Tooth Sensitivity Causes and Treatments

For people with tooth sensitivity, eating or drinking certain substances or those at certain temperatures causes discomfort or pain in their teeth. At least 40 million adults suffer from sensitive teeth in the United States, according to the Academy of General Dentistry

The pain is often sharp and sudden, but temporary. Tooth pain occurs when hot and cold substances reach a tooth’s exposed nerve endings, according to the Cleveland Clinic. Fortunately, sensitive teeth can be treated, and the condition can improve. 

Tooth sensitivity generally results from a layer of the tooth called dentin being exposed. The outside of each tooth is normally covered by a hard outer layer, called enamel or cementum, which protects that dentin — the softer, inner layer of the tooth. Enamel protects the crown, the part of the tooth that’s visible above the gum. Cementum covers the dentin surrounding the root, the pointy part of the tooth that extends into the jaw bone, according to the American Dental Association. The gum also protects the root. If the enamel or cementum gets worn down or if the gum line has receded, then the dentin becomes exposed. Cavities, cracked and chipped teeth, gum recession, enamel and root erosion all cause dentin to be exposed. When exposed, heat, cold or acidic substances reach the tooth’s nerves inside and cause pain.  

According to the Cleveland Clinic, 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 gum disease, including gingivitis. Gum recession exposes the dentin.
  • Cracked teeth. Cracks 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.
  • Plaque buildup.
  • Long-term use of mouthwash. Some over-the-counter mouthwashes contain acids. If dentin is exposed, the acids can worsen existing tooth sensitivity and 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 procedures. Usually, the pain will disappear in four to six weeks.

Some people may experience tooth sensitivity after having a cavity filled, according to the Cleveland Clinic. Fortunately, tooth sensitivity following a filling should improve on its own within a few weeks.

Sometimes teeth become sensitive when biting down after a filling. This can happen because the filling is too high and prevents your bottom and top teeth from fitting together properly. In this case, the dentist may need to reshape the filling. If you get a metal filling and it touches another type of metal, such as a gold or silver crown, when you bite down, the contact between the two different metals may cause some pain initially, but it should subside.

If you have toothache-like pain after a filling and it doesn’t go away, the interior of the tooth, called the pulp, may be severely inflamed. Speak with your dentist or oral specialist to see if you need another treatment.

Teeth-whitening treatments — done either in a dentist’s office or using an over-the-counter product — contain harsh chemicals (hydrogen peroxide or carbamide peroxide) that remove stains, but they can also cause tooth sensitivity. When peroxide penetrates the enamel, it can temporarily irritate the tooth. Overuse of whiteners can also damage the enamel and gums, according to the American Dental Association.   If you have tooth sensitivity discuss this with your dentist.

The following are some at-home treatments suggested by the Cleveland Clinic:

Desensitizing toothpaste. There are several brands of toothpaste for sensitive teeth that are 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 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. Consider getting a mouth guard.

The following are some dental procedures that may reduce tooth sensitivity, according to the American Dental Association:

  • Bonding, crowns or inlays. These may fix a tooth flaw or decay that is causing sensitivity.
  • Fluoride gel.
  • 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.

By continuing regularly scheduled dental checkups, committing to a rigorous oral care routine, and doing everything you can to live a healthy lifestyle, you’re mitigating all chances of experiencing tooth sensitivity.

 

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