What are sensitive teeth trying to tell us?

Teeth can’t talk, but they still tell us when they feel stressed or weak. In fact, teeth talk to us with sensitivity. We feel pain from hot, cold or sweet because our nerve has gotten overly sensitive (inflammation). In healthy teeth, a strong, protective layer of enamel acts as a shield. Healthy enamel insulates teeth from temperature changes and sweets. However, weak or damaged enamel leaves nerves exposed. Although it feels miserable, it helps us that our nerves are so sensitive. Their sensitivity tells us  when our teeth are at risk.

Four conditions that cause teeth sensitivity:

1. Enamel Erosion

Enamel erodes or dissolves away when it is regularly exposed to acids or grinding forces. Acids that hurt teeth include acidic foods and beverages, acid reflux, vomiting and the acid that bacteria produce from the sugar we eat. Teeth sensitivity caused by early enamel erosion can often be reversed. Topical fluoride varnishes treat early sensitivity by re-sealing the enamel. Using a toothpaste for sensitive teeth also helps. If tooth enamel erodes too much, the tooth may need a sealant or filling. Sealants reinforce weakened enamel.  Meanwhile, fillings replace lost and infected enamel to prevent a cavity from spreading.

2. Cavities

In their advanced stage, cavities cause terrible tooth sensitivity. They form when enamel erosion allows bacteria to infect the weakened area. In addition, cavities progress faster in people with diets high in sugar and simple types of carbohydrates. Furthermore, cavities cause damage even faster when sugar and carbs are allowed to stay on the teeth. This happens when people don’t brush frequently or thoroughly enough. Moreover, sugar also sits on the teeth too long when people sip or chew on sugary things throughout the day. Small cavities get repaired with simple fillings. However, untreated cavities eventually destroy the outer and inner structure of a tooth and infect the nerve. Larger cavities require crowns to replace lost tooth structure. In addition, infected nerves need to be treated to prevent complicated bone infections.

3. Infected Nerves

Nerve infections cause specific patterns of hot and cold teeth sensitivity. These patterns tell a dentist if the infection just started or has killed the nerve. For many years, root canal treatment was the only solution dentists had for infected teeth besides extraction. During a root canal, the dentist cleans out the infected tissue in the roots of the teeth. While root canals are still appropriate and effective for some teeth, dental implants have become a second option for infected, broken down teeth. Dental implants become a new tooth that can never get another cavity or need another root canal. Therefore, for many patients, a dental implant is the better long term choice for teeth with huge cavities and infected nerves. (Read more on infections being the cause of tooth temperature sensivitity).

4. Recession

Recession happens when the gum tissue around a tooth recedes up the tooth leaving dentin or tooth root exposed. These exposed areas react dramatically to changes with sensitivity. In healthy teeth, gum tissue covers and insulates dentin and tooth roots. On the other hand, when gums recede and leave dentin and roots exposed, these sensitive areas start protesting. In other words, that’s usually why you feel a zing of pain when these areas get hit by air or sweets. As we discussed in more detail on our page on recession, many things cause gum recession: brushing too hard, gum disease and clenching and grinding. Sensitivity in areas with recession can be reduced by applying fluoride varnish to temporarily seal the exposed dentin or root surface. Treating recession depends on what has caused it. Therefore, treating recession-caused sensitivity requires a combination of new toothbrushing techniques, gum therapy or bite therapy.

Can’t I Do Anything at Home to Help with Teeth Sensitivity?

Absolutely! Treating sensitivity always involves the following home remedies:

• Use a toothpaste for sensitive teeth.
• Get an ultrasonic toothbrush: If you can’t resist pressing and scrubbing when you brush, trade in your manual brush for a Sonicare or Oral-B ultrasonic toothbrush. These brushes clean teeth with rapidly vibrating and rotating bristles. Most importantly, many models alert you when you’re pressing too hard!
• Limit sugary and acidic foods & beverages to limit the progression of enamel erosion and cavities.