Expert Q&A: Preventing Tooth Sensitivity
Q: My teeth hurt whenever I eat foods or drink liquids that are either very hot or very cold. Why does this happen, and is there anything that I can do to prevent it?
A: If you experience a sharp pain in your teeth while eating ice cream or drinking hot coffee you may be suffering from tooth sensitivity (also known as dentinal hypersensitivity). It's a common complaint, affecting approximately one in five adults. Sensitivity pain occurs most often when exposed sensory nerves (which are usually found on the surface of the root) react to various stimuli, like coffee or ice cream.
The most common causes for this condition are:
- Receding gums: As the gum levels become lower, more and more of the tooth's root surface is exposed. Enamel, which is the dense calcified protective layer of a tooth, is not present on the root surface. The root, now exposed to the environment, has small microscopic tubules that transmit stimuli directly to the nerve of the tooth. This is the most frequent cause of tooth sensitivity.
- Gingivitis and Periodontal Disease: Periodontal disease often causes your gums to recede as the condition progresses. If you have already been diagnosed with periodontal disease and are experiencing sensitivity, you should speak to your dentist or periodontist about your specific situation.
- Recent dental work: Some procedures can temporarily irritate the nerve of a tooth. For example, routine fillings can make teeth sensitive to temperature and biting pressure. This condition can last up to three weeks, depending on the size of the filling and the materials used.
- Chipped teeth or broken fillings: Sometimes a small chip in a tooth or filling can expose part of the dentin (the layer of tooth under enamel) to the oral environment. This layer has similar sensory nerves to that of the root surface and will thus result in sensitivity. See your dentist to have the area repaired.
- Teeth grinding or clenching: If you are grinding or clenching your teeth, small V-shaped notches may develop on the tooth surface just above the gum line. These indentations can also become sensitive as more of the tooth surface is exposed. If your dentist believes you are grinding, a night guard may be prescribed to protect your teeth from further damage.
- Excessive plaque buildup: If it has been a while since you have had a professional cleaning, plaque and tarter can build up on your teeth below the gum line, causing sensitivity as well.
Most patients will experience sensitivity with cold stimuli more frequently than with hot stimuli. Usually, the pain will subside fairly quickly once the stimulus has been removed. Tooth pain associated with biting and chewing is usually not a symptom of dentinal hypersensitivity. This may be indicative of a cavity or a crack in the tooth. If you are experiencing tooth sensitivity that lasts longer than a few weeks, is getting progressively worse, or is severe enough that you feel the need to take pain medication, you should seek help from your dentist.
The majority of treatments focus on sealing the exposed tubules and/or desensitizing the nerve. There are a number of over-the-counter products that can be used to accomplish these goals. Toothpastes that contain potassium nitrate are the most effective nerve desensitizers and are approved by the American Dental Association. Be aware that you will need to use these products for at least three weeks before you will notice substantial results. Rinses that contain stannous fluoride will also reduce sensitivity by sealing the tubules. These rinses will provide the added benefit of cavity protection. Any rinse or toothpaste product with fluoride in it will help with sensitivity; however, look for products with a neutral preparation as acidic rinses can irritate the nerve.
If these methods do not relieve your symptoms, your dentist may make fluoride trays, coat your teeth with prescription strength varnish, prescribe medications, or cover the exposed surface with a dental filling or tissue grafting procedure.
Once the reason for the sensitivity has been identified, your dentist can treat the cause, as well as the pain. By treating the cause, the problem will not progress any further. The symptoms will likely improve or be eliminated with time. Proper oral hygiene, use of a soft toothbrush with proper brushing technique, and regular dental checkups and cleanings every six months can prevent sensitivity as well as a variety of other dental problems from developing.
Kevin Hansen, DDS, received his dental degree from the State University of
New York at Buffalo, School of Dental Medicine. Additionally, he has
completed one year of General Practice Residency training at The Long Island
College Hospital in Brooklyn, NY. He is a member of the American Dental
Association, the Academy of General Dentistry, and the Academy of Cosmetic
Dentistry. Dr. Hansen is also an attending dentist at United Cerebral Palsy
of NYC, where he teaches Columbia University dental students. He currently
maintains private practices in both New York City and Brooklyn, NY.
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