Many patients come to see me with complaints of tooth sensitivity. It can range from annoying to mind numbingly painful. My job as a dentist is to figure out the cause and then to fix it. Sometimes sensitivity has a very obvious cause like a broken tooth or a cavity. Sometimes though, it is more difficult to diagnose the reason.
When a person has gum disease bacteria will destroy the bone supporting the teeth. Eventually the gums will recede and the roots of the teeth are partially exposed. Since there is no enamel covering the roots they can be very sensitive to hot, cold and touch. Another case where teeth are sensitive up near the gum line happens when someone clenches or grinds their teeth. The very thinnest part of the enamel up by the gums breaks off and then vigorous tooth brushing can wear away the root to form a notch. Sometimes these areas can be hypersensitive. If not kept clean they can also be a place where a cavity can form. In extreme cases they can weaken the tooth so much as to risk the tooth breaking off!
Grinding your teeth is another common cause of sensitivity. Years of grinding can expose the inner, more sensitive layer of tooth called the dentin. Some people experience cold, hot, or chewing sensitivity. Hard food such as chips or seeds can give quite a “zing” when chewing where there is exposed dentin.
Fortunately there are treatments for tooth sensitivity. Sometimes, if decay is present the treatment may consist of a filling, or even a root canal or crown. If the sensitivity is from grinding and clenching we may recommend a nightguard to prevent further damage. If no decay or structural damage is present I like to take a stepwise approach. I recommend toothpaste for sensitive teeth first. If the sensitivity is mild, sometimes this is all a patient needs to do. From there we may place a desensitizing medicine in the office, recommend a fluoride treatment, or even a filling to stop the sensitivity. It is best to have a conversation with your dentist to figure out what treatment is best for you.
Tooth sensitivity is quite literally a pain, but it is comforting to know that your dentist can give you relief!