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Sensitive Teeth

Overview:

Those of you with sensitive teeth may feel teeth discomfort or pain during the following situations, which include but are not limited to; drinking or eating cold or hot beverages and foods, eating sweets, and touching you teeth.

The two type of teeth sensitivity that occurs are:

  1. Sensitivity of the dentin layer of the teeth, when this layer of the tooth/teeth is exposed. The dentin is the inner layer of the tooth that communicates with the tooth�s pulp via tiny dentinal tubules. When exposed to heat, cold, sweets, and/or touch, these nerves endings cause tooth sensitivity. This dentinal exposure occurs when the outer layer of the tooth is uncovered, and occurs more frequently when there is gum recession and loss of the cementum layer of the tooth surface. It may also occur when the enamel surface of the tooth is absent. Several reasons for dentin exposure are:
    1. Wearing away of the enamel by brushing too hard.
    2. Poor oral hygiene, which allows acid-producing bacteria to dissolve the enamel layer of the tooth.
    3. Tooth wear over a long period of time.
    4. Dental caries that are left untreated.
    5. Faulty and leaking old fillings.
    6. Receding gums caused by periodontal disease or overzealous brushing that expose the tooth's root(s).
    7. Gum surgery exposing the tooth's root(s).
    8. Excessive use of teeth whitening materials, especially if the tooth's root(s) are already exposed; and,
    9. Eating or drinking acidic foods or beverages excessively.
  2. Sensitivity of the tooth's pulpal tissue. Pulp tissue contains blood vessels and nerves in the middle of each tooth, which affects that tooth only. Pulpal sensitivity is due to:
    1. Severe dental caries or infections.
    2. Recent drilling of a tooth.
    3. Excessive tooth grinding or clenching; and,
    4. A broken or cracked tooth, especially if you feel sharp pain when you bite.

Symptoms:

Dentin and pulp sensitivity involves temperature and pressure variations. Cold foods and beverages are the most common culprit, and to a lesser extent hot foods and beverages. When a tooth begins to feel heat, a root canal may be required.

Diagnosis:

Your dentist will take a medical history and then perform a complete oral examination, looking for signs of dental and other oral diseases. Your dentist will check your teeth for sensitivity, and then make the appropriate decision about how to best treat the tooth sensitivity. You tooth can be sensitive for a few days after a filling is placed, however this should subside in 1-2 days. Your test will also be tested to see if it requires root canal therapy.

Duration:

Tooth sensitivity after an amalgam filling may last for a few days to a few weeks. If the sensitivity doesn�t go away by a few weeks, a root canal will most likely be required. Tooth sensitivity could last from several weeks to a month, or may be a problem throughout one�s lifetime.

Prevention:

Dentinal sensitivity could be prevented by:

  • Brushing your teeth twice daily and flossing once a day
  • Modifying your brushing habits; using a soft bristle brush in an up and down motion and not the usual side to side motion.
  • Making sure that your toothpaste and mouth rinses are fluoridated.
  • Using toothpastes specifically designed for tooth sensitivity that is recommended by your dentist.
  • Having treatment if you grind or clench your teeth.

Pulpal sensitivity is usually treated with root canal therapy, and can not usually be prevented. Postponing root canal therapy can lead to more serious problems.

Treatment:

Dentinal sensitivity can be treatable by having your teeth professionally cleaned and then having a fluoride varnish placed on sensitive areas of your teeth. There are also other products that your dentist may place on your exposed dentin to fix the dentinal tubules. At home fluoride mouth rinses and toothpastes can also help. Pulpal sensitivity can be relieved with root canal therapy or adjusting the bite if the tooth is hitting the opposing tooth prematurely. Calling the Dentist: If your tooth sensitivity lasts for more than two weeks, call your dentist. In most cases, dentinal sensitivity is treatable, especially if caught early-on.

Prognosis:

Prognosis depends on the person and the situation. Some individuals may have short-term sensitivity while others have longer-term sensitivity.