Sensitive Teeth
Prof Phillip Dowell BDS MScD MFGDP RCS(UK) F/CD
Tooth sensitivity (also known as dentine hypersensitivity) often appears as a painful reaction to temperature changes, pressure, sweet and acidic food or drink. This reaction may be mild and tingling, or sharp and intense. People whose teeth are sensitive often feel pain when they eat or drink things which are very cold. The classic example is eating ice cream, but simply being out in the cold weather is sometimes enough to set off the problem. Sensitivity to touch may also mean that tooth brushing is uncomfortable.
Research shows that I in 3 people in the UK suffer from sensitive teeth at any one time. Dentine hypersensitivity can occur from 15 to 70 years of age or more, however the age group when it occurs most is between 20 and 40 years.
What are the most common triggers?
Triggers of tooth sensitivity and the severity will vary from person to person, although the most common triggers are:
- Cold food and drinks (e.g. ice cream)
- Over-enthusiastic or incorrect tooth brushing
- Hot food and drinks (e.g. hot tea or coffee)
- Sharp acidic foods (e.g. apples, oranges)
Which teeth are normally affected?
Any teeth can be affected but the most likely are those at the front corners of the mouth. It is suggested that this might be because these are the teeth which tend to be brushed more vigorously causing the wearing away of protective tooth enamel.
How does dentine hypersensitivity develop?
A healthy tooth has a chamber inside for the tooth pulp, which consists of nerves and blood vessels. A young and healthy tooth has a large pulp chamber where the sensitive nerves are more exposed to temperature or pressure changes from the outside. However tooth sensitivity can occur at any age. There are two general ways in which this sensitivity can develop:
1.
Wearing or destruction of the hard, protective, outer layer of the tooth crown called enamel. This may be related to:-
- Biting abnormalities or abnormal tooth grinding
- Toothbrush abrasion i.e. the wearing-away of enamel and/or recession of gums caused by over-enthusiastic or incorrect brushing
- Dietary erosion — the destruction of enamel by acidic food and drink or by acid regurgitation from the stomach
- Habit – nail biting or the placing of metal objects between the teeth
- Attrition – the wearing away of enamel by tooth grinding.
2.
Gum recession exposing the softer porous tooth structures called dentine and cementum. This may be related to:
- chronic gum (periodontal) disease
- surgery – difficult tooth extractions
- incorrect tooth brushing.
Sensitivity and dental pain can also be experienced for a number of other reasons:-
- Chipped teeth
- Fractured or cracked fillings
- Dental decay (caries)
- Deep fillings
- Cracked teeth.
What can you do?
- Clean your teeth thoroughly but carefully once or twice a day. Chewing a disclosing tablet (obtainable from chemists) after brushing will show you if you have left any plaque behind
- Make sure that you use the correct brushing technique, If you need advice as to the best technique for you ask your dentist or hygienist
- Use a specialist toothpaste formulated for sensitive teeth
- Watch what you eat: a high intake of acid-containing food and drink such as citrus fruits and fizzy drinks will make your teeth more sensitive and can lead to destruction of the tooth enamel.
What can your dentist or hygienist do?
Your dental professional can tell you whether you are brushing correctly and give helpful dietary advice.
He or she can also:-
- Apply fluoride varnish to exposed sensitive dentine or cementum
- Apply a sealer to exposed root surfaces to block the tiny tubes which are exposed or offer treatment that will desensitise the dental nerves (no drilling is required)
- Correct any bite abnormalities to help reduce the wearing of enamel
- Place fillings to cover exposed dentine or cementum on root surfaces.
Other dental treatment may be necessary and options should be discussed with your dentist.
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