Sensitive Teeth

The causes of tooth sensitivity are varied but they may include the following causes:

  1. Abrasion, which is the loss of tooth substance, may occur as a result of an aggressive tooth-brushing habit making the gums recede and exposing the softer dentine of the root surface.
  2. Other habits such as pipe smoking, holding pins or other hard objects between the teeth or chronic nail biting can also cause loss of tooth substance.
  3. Attrition is loss of tooth substance or of the tooth's restoration, as a result of excessive wear through abrasive diets, habitual grinding or clenching of the teeth. Attrition of the biting surfaces may result in excessive pressure causing hairline fractures within the tooth or restorations.
  4. Erosion is the progressive loss of hard dental tissues by a chemical process. Enamel may be dissolved by acids in the diet and through excessive consumption of the following items: Fruit juices and fruit teas, Smoothies, Fizzy drinks, Alcoholic drinks such as wine, cider, alcopops, Vinegar based salad dressings, Citric fruits
  5. Other causes of tooth erosion followed by sensitivity include various medical disorders such as Hiatus Hernia, Bulimia, or Alcoholism all of which involve chronic acid reflux and vomiting.
  6. Cavities caused through decay and old ‘leaky’ fillings should be addressed.

 

Management of sensitivity involves placement of a 'barrier:'

In the absence of obvious tooth decay or leaky fillings, the ‘barrier’ may take the form of chemical applications to ‘hardened’ the root surface

  1. Daily applications of fluoride or sensitive formula toothpastes
  2. Concentrated applications of fluoride in the dental surgery
  3. In severe cases the dentist may need to place a filling or gum graft over the exposed root
  4. Modify habits to prevent further recession and sensitivity

 

Advice on Daily home Care:

  1. Twice-daily brushing with a fluoride toothpaste or a toothpaste for sensitive teeth. Fluoride protects exposed root surfaces from increased risk of decay. Fluoride also acts as a de-sensitising agent, and the filler content in toothpastes blocks the end of the tubules for a short time after brushing.
  2. Regularly using a fluoride mouthwash may also provide relief, particularly if used at a different time of the day to conventional tooth-brushing, to maximize applications.
  3. Adjusting habits: If an abrasive technique has been responsible for the exposed dentine then this needs to remedied with the appropriate instruction, or perhaps by switching to an electric toothbrush.
  4. Restrict the intake of acidic foods and drinks to preferably to mealtimes in order to minimise exposure and allow teeth time to recover.
  5. Sugar-free gum or cheese at the end of a meal can be useful in neutralising acids.

 

At the Dental Surgery:

  1. Fluoride varnish can be applied, but needs to be repeated regularly.
  2. White filling materials can be bonded to the tooth's surface.
  3. A mouthguard can made if grinding has been the cause of the exposed dentine.
  4. In extreme cases the tooth can be root-filled to ‘deaden’ the nerve supply.

 

Note: Tooth bleaching/whitening may increase tooth sensitivity.