disease
- Teeth grinding (bruxism)
Apart from these dental issues, dentin can also become exposed by brushing the teeth too vigorously or by using abrasive toothpastes or whitening products.
Damaged Tooth Enamel
Research has shown that almost 57% of dental patients suffer from tooth sensitivity at some time or another and most of these cases can be attributed to one of three causes:
- Teeth grinding which chips, flakes and erodes dental enamel.
- Vigorous brushing, or using a hard-bristled toothbrush, wears down the enamel.
- Enamel erosion caused by acids contained in food and drink.
These three causes have one thing in common: they all damage or erode tooth enamel which leaves the dentin layer exposed to the atmosphere which, in turn, leads to tooth sensitivity.
If you grind your teeth, your dentist can help. If aggressive brushing is the problem, you may need a change in the type of toothbrush used and how the teeth are brushed. Small, circular motions should be used rather than sweeping up, down and sideways strokes. Tackling erosion damage can often be done with some simple dietary changes.
Because tooth sensitivity can have simple explanations (such as using abrasive toothpaste) it is important to have the problem, and its underlying cause, investigated by a dentist who can deliver a professional diagnosis.
The dentist will carry out a thorough examination of the tooth or teeth affected and carry out a simulated test to determine the root cause of the problem.
Several routine questions will also be asked including:
- The physical location of the sensitivity
- The frequency of the pain
- The severity of the pain compared to a prescribed pain scale
- The trigger (or triggers) that cause the pain
Once satisfied as to the cause, location and severity of the problem the dentist will make a diagnosis and decide on the best course of treatment.
Depending on the severity and cause, DH can be treated in a number of ways. This could be as simple as changing the type of toothbrush or toothpaste used or may require a surgical procedure in more severe cases.
Among the possible avenues of treatment are:
- Use of a desensitizing gel or toothpaste
- Switching to a soft-bristled toothbrush
- Using a fluoride gel to strengthen tooth enamel
- Fitting a crown or filling the tooth if it is cracked, chipped or damaged
- Grafting of gum tissue if the problem is caused by receded gums
In extreme and severe cases, it may be necessary to undergo root canal treatment — but this is reserved for the worst cases where no other viable option exists.
Prevention is always preferable than cure and this maxim certainly applies to avoiding sensitive teeth. It may seem like a case of stating the obvious but taking proper care of teeth and gums from the earliest age will help prevent and avoid many dental problems in later life.
Proper oral hygiene and dental care should be taught at an early age and become an everyday part of life. Following a good dental health regimen means:
- Using a soft-bristled toothbrush and never one with hard bristles
- Brushing teeth correctly twice a day (during the day and last thing before bed) and flossing once
- Replacing a toothbrush every two to three months or when worn down
- Waiting at least an hour after eating before brushing teeth as food can soften dental enamel
- Never using dental products (mouth rinse, whitening agents) containing strong abrasive chemicals
- Limiting the intake of fizzy drinks and sweet or sugary foodstuffs
Most importantly, having a proper check-up with a dentist every two to three months will catch any possible issues at an early stage making treatment easier, cheaper and less painful than might otherwise be the case.