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Understanding Sensitive Teeth

March 17, 2011

Frequently, I have patients ask me about their sensitive teeth.  It is important to understand that there are many causes of sensitive teeth and solving the problem requires an accurate diagnosis to determine the cause of the sensitivity.  Sensitivity is present when there is pain in one or more teeth to a stimulus such as eating or drinking hot or cold food or liquids.  Sensitivity may also occur with biting pressure and chewing hard foods or when eating sweets.  Some sensitivity is only temporary and lasts for a few weeks, some is intermittent in that it comes and goes and some may last for many years.

There are many different types and causes of sensitivity.  In some cases it is due to exposure of dentin or the middle layer of the tooth.  Normally, the dentin is covered with enamel on the crown of the tooth and cementum on the root of the tooth.  Exposure of dentin may be caused by many things such as excessive wear on the teeth due to long-term grinding of the teeth or bruxism, recession of the gums, improper brushing with a hard toothbrush, or a broken or leaking filling.  Untreated tooth decay, gum surgery that results in root exposure and teeth whitening procedures can also cause  dental sensitivity.

Some sensitivity involves the deepest layer of the tooth or the dental pulp.  This type of sensitity may be caused by decay or infection, excessive clenching or grinding, a recent filling, or a cracked or broken tooth.  If you have a sharp pain when biting or when releasing a bite, you may have a cracked tooth.  It is prudent to treat a symptomatic cracked tooth early, usually with a crown.  If the problem is due to excessive clenching or grinding, we can make a night guard for you to wear while you sleep to protect your teeth and jaws.

Occasionally, new fillings cause a tooth to be sensitive.  Amalgam or metal fillings tend to conduct temperature changes to the center of the tooth more readily than natural tooth structure resulting in sensitivity.  Tooth colored fillings require treatment of the tooth with materials to help the filling adhere to the tooth which may irritate the nerve causing sensitivity to cold.  Although recent advances in bonding technology have reduced this problem significantly, it does still occur in isolated cases.  Sensitivity that occcurs after a new filling is usually temporary and decreases over a few weeks.  However, in some cases, additional treatment may be required.  

When a tooth becomes sensitive to heat, it is usually an indicator that a nerve is dying and root canal treatment is likely necessary.  It is important that your dentist be very thorough with your diagnosis to pinpoint the source of your sensitivity.  An accurate history of the problem by the patient will help us diagnose the problem.

Some things you can do to prevent sensitivity include daily, proper brushing and flossing using a soft toothbrush.  Using a fluoride toothpaste and mouth rinse may help.  You may also use a toothpaste formulated specifically for sensitivity.  Consultation with us can help you chose a regimen that is right for you.  Regular professional care is crucial.  If your teeth are too sensitive to tolerate a professional cleaning, we may recommend using nitrous oxide or local anesthesia to clean your teeth.  In certain instances, we may also apply a fluoride type sealer to the affected teeth.

If you have sensitivity that lasts longer than a few weeks, contact us or feel free to discuss it with us at your next appointment….the solution may be easier than you think.

For  a more detailed discussion about sensitivity click on the following link.

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