Posts for tag: sensitive teeth
You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.
Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.
There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.
Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.
Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.
If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.
If you would like more information on tooth sensitivity and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”
In a healthy tooth, a coating of enamel protects the crown — the part above the gum line — and a layer of cementum protects the tooth root below the gum line. Enamel and cementum are inert (nonliving) substances that do not respond to stimuli such as heat or cold; however, dentin, the living tissue below them, does. Dentin contains numerous microscopic tubules that readily transmit stimuli toward the nerve-filled center of the tooth (pulp tissue). Loss of protective enamel or cementum leaves dentin exposed to all sorts of stimuli in the oral environment, which can trigger “dentinal hypersensitivity” — anything from a mild twinge to shooting pain.
Fortunately, there are many options for treating hypersensitivity. The key to selecting the most appropriate one(s) is determining the cause(s). Some of the more common reasons for sensitivity due to dentin exposure include:
- Enamel erosion caused by an “acid attack” related to external (extrinsic) causes — i.e., consumption of acidic beverages/food — or internal causes — i.e., regurgitation of stomach acids due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia
- Using an overly abrasive brush or toothpaste, brushing incorrectly or too frequently, or brushing too soon after an “acid attack” — all of which can result in a loss of enamel
- Tooth decay (dental caries or cavities)
- Tooth fracture or chipping: tooth grinding (bruxism) is a common cause
- Worn fillings
- Gum recession, due to age or improper tooth brushing, that exposes the tooth root
- Gum disease, which can result in gum recession
Sensitivity can also occur following a procedure like treating a cavity. Normally it subsides within a couple of weeks or so but if it continues there may be another underlying cause.
Whatever the source(s) of your discomfort, our office can get to the bottom of it and recommend an effective course of treatment that meets your personal needs!
If you would like more information about tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”
An icy cold beverage on a hot day or a steaming cup of cocoa on a frigid day are some of the simple pleasures in life. So why do they sometimes seem to turn against you and send sharp, sudden pain shooting through your teeth?
When pain affects your teeth, it's because the nerves within the very center portion, the “pulp,” are reacting to a stimulus such as temperature, pressure changes, or acidic or sugary substances. In healthy teeth, the pulp is protected from stimuli. Above the gum line, a layer of enamel encases and protects the visible portion of tooth (crown). Below, the gums (gingiva) and a thin layer of “cementum” protect the root portion. Neither of these contains nerves. However, directly under the enamel and cementum, surrounding the interior pulp, is the “dentin.” This layer contains nerve fibers that can relay sensations to the nerves in the pulp, which respond as they are designed to — with an unpleasant feeling that tells you something's wrong.
That feeling can range from a momentary pang, to prolonged dull throbbing, to downright excruciating distress. The nature of the pain depends on the type and degree of stimulus. The only way to be certain of what's causing the pain is with a professional dental examination. However, your symptoms can hint at some possible sources.
Fleeting sensitivity triggered by hot and cold foods generally does not indicate a serious problem. It may be due to any of the following:
- a small area of decay in a tooth,
- a loose filling,
- an exposed root surface resulting from gum recession (often due to improper or excessive brushing), or
- temporary pulp tissue irritation from recent dental work.
To help alleviate root sensitivity, make sure the tooth is free of dental bacterial plaque by brushing gently no more than twice a day. Fluoride-containing toothpaste made for sensitive teeth might help. Fluoride and additives such as potassium nitrate or strontium chloride help relieve sensitivity. Try using the toothpaste like a balm, gently rubbing it into the tooth surface for about 10 minutes. If the sensitivity is related to recent dental work, it should resolve within a few days to a week or two, depending on the extent of the work you had done. A mild over-the-counter pain reliever may help in the meantime.
No matter what the reason, if the sensitivity persists or worsens, please come see us. Together we'll get to the root of the underlying problem and resolve it so you can get back to enjoying the foods and beverages you love, no matter what the temperature!
If you would like more information about tooth sensitivity and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sensitive Teeth” and “Tooth Pain? Don't Wait!”
It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.
What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).
The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.
What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.
What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.
Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.
How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.