Sensitive Teeth

Introduction

Are you feeling a sharp pain or discomfort when you eat or drink something that is hot, cold or sweet? Most of us have experienced this type of pain. It is called “Tooth sensitivity” or” Sensitive Teeth”. This is due to wearing away of the tooth surface or gum tissue. Tooth sensitivity can be the first warning sign of a more serious dental disease that has to be treated.

Normal tooth Anatomy

A tooth has two main parts: a crown portion and a root portion

The different parts of a tooth consist of:

• Enamel: Enamel is the highly mineralized and hard outer substance of the tooth. Its colour varies from light yellow to greyish white.
• Dentin: Dentin is that part of the tooth which is present between enamel or cementum and pulp chamber. It is softer than enamel and therefore decays more rapidly.
• Cementum: Cementum is a bony substance covering the root of the tooth. Its colour is yellowish and is softer than dentin or enamel. The main function of cementum is to serve as a medium for periodontal ligaments to attach to the tooth for stability.
• Pulp: The dental pulp is the centre portion of the tooth. It is filled with soft connective tissue which contains blood vessels and nerves .It is commonly called the “nerve of the tooth”.

What is tooth sensitivity?

Tooth Sensitivity is sharp, sudden and shooting pain in one or more teeth, which is increased by hot, cold, sweet or sour foods and drinks.

Types of tooth sensitivity

• Dentinal Sensitivity: This occurs when the dentin layer of tooth is exposed. It can affect one or more teeth.
• Pulpal Sensitivity: This is a reaction of the tooth’s pulp. It affects only a single tooth.
• Signs
• Discoloration or yellowing of teeth can occur
• The tooth appears transparent
• Edges of teeth start to crack

Symptoms

The most common symptom is sensitivity – short, sharp pain that occurs when consuming cold, hot and sweet foods or drinks.

Causes

• Caries
• Gum disease
• Brushing too hard
• Plaque
• Chipped or broken teeth
• Regular intake of high acid content foods (e.g. citrus fruits, pickles etc.)
• Poor oral hygiene
• Use of tooth whitening products
• Grinding of teeth may wear down enamel exposing the dentin.
• Dental procedures (teeth cleaning, and tooth restorations; the sensitivity caused is temporary)

Risk Factors

• Dental caries, dental fractures or cracks
• Excessive intake of citrus fruits and juices.
• Over brushing
• Grinding of teeth
• Dental procedures

Diagnosis

Dental history and examination of teeth with explorer to look for any caries, fillings and exposed roots. X-rays can help to detect teeth that are constantly under trauma. Your Dentist will ask about your oral habits. Bruxism is a habit some people have of grinding their teeth at night or when under stress. Others might clench their jaws or clatter their teeth. This may cause severe wear of the teeth, pain in the jaws or cracked teeth. Generalized sensitivity can be a symptom of this condition. A tooth may be sensitive to cold for several weeks after a filling is placed. The metals in amalgam (silver) conduct the cold very well transmitting it to the pulp.

Treatment

• Dentinal sensitivity – Cleaning of teeth and application of fluoride varnish.
• Pulpal sensitivity – will be treated with a root canal if the tooth’s nerve is damaged .The nerve will be removed and a nonreactive substance will be placed in the space where the nerve was.

In Office Procedures

• Fluoride varnish can be applied to exposed areas to strengthen enamel and dentin.
• Fluoride gel can be placed in to a mouth tray, and then placed in the patient’s mouth for 3 to 5 minutes, providing the teeth with high concentration of fluoride to strengthen the areas.
• Bonding agent, a material used to stick tooth coloured fillings to teeth, can be used to seal the dentin surface that cause sensitivity.
• Dental laser is a newer approach to treat sensitivity. The laser treatment alters the dentinal tubules to reduce sensitivity.

At Home

• Use a very soft bristle toothbrush and brush correctly.
• Use fluoride tooth paste and mouth washes.
• Stop snuffing: Chewing tobacco, also known as snuff, is a popular habit among many teenagers. This causes the gums to recede, leading to gum sensitivity and decay.
• To reduce pain due to grinding or clenching, a plastic night guard is used while sleeping.

Prevention

Some steps you can take to reduce tooth sensitivity include:

• Oral hygiene:
  • Use of soft bristled tooth brush
  • Use of fluoridated tooth paste
  • Use of fluoridated mouth washes
  • Maintain good oral Hygiene every day
• Dietary modifications:
  • Watch what you eat: Frequent consumption of highly acidic foods can gradually dissolve tooth enamel and lead to dentin exposure. This may also aggravate the sensitivity and start the pain reaction.
• Other preventive Measures:
  • Avoid teeth grinding: If you grind or clench your teeth use a mouth guard.

Check-ups

• See your dentist at regular intervals
• Prognosis depends on the person and situation. Some individuals may have short term sensitivity while others have long term sensitivity. The outlook is different depending upon the cause of sensitivity.
• Although every effort is made to educate you on tooth sensitivity and prevention .Talk to your dentist or health care provider about any concerns you have about tooth sensitivity.