Sensitive teeth are one of the most commonly found dental problems. 22-30% of Canadian adults face it without a specific age pattern1 . Before delving into the particulars, it is crucial to know the composition of teeth in order to understand what causes sensitivity. Teeth crowns that are visible in our mouth comprise three layers. The innermost is a hollow core— the pulp of the tooth. It houses the blood vessels and the neural fibres conducting the sensations.
A layer of dentine periphery outside the pulp is the dentinal layer. This middle layer is stacks of tubules running away from the pulp towards the outer enamel covering.
The outermost layer that covers the crown part is enamel. Cementum covers the root part.
According to the most accepted theory, these dentin tubules are hollow. They have fluid that shrinks and expands with any change in the environment surrounding the tooth.
What Causes Sensitive Teeth?
The most common reason for sensitive teeth is the loss of enamel at the crown-root juncture, resulting in exposure to dentin. In such conditions, consuming food or beverages at extreme temperatures triggers a sudden reaction, causing fluid movement in dentin that evokes nerves. Any trigger in the exposed region gives rise to acute pain, making the teeth sensitive.
More Reasons for Sensitive Teeth
Any cause that leads to the loss of enamel covering can cause sensitive teeth. Listed below are twelve common reasons for sudden sensitive teeth:
1. Deep Cavities That Extend Till the Dentin
Enamel has no signs of living units, neither blood vessels nor nerves to conduct any sensations. An individual may not know about the progressing decay unless it is noticed as a tiny black or brown spot on the tooth surface. The decay can spread to the dentin below if it is not removed. As the decay progresses, the enamel undergoes demineralization. It loses the outer enamel, forming a cavity and exposing the dentin. The tooth suddenly gets sensitive at this point.
2. Receding Gums2
Receding gums and subsequent root uncovering can cause an extensive revelation of the underlying dentin. As the cementum layer is thin and easily removed, it induces sensitivity in the tooth affected by gum disease. As the gum disease spreads to multiple teeth, complexity with sensitivity adds up.
Occasionally, even gum disease treatment can cause sensitivity. However, a visit to the gum specialist can help resolve it.
3. Outwardly Placed Tooth
Typically, bone surrounds the tooth root circumferentially. However, it holds true only until the tooth lies in its usual position. If the tooth position is outside the arch line, more towards the lips or cheek, studies observe the lack of tooth-supporting bone. Without the tooth-supporting bone, the root gets exposed from the gums. This leads to receding gums and causes sensitivity.3
4. A Cracked Tooth
A tooth can crack due to multiple reasons and often constitutes a dental emergency. Being structurally weak, self or external causes, following dental treatment, dietary causes, trauma, etc., are a few that you can enlist. One mechanism for it to develop is our eating habits— eating alternating heated and chilled foodstuffs in a meal can cause micro-cracks. However, they are not detrimental unless additional underlying issues are present.
5. Fractured Fillings
Dentists treat tooth decay by removing the decayed part and filling it. The dental fillings are such that they seal the remaining tooth. However, multiple underlying issues can cause defective or fractured fillings, leaving decay between teeth, which spreads below the filled cavities. All of these can cause gaps at the tooth-filling point and expose the underlying dentin.
6. Tooth Trimming
Trimming a vital tooth to place a crown or a bridge increases dentin permeability and irritation to the pulp. In most individuals, it is due to removing enamel and dentin thickness. Tooth trimming for crown placement can lead to the exposure of 1-2 million dentinal tubules, thus causing sensitivity.4
7. Night Grinding
Bruxism or night grinding refers to the habit of grinding teeth, typically during sleep. About 2/3rd dentists believe bruxism can cause sensitivity. One can prevent sensitivity by using a night guard as a cushioning agent. This prevents the wear-out of teeth and eventually reduces the chances of sensitivity.
8. Aggressive Brushing
Apart from the loss of gum tissue caused by diseases, an additional factor that impacts is aggressive brushing on the exposed dentin. They quicken the tooth wear process at the junction of teeth and gums. Aggressive brushing even causes splitting of gums or gum injury, which leads to sensitivity.
9. Tooth Wear
Wearing of teeth on the biting surface due to opposing teeth (attrition) and on a smooth surface facing the cheeks due to mechanical force from an external object like a toothbrush (abrasion), in a synergistic way, can lead to sensitivity in teeth.
10. Erosion
Teeth erosion is most common in individuals suffering from acid reflux, causing heartburn. The outer layer of enamel erodes due to repeated exposure to acid. Dentists usually detect the acidic insults (erosion) on the tongue side of the front teeth. Further erosion can be prevented with restorative dentistry treatments and proper care.
11. Aging
With age, multiple factors cause increased sensitivity, primarily due to untreated gum disease and wasting diseases like attrition, abrasion, and erosion that weaken teeth. Also, dryness of the mouth in older adults can increase decay on the root surface, ultimately causing increased teeth sensitivity.
12. Teeth Whitening
Teeth sensitivity is the most common expected outcome after a teeth whitening treatment at a dental office. Sensitivity usually occurs at the time of whitening and gradually reduces over days. However, these agents penetrate and induce an immune response and can sensitize the neural tissues of multiple teeth.5 Whatever may be the reason, getting rid of it is necessary.
How To Stop Sensitive Teeth Pain Immediately
You can follow the below-given steps for the effective management of sensitive teeth:
1. Diagnosing The Condition
A visit to a professional dental clinic and a thorough explanation about the condition will help the dentist exclude any other cause and arrive at a diagnosis for your sensitive teeth.
2. Developing The Treatment Plan
The treatment for tooth sensitivity depends on the cause, and a comprehensive treatment plan is developed to address the root causes and effective preventive measures.
3. Locating the Tooth:
The dentist localizes sensitive teeth or the affected areas and identifies the factors that evoke sensitivity.
4. Proper Brushing
Dentists educate the patient with proper brushing techniques that can prevent further deterioration and repeated occurrence. Also, they specify the toothbrush types and suitable toothpaste that helps you in reducing sensitivity.
5. Use of Desensitizing Agents
An appropriate product or formulation based on your dentist’s recommendation is to be used.
The products designed for treating sensitivity fall under two categories: Formulations that can be applied “In-office” and used “At-home.” Choosing any alternative may help stop the pain in sensitive teeth immediately. However, no treatment method has shown superiority over others with a consistent long-term effect.
Home Remedies For Teeth Sensitivity
To begin with, prevention is better than cure. Avoiding the causative factors can prevent teeth sensitivity. Avoid aggressive brushing, acidic beverages, tobacco-based products, and abrasive toothpaste to prevent teeth sensitivity.
Once teeth sensitivity develops, multiple home care modalities are helpful.
The formulations for “At-Home” usage are available as over-the-counter products. e.g. dentifrices, gels, mouthwash, and chewing gums. Alternatively, you can also opt for the following to treat sensitive teeth:
1. Dentifrices
A dentifrice is a paste or powder for cleaning teeth. These contain potassium salts that move along the dentinal tubules and reduce the triggering of nerves, thus reducing sensitivity.
2. Soft-Bristled Toothbrush:
Using a soft toothbrush reduces the removal of the fragile cementum layers. Also, one should learn the correct brushing method from the dentist.
3. Mouthwashes
The dentist localizes sensitive teeth or the affected areas and identifies the factors that evoke sensitivity.
4. Tooth Mousse
This recently developed topical dental cream has shown effectiveness in reducing teeth sensitivity. It contains casein phosphopeptides with amorphous calcium that promote remineralization and must be applied after brushing for over 12 weeks.
If teeth sensitivity persists after persistent use of home care products for more than 4 weeks, it is best recommended to visit the dental office for treatment with dental varnishes, sealants, and lasers, or as prescribed by the dentist.
Need for a Dental Office Visit
Sensitivity in teeth is a dental emergency and requires urgent care to prevent further worsening. The dentist conducts a complete oral examination to find the exact cause of sensitivity and treats any underlying condition. If the patient has no other underlying issues, the dentist may use varnish, gels, desensitizing polishing pastes, and laser therapy alone or in combination with others to treat the sensitivity.
1. Use of Sealants
It is a well-known fact that sealants successfully help prevent cavities and manage teeth cracks. So its use by dentists as an “in-office” agent for sensitive teeth is promising.
2. Lasers in Sensitivity
Lasers are capable of reducing sensitivity in low energy mode (photobiomodulation). This helps by reducing inflamed dentinal tissue. Lasers can be used as a stand-alone treatment or in combination with other sensitivity treatment/s.
Affordable Dental Services in Oakville, Ontario
Sensitivity is a problem for a large proportion of the public. Dentin exposure is a prerequisite for sensitivity. Accurate diagnosis is the key to the successful management of sensitivity. It also is equally important to treat sensitivity immediately. Identifying the reason for your dentin exposure can help you know why your teeth are suddenly sensitive. Trafalgar Dental Oakville offers dental services at affordable charges. Schedule an appointment for detailed information on the procedure.
References
- Canadian Advisory Board on Dentin Hypersensitivity Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003;69:222–226.
- Liu, XX., Tenenbaum, H.C., Wilder, R.S. et al. Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners. BMC Oral Health 20, 220 (2020). https://doi.org/10.1186/s12903-020-01199-z
- Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc. 2003 Feb;134(2):220-5. doi: 10.14219/jada.archive.2003.0137. PMID: 12636127.
- Abdollahi A, Jalalian E. Effectiveness of Two Desensitizer Materials, Potassium Nitrate and Fluoride Varnish in Relieving Hypersensitivity After Crown Preparation. J Contemp Dent Pract 2019;20(4):489-493.
- Carneiro, A.M.P., Barros, A.P.O., de Oliveira, R.P. et al. The effect of photobiomodulation using low-level laser therapy on tooth sensitivity after dental bleaching: a systematic review. Lasers Med Sci 37, 2791–2804 (2022). https://doi.org/10.1007/s10103-022-03578-0
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