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Why Do I Have Sensitive Teeth?

Having sensitive teeth is a common complaint. In most cases, tooth sensitivity is a minor annoyance, but for some it can be a chronic problem. It can be hard to know when a sensitive tooth requires a visit to the dentist. Fortunately, most tooth sensitivity is entirely treatable, and easily solved with only basic interventions. In those rare cases where tooth pain requires dental treatment, the pain is usually treatable by a dental professional who can get you back to living your best life quickly.

When To Worry

If tooth pain is accompanied by signs of infection, then you should see your dentist immediately. Below are some examples of things to be on the lookout for if you suspect you may have an infection:

  • Pus / drainage
  • Persistent metallic taste
  • Putrid breath that persists throughout the day even after brushing
  • Swelling and/or redness around the affected tooth
  • Broken, cracked, fractured tooth

Other reasons to see your dentist include:

  • Pain when eating or drinking hot things
  • Continuous throbbing pain, especially if it gets worse when lying down
  • Continuous pain that subsides when consuming cold food or drink
  • Prolonged pain after eating or drinking something cold
  • Tooth pain that accompanies eating or drinking sweets

When Not To Worry

Most tooth pain is simple a case of tooth sensitivity. Usually, tooth sensitivity will resolve on its own, especially if it is the result of a minor injury. Some examples of things that may cause a tooth to become sensitive include:

  • Biting into something hard like a popcorn kernel, gristle, or a bone fragment
  • Injury to the surrounding gum from something sharp like a chip, or a popcorn kernel husk stuck between the tooth and gum
  • Recent dental work, especially a filling or a crown
  • Orthodontic treatment such as braces or aligners, particularly at the beginning of treatment or when an adjustment was made
  • Bleaching / whitening
  • Sinus infection

Chronic tooth sensitivity can affect a patient’s quality of life. For some patients, eating something cold like ice cream is unthinkable. In most cases, this kind of generalized tooth sensitivity is caused by gum recession.

Gum recession

As gums recede, they reveal parts of the tooth that can be very sensitive. Tooth enamel is not just the hardest substance in the body, it also protects teeth from sensitivity. The enamel of teeth can’t feel sensation, but other parts of the tooth can. In this way, enamel acts like a protective barrier against sensitivity. When gums recede, they expose the roots of the teeth where there is no protective enamel. The roots of teeth can be very sensitive, especially to cold.

Tooth Anatomy

Enamel Loss or Damage

Another way teeth become sensitive is through loss of enamel. Beneath the protective layer of enamel is the second layer of the tooth, called the dentin. Tiny fluid-filled tubes run through the dentin, and this is how teeth feel hot and cold. If the enamel is worn away or damaged, then these tiny fluid-filled tubes are exposed directly to the outside world, causing sensitivity.

Some common causes of chronic sensitivity are:

  • Gum recession
  • Enamel loss
  • Cracked teeth
  • Small cavities
  • Dental work

How Can I Treat My Sensitive Teeth?

Sensodyne Toothpaste for Sensitive Teeth

In most cases, tooth sensitivity is easy to treat. Your dentist may recommend a special toothpaste to reduce sensitivity. Sensodyne is the go-to recommendation for most dentists. Note that it may take up to six weeks for desensitizing toothpaste to work. For the record, Sensodyne does not compensate me for recommending their products.

When over-the-counter toothpastes improve sensitivity, but don’t stop symptoms entirely, your dentist may prescribe a toothpaste. The concentration of the active ingredient potassium nitrate is the same in both the over-the-counter and the prescription toothpastes. However, prescription toothpastes are low abrasion and have a higher concentration of fluoride, these attributes enhance desensitization of the toothpaste.

In some cases, your dentist may recommend using a dentifrice like MI Paste which has been shown to help reduce certain kinds of tooth sensitivity. Because MI Paste re-mineralizes enamel, it is especially effective for sensitivity following whitening / bleaching, or when there is damage to the enamel.

In more difficult cases, simply applying a desensitizing agent to the tooth, and then covering up the exposed root surface with a thin layer of protective film can resolve sensitivity. This minimally invasive approach must be done by your dentist. Because it requires few materials and very little time in the chair, the treatment is very inexpensive.

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