Sensitive Teeth: Is this normal and how can I fix it?

Imagine this, you’ve just finished dinner and decide to head over to the fridge to grab an ice-cream as a post dinner treat. As you bite down, you feel a zap-like jolt or pain coming from one or more teeth. The pain is momentary, but it keeps re-occurring with each bite.

You then go and brush your teeth before hopping into bed, again that same ache occurs from the cold running water and the motions of brushing. Once you’ve finished brushing your teeth the discomfort and pain goes away.

What is happening? Is this normal?

Tooth sensitivity – it is extremely common and can go untreated in many individuals.

What are sensitive teeth?

Tooth sensitivity is a common name for dentine hypersensitivity and can result in a pain like sensation when the tooth is exposed to cold, hot, sweets, acidic or sour food and beverages. This pain can be mild (like a tingle) or a short and sharp pain shooting through the inside of your tooth (‘nerve pain’). The pain then dissipates as soon as the stimulus is removed.

What are some different triggers?

• – Cold air
• – Cold/hot food and beverages
• – Acidic foods and beverages
• – Sour foods and beverages
• – Brushing teeth: especially when using a medium/hard or electric toothbrush
• – Mouth wash

Why are my teeth sensitive?

In order to understand the mechanics of tooth sensitivity, it is important to understand the anatomy of our teeth.

Our teeth are made up of 3 predominant layers. This includes the:

• – Enamel: This is the hard outer layer of the tooth and covers the top portion of the tooth. The enamel is very dense, composed of a crystalline structure that protects the dentine and pulpal layers. It serves primarily as an insulating barrier that protects the tooth from physical, chemical and thermal forces. The white shiny surface that we can see in the mirror is our enamel.

Fun fact: enamel is one of the hardest substances in our body

• – Dentine: This is the second or inner layer of the tooth and makes up the majority of the tooth. The dentine is comprised of a multitude of tubules (dentine tubules) which connect from the outside of the tooth to the inside of the tooth (pulp). Dentine is generally a yellow/orange colour.
• – Pulp/nerve tissue: This is the most inner layer of the tooth and consists of the nerve tissue and blood supply. Having a nerve and blood supply means that our teeth are essentially ‘alive’ and can be subject to different sensations such as pain.The other surrounding support structures for the tooth include the gums and the underlying bone. The roots (or ‘legs’) of our teeth sit in the bone and the gums cover the bone, the top portion of the roots and a portion of the tooth enamel (only marginally).Dentine hypersensitivity

Over time, our gums can become damaged or recede as a result of age, gum disease or brushing too hard. This exposes the root surfaces of the tooth and the underlying dentinal tubules which can react when they come into contact with cold, hot, acidic, sour or physical stimuli (such as brushing or touching the tooth).It is important to note that not everyone experiences sensitivity to the same degree. Some individuals may experience a lot of sensitivity when a small amount of dentine is exposed, whereas others may not experience anything at all for the same amount.

What causes our teeth to be sensitive?

Of course, it’s not fair or expected you’d have to avoid all the good pleasures in life such as ice cream to escape sensitivity – so by understanding why our teeth are sensitive, we can work out ways to minimise the symptoms.

Tooth wear, is reasonable for the majority of tooth sensitive cases.

Here are a few reasons why your teeth might be sensitive:

1. Worn tooth enamel from brushing too hard or using a hard/medium bristle brush

Although our enamel is one of the hardest substances in our body, it can still be worn away. Remember when brushing your teeth, it is important to use a soft bristle brush and apply gentle pressure. Don’t brush your teeth like how you would scrub our pots and pans. If you’re using a scrubbing motion – you’re doing it wrong.

Some of us are actually stronger than we think, so if you find it hard to control the pressure, it may be time to consider an electric toothbrush. Technology in certain electric toothbrushes now come with pressure sensors to indicate if you are applying too much pressure on your teeth.

2. Dental erosion

Dental erosion is caused from exposure of our teeth to a highly acidic environment. This can be due to the acidic foods we consume or underlying health conditions such as reflux.

Drinking water after consuming acidic foods and beverages can help with increasing salivary flow and diluting the acidic levels in your mouth. If your dental professional has mentioned you may have dental erosion, considerations such as not brushing straight after a meal/beverage can be helpful in limiting further erosion.

3. Tooth decay/ broken teeth/ worn down fillings

Tooth decay, broken teeth or worn-down fillings can cause exposure to the inside of the tooth, which can result in sensitivity. The tooth therefore may require fillings to replace the missing tooth structure and protect the exposed dentine.

4. Gum recession

Gum recession can be a result of brushing too hard or a result of gum disease. Plaque and calculus that builds up near the gum line has the potential to push the gums down further. This exposes the underlying root surfaces which are not covered in enamel. Regular professional dental cleanings are important to remove the build-up in a timely manner before they cause damage to the gums.

5. Grinding or clenching your teeth

Grinding your teeth can cause serious wear to your teeth. This can cause your enamel to be slowly worn down over time exposing the underlying dentine. Similarly, clenching forces are also cause areas of the enamel to break off (most predominantly near the gum line). This is known as ‘abfraction’.

Treatment for clenching and grinding include construction of a custom occlusal splint (night guard) to protect your teeth from further wear or muscle relaxants in the jaw muscle.

6. Developmental Enamel defects

In some cases, some people are born with weaker enamel. Hypomineralised or hypoplastic teeth are defects in the quality and quantity of enamel respectively and one of the biggest side effects can be sensitive teeth. There are many ways to manage enamel defects, but it is always best to speak to your dental professional to determine which treatment is best.

7. Post-dental treatment sensitivity

This can be a common reason for tooth sensitivity but is usually temporary. After procedures such as large fillings, crowns or even teeth whitening, our teeth can become a little sensitive. These symptoms normally subside within a few weeks post-treatment.

Managing sensitive teeth

Sensitive teeth can often be managed at home first with symptoms resolving within a week or two. The following suggestions may help, however, it is important to speak to your dental professional to see what may work best for you.

1. Desensitising toothpaste: specific sensitive toothpaste such as Sensodyne or Colgate sensitive pro-relief have ingredients in them which can help to block and cover the exposed dentinal tubules, which can improve or in some cases eliminate teeth sensitivity.
2. Soft bristle toothbrushes: Using a soft bristle brush (and even soaking it in warm water to soften it further before brushing) can help as this is much gentler on the gums and won’t irritate them as you brush.
3. Specialised dental products: your dentist or oral health therapist may recommend specialised products such as Tooth Mousse Plus or a higher fluoride toothpaste depending on your circumstances. It is always best to speak to a dental professional before using specialised dental products to see if it is right for you
4. Fillings: If tooth sensitivity cannot be managed with at-home products, in some cases, dental fillings may be required to cover up any exposed tooth or dentinal surface.
5. Surgery: In more severe cases where the gums have dramatically receded and you are unhappy with the appearance of your smile, gum grafting may be a solution to bring back the gums.

If you are experiencing tooth sensitivity or are unsure if you are suffering from tooth sensitivity, contact the friendly team at True Smiles Dental in Marrickville to see if we can find a treatment or solution that works for you. Call us on (02) 7228 7272 or book online at www.truesmilesdental.com.au