Tooth Sensitivity: The How, The Why and The Treatment
Tooth pain is no picnic. In fact, pain from pulpitis (inflammation of the tooth nerve) is classified as the second most severe pain that a human can feel, second only to passing kidney stones.
Pain from teeth sensitivity is nowhere as severe as pulpitis pain, but can still be quite annoying, taking the fun away from simple everyday activities such as having a cup of hot coffee, or a cold scoop of ice cream.
Dr. Adesanya, heralded as one of the best dentists in Bowie, Maryland, explains the cause of tooth sensitivity:
“ The human tooth is quite a fascinating structure. It is formed of multiple layers, the outermost of which (called the enamel) is almost entirely made of calcium, so is quite insensitive and responsible for the protection of the tooth. The layer under that is known as the dentin and forms the main mantle of the tooth. Unlike the enamel, dentin is very sensitive, therefore when the enamel gets broken or chipped away, exposing the underlying dentin, that’s when the pain and sensitivity start.”
What Causes Enamel Wear and Tear/Dentin Exposure?
- Tooth decay:
It is obvious that the first reason for tooth sensitivity is tooth decay, which eats away at the strong enamel. When the decay has been present for a while without intervention, the enamel dissolves from the surface of the tooth, leaving the dentin to deal with the oral environment, and the pain starts. A fact that is quite unknown to most people is that tooth decay doesn’t have to cause a cavity in the tooth, which means the tooth could be ravaged by decay and you may not even know it. This decay isn’t always visible to the human eye but is something that would be visible on an x-ray. For tips on brushing and flossing, check out our blog on Demystifying Oral Hygiene or schedule an appointment with one of our hygienists.
- Teeth grinding:
Another very common reason for tooth sensitivity is teeth grinding. The continuous friction between the upper and lower teeth gradually wears away the protective enamel layer, and eventually all the enamel disappears leaving the exposed dentin. This means that any cold or hot food or drink would cause pain.
- Cracked Tooth:
This is the most difficult case, not because the pain is more severe, but because it is the most difficult to diagnose. A crack has no visible clinical symptoms (apart from some sensitivity of course), and it also doesn’t show up on an x-ray. So, the only way the dentist could accurately diagnose the condition is a process of exclusion of all other causes of pain and sensitivity. The treatment is also quite aggressive, as it can only be treated by covering the tooth with a crown or even an extraction might be necessary.
- Pockets and gum recession:
This cause is unrelated to enamel, but is also due to exposure of dentin, this time that of the root rather than the crown. The root of the tooth is also mainly formed of dentin but is covered by the gums rather than the enamel. So, when the root gets exposed (as in cases of pockets or gum recession) it is only common sense to assume that sensitivity would ensue.
- Charcoal Toothpaste:
You read that right, charcoal toothpaste is a cause for enamel wear and tear leading to tooth sensitivity despite its claims otherwise. In fact, Dr. Adesanya, along with the American Dental Association, warns against the use of charcoal toothpaste. Charcoal is too abrasive and can cause enamel erosion leading to dentin exposure.
Treatment and Prevention of Tooth Sensitivity
As Dr. Adesanya always says, prevention is better than cure. It is so much easier to prevent sensitivity than deal with its ramifications and treatment options. Prevention mainly consists of removing the causes of sensitivity, that is achieved through:
- Proper oral hygiene:
Brushing and flossing, together with a fluoride containing toothpaste go a long way as to prevent decay, as well as gingivitis and pockets. The proper way of brushing is also important. Vigorous or improper brushing could lead to gum recession and subsequently sensitivity.
- Night guard:
A plastic or rubber stent that is worn on top of teeth, especially at night, to prevent teeth grinding. This in turn prevents wear of enamel as well as tooth cracks which are two of the main reasons for sensitivity.
If the problem already occurred, here is how you could treat it:
- Fluoride application:
The first line of treatment of sensitivity is closing away the sensitive pores of the dentin with fluoride. Fluoride is applied either at home through toothpastes and mouthwashes, or professionally through varnishes and gels in the dentist’s office. Dr. Adesanya recommends that if your tooth is a little sensitive, after brushing your teeth, place a small, pea sized amount of toothpaste on your finger and rub it into the gum area of your sensitive tooth. This can help ease some of the discomfort.
The remedy could be as simple as removing the decay and covering the exposed dentin layer with a small filling. This, of course, is for simple cases but doesn’t quite work with largely exposed dentin areas.
A crown is a cap that is cemented on to your tooth to restore the tooth’s shape, size and strength. There are a number of reasons you may need a crown; exposed dentin is one of them. Covering the entire tooth with a crown would surely shield the dentin from exposure to hot and cold foods and drinks, and therefore no sensitivity would be expected.
Family Dentist in Bowie, Maryland
With patients that call Dr. Adesanya the best dentist in Bowie, Maryland, he takes pride in his work and in the level of care he provides to every single patient. With a focus on general and cosmetic dentistry, Dr. Adesanya’s goal and mission is to provide you and your family with the highest quality dental care in a caring, safe and relaxed environment.