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SENSITIVE TEETH
Patients often complain about tooth sensitivity, but due to a
lack of dental knowledge and available public information on the
subject, they don't always find adequate relief. Following is information
about the major causes of tooth sensitivity, along with the procedures
and products used in reducing or eliminating this dental condition:
 Biting
Pressure
Exposure
to Cold
Exposure
to Heat
Exposure
to Sweet
Exposure
to Sour
Receding
Gum Line
Dental
Compression Syndrome
Abusive
Brushing
Carbonated
Cola Beverages
Tartar-control
Toothpaste
Bulimia
Biting Pressure
Individual teeth that make initial or premature contact with an
opposing tooth during biting or clenching movement can become very
sensitive. A newly placed filling that doesn't feel quite right
or an improper bite (malocclusion) can cause sensitivity. Excessive
clenching and grinding (bruxism), brought on by emotional stress,
is sometimes responsible for teeth becoming sensitive. A crack in
a tooth that extends into the nerve will also result in biting pressure
sensitivity. If the tooth develops a gumboil (abscess or infected
periodontal pocket) the tooth can also become sensitive to biting
pressure. Teeth that are decayed or chipped, as well as those with
leaking fillings are subject to sensitivity. Painful teeth with
these conditions require professional help. Early treatment can
prevent needless long-term suffering and expense.
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Exposure to Cold
As with biting pressure, teeth having premature biting contact can
become very sensitive to cold. Deep decay close to the nerve, leaking
fillings, and receding gum line problems can result in a painful
response to cold.
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Exposure to Heat
Painful response to heat almost always means that the tooth in question
has a serious problem - usually irreversible nerve damage. A tooth
that is painful to heat stimulus is generally infected and attention
should be sought immediately. Treatment options for infected or
damaged nerves are root canal therapy or extraction. The exception
is sinus infection or blockage. Upper back teeth can become painful
as the roots of these teeth lay close to the sinus. These teeth
are otherwise healthy and should not be treated until a sinus condition
is ruled out.
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Exposure to Sweet
Painful response to sweet is a result of decay, leaking filling,
or gum line problems. By habit, certain products such as breath
candies, chewing tobacco, or gum are often placed in the same location
in the mouth. Their sugar content, combined with plaque debris,
allows the tooth to demineralize (dissolve) and decay - especially
in gum line areas. People using these products are urged to change
their destructive habits. Sweet sensitivity is commonly the "wakeup
call" for seeking professional help.
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Exposure to Sour
Teeth frequently exposed to citric acid will often become demineralized
and sensitive. Naturally occurring citric acid is found in lemon,
lime, orange, and grapefruit juices. Habits such as sucking on lemon
slices should be strictly avoided.
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Receding Gum Line
Gum tissue can recede around the tooth and a sensitive tooth layer
just beneath the root surface can become exposed. This sensitive
tooth layer (dentin) comprises the vast majority of tooth structure
and is comprised of a fine network of microscopic canals filled
with tiny nerve fibers. Dentin is relatively soft and vulnerable
to trauma, such as abusive tooth brushing, acidic mouth fluids,
food debris, and microorganisms (plaque). Invasion of these substances
into the open dentin canals often causes severe sensitivity. Some
patients complain of sensitivity with only minor gum recession,
others report having no sensitivity with major gum recession and
exposed dentin.
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Dental Compression Syndrome
This problem results in the breaking away of tooth structure at
the gum line and the biting surface due to the tooth bending and
flexing from excessive clenching and grinding forces (bruxism).
V-shaped notches near the gum line and crater-like depressions on
the biting surface of back teeth, that can cause chronic sensitivity,
characterize these crater-like defects. Over time, clenching and
grinding becomes quite destructive, requiring extensive tooth rehabilitation.
Protective mouth guard appliances are often recommended to control
the problem after defects are restored.
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Abusive Tooth Brushing
Notches at the gum line can be cut by the ends of synthetic toothbrush
fibers when used in a harsh, back-and-forth brushing motion similar
to the sawing action on a piece of wood. Patients are advised to
eliminate such abusive tooth brushing habits as soon as they are
observed and start brushing with a soft brush in circular motions.
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Carbonated Cola Beverages
Both regular and diet cola soft drink beverages contain a low pH
chemical (phosphoric acid). It is not uncommon for some individuals
to consume a dozen or more of these teeth-destroying beverages per
day (like Coke and Pepsi). Tooth enamel will demineralize (dissolve)
when continually exposed to these beverages, leaving them horribly
mutilated and susceptible to decay. When patients complain of gum
line tooth sensitivity, they should question their consumption of
colas, as well as other acidic beverages like fruit juices. Individuals
consuming any low-pH beverages in excess should reduce consumption
and rinse their mouths with water frequently.
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Tartar control toothpaste
This form of toothpaste contains pyrophosphates, which often cause
gum - line tooth sensitivity. If teeth become sensitive when using
tartar control toothpaste, patients are advised to avoid all toothpaste
for at least two weeks - using only toothbrush, water irrigation,
and floss for oral hygiene. When sensitivity is reduced, patients
are advised to begin using toothpaste without pyrophosphates.
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Bulimia
Bulimia is a common disorder, primarily affecting women who attempt
to reduce or control their weight by vomiting - sometimes several
times per day. Tooth enamel is demineralized (dissolved) very rapidly
by the continual presence of low-pH stomach fluids (hydrochloric
acid) in the mouth. This can cause severe tooth sensitivity, to
the degree that even the slightest temperature change is intolerably
painful. If bulimia is suspected, professional medical help is needed
immediately.
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PROCEDURES AND PRODUCTS FOR REDUCING OR ELIMINATING
GUM LINE TOOTH SENSITIVITY
Reducing
or removing the off-ending factors that cause sensitivity is the
first step. Clinical procedures are unnecessary if patients can
accomplish tooth desensitization themselves.
In
mild sensitivity cases, over-the-counter tooth-desensitizing toothpaste
can be used. There are numerous brands on the market. Some examples
are Sensodyne and Crest for Sensitive Teeth. Both
contain low concentrations of fluoride, allowing them to be dispensed
without a prescription. Their therapeutic value is sometimes less
than ideal, but can be used in combination with the reduction of
tooth sensitizing habits.
The
next step is to place affected patients on highly fluoridated toothpaste.
Colgate Prevident 5000 is prescription toothpaste containing
five times more fluoride than most over-the-counter toothpaste,
which is also highly effective in preventing decay.
Application
of dentin-bonding agents to affected tooth surfaces is the most
commonly performed clinical procedure employed to control gum line
sensitivity. Highly sensitive teeth are typically anesthetized,
and then a chemical resin bonding liquid is used to close off the
dentin canals, sealing the sensitive nerves from trauma.
CONCLUSION
One of the most common, yet avoidable, dental problems is tooth
sensitivity. After personal habits that lead to tooth sensitivity
are reduced or eliminated, clinical procedures can then control
any remaining tooth sensitivity. Clinical desensitization procedures
are well accepted by patients and bring welcomed pain relief.
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925.692.2010