Posts for tag: sensitive teeth
You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.
Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.
There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.
Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.
Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.
If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.
If you would like more information on tooth sensitivity and how to treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”
“We all scream for ice cream,” the saying goes. But what if eating ice cream — or any very cold or hot food — literally makes you want to scream because your teeth hurt so much?
What causes sensitivity in teeth?
Understanding the anatomy of a tooth helps explain what happens when a tooth becomes sensitive to heat and cold. A tooth is composed of three types of tissue: a hard outer shell of enamel, the body of the tooth composed of the dentin, and an interior tissue of the pulp.
Enamel: The enamel forms the outside of the crown, the part of the tooth you normally see. Made of densely packed crystals of calcium, it is resistant to wear. It is not living tissue, and does not contain nerves, but it is capable of transmitting temperature like hot and cold.
Dentin: Inside the tooth's crown and root is a living tissue called dentin, which is a porous structure similar to bone. It is composed of microscopic tubules containing living cells, which are encased in a hard substance made of calcium crystals.
Pulp: The living dentin transmits sensation through to the pulp, which is in the center of the tooth and contains the tooth's blood vessels and nerves.
A tooth's enamel normally protects the dentin from exposure to extremes of temperature and pressure. If you wear away the enamel and expose the dentin, it will pass sensation through to the nerves in the pulp more directly. The result can range from a twinge to an excruciating pain.
Sensitivity can be caused by:
- Overzealous tooth brushing resulting in enamel wear and consequently dentin exposure and wear.
- Enamel and dentin erosion by acids in the foods and beverages you eat and drink.
- Tooth decay — the most common cause of sensitivity. Decay destroys enamel and dentin inflaming and infecting the living tissues of the pulp, which become increasingly painful.
What can you do to make your teeth less sensitive?
- Use a soft bristle tooth brush, and brush the affected teeth gently to remove all bacterial plaque. We can advise you on safe and effective brushing techniques.
- Use toothpaste that contains fluoride. Fluoride strengthens tooth surfaces and makes them more resistant to sensitivity and decay.
- Ask us about professionally applied fluoride varnishes or filling materials that can cover and replace sensitive or lost tooth structure.
Of course, if the problem is caused by tooth decay, make an appointment with us to remove the decay and place a filling in the sensitive teeth.
If you wince while eating certain foods and beverages, you're not alone — one in three Americans suffer from the pain of tooth sensitivity. Fortunately, there are ways to treat it and reduce the pain.
Dentinal hypersensitivity occurs when dentin loses its protective cover. Dentin, a living tissue within a tooth, is composed of tiny tubules that act as conduits for transmitting sensations from the surface of the tooth to the nerves in the inner pulp. These tubules are protected by cementum, a hard, outer layer that covers the tooth root. But when the root becomes exposed, the cementum is easily stripped from the root. The tubules become more sensitive to sensations of temperature or pressure.
Receding gums are the main culprit for root exposure. This condition can result from periodontal disease, which arises mainly from poor oral hygiene. At the other end of the spectrum, over-aggressive brushing can lead to receding gums. Brushing may also contribute to another source of dentinal hypersensitivity: enamel erosion. The minerals in enamel begin to soften and erode as the acidic level of the mouth rises. Saliva neutralizes the acid and can restore a neutral balance in about thirty minutes to an hour after eating. If you brush before this process completes, you could brush away some of the softened enamel.
To properly treat tooth sensitivity, our first step is to find the cause. If it stems from improper or premature brushing, we can counsel you on proper technique. If periodontal disease is a factor, we would first treat the disease and then work with you on a proper oral hygiene regimen to reduce bacterial plaque, the main cause of the infection.
There are treatments as well to reduce nerve sensitivity and thereby ease the pain. Toothpastes and other mouth products with fluoride help reduce sensitivity, as well as products containing potassium nitrate or potassium citrate. We can also apply a varnish containing a concentrated dose of fluoride directly to tooth surfaces. Another approach is to block the tubules using bonding agents or sealants; this will reduce their capacity to receive and transmit sensations.
If you would like more information on the causes and treatment of tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treatment of Tooth Sensitivity.”
In a healthy tooth, a coating of enamel protects the crown — the part above the gum line — and a layer of cementum protects the tooth root below the gum line. Enamel and cementum are inert (nonliving) substances that do not respond to stimuli such as heat or cold; however, dentin, the living tissue below them, does. Dentin contains numerous microscopic tubules that readily transmit stimuli toward the nerve-filled center of the tooth (pulp tissue). Loss of protective enamel or cementum leaves dentin exposed to all sorts of stimuli in the oral environment, which can trigger “dentinal hypersensitivity” — anything from a mild twinge to shooting pain.
Fortunately, there are many options for treating hypersensitivity. The key to selecting the most appropriate one(s) is determining the cause(s). Some of the more common reasons for sensitivity due to dentin exposure include:
- Enamel erosion caused by an “acid attack” related to external (extrinsic) causes — i.e., consumption of acidic beverages/food — or internal causes — i.e., regurgitation of stomach acids due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia
- Using an overly abrasive brush or toothpaste, brushing incorrectly or too frequently, or brushing too soon after an “acid attack” — all of which can result in a loss of enamel
- Tooth decay (dental caries or cavities)
- Tooth fracture or chipping: tooth grinding (bruxism) is a common cause
- Worn fillings
- Gum recession, due to age or improper tooth brushing, that exposes the tooth root
- Gum disease, which can result in gum recession
Sensitivity can also occur following a procedure like treating a cavity. Normally it subsides within a couple of weeks or so but if it continues there may be another underlying cause.
Whatever the source(s) of your discomfort, our office can get to the bottom of it and recommend an effective course of treatment that meets your personal needs!
If you would like more information about tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”
It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.
What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).
The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.
What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.
What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.
Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.
How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.