Sensitive teeth – help and causes
What's behind the sudden, flash-like toothache and that's what you can do about teeth sensitive to pain.
People suffering from sensitive teeth know the sudden, flash-like pain caused by a mouthful of hot tea, when licking cold ice-cream or caused by biting into a sour apple. It can be estimated that approximately every second person is affected by the so-called dentin hypersensitivity. According to some studies, figures are assumed to be even much higher for those affected.
The reasons for sensitivity to pain are exposed dental necks. Sometimes they are visible; frequently, however, they are only visible to the experienced eyes of a dentist. Either the tooth's enamel is defective or the gums have receded. In any event, the dentin is exposed and stimuli are directly and immediately transmitted to the nerves.
This article will tell you about the most frequent causes for exposed necks of teeth and the causes for sensitive teeth; it will also tell you what to do in the way of prevention and what can help when you have teeth sensitive to pain.
Why do teeth suddenly react so sensitively?
There are different causes for painful teeth. For most people, caries will certainly come to mind. However, teeth are painful much more frequently if the bony substance of the tooth that is underneath the outer layer (enamel) or the so-called dentin is exposed.
With healthy teeth, the bony dental substance is protected by the overlying enamel and sheathed by the gums. That substance is permeated by many small channels – in dental language, they are called dentin tubules. These small, liquid-filled channels transmit stimuli to the inside of the tooth, the pulp. The pulp consists of numerous fine nerve pathways and blood streams.
If the enamel is damaged, especially in the peripheral area at the transition to the gums, or if the gums have receded, the dentin will be exposed. When savouring hot or cold drinks or foods, thermal stimuli will be directly transmitted to the pulp via the small dentin tubules. The nerves in the pulp immediately signal to our brain the flash-like, sharp pain.
But such pain is not only triggered by heat and cold but also by foods. These are mostly sour or sweet dishes. This is also called chemical stimuli. Exactly as with thermal stimuli, these chemical stimuli are transmitted to the pulp through the liquid-filled dentin tubules.
Six causes for sensitive teeth
The development of sensitive teeth is possible due to a large number of triggers. They can be classified in four categories:
- Erosions: Here concerned are enamel damages caused by chemical processes, thus caused by an acid-induced dental enamel erosion. The acids are here e.g. from foods and can dissolve the tooth over time. If this happens permanently, the enamel will become ever thinner, and the neck of the tooth is exposed.
- Abrasions: Enamel is here also affected. However, the damage is due rather to mechanical effects. Enamel is eroded due to pressure or friction; thus, abraded so to speak – e.g. by brushing teeth too intensively or by using the wrong (to abrasive) toothpaste. Here again, the areas on the neck of teeth are frequently concerned so that dentin is exposed.
- Recessions: The term describes the (non-inflammatory) withdrawal of the gums. Once the gingiva recedes, the neck of the tooth is exposed and thus the dentin as well.
- Gingival diseases: Especially the inflammatory diseases of the gums (gingivitis, periodontitis) cause the gingiva to recede. Here as well, the consequences are exposed necks of teeth.
Acidic foods and drinks
People enjoying lemonades, fruit juices and energy drinks will not like the following news item. In case of permanent consumption, acidic drinks will demineralise the dental enamel, rendering it porous and increasingly thinner. Microscopic fissures will be formed so that the enamel has a hard time to protect the dentin and dental nerves from thermal or chemical influences.
Unlike with caries, these erosions occur not by acids produced by bacteria but rather through acid attacks of a non-bacterial origin. Aside from acidic foods and drinks, gastric acid can also result in hydroxyapatite crystals being slowly dissolved from the dental enamel. Accordingly, causes for sensitive teeth can also be reflux, frequent vomiting during pregnancy or bulimia nervosa.
Lack of oral hygiene
The oral cavity has a variety of bacteria which are indispensable for a healthy oral flora. In case of a faulty or non-balanced nutrition, however, harmful bacteria will dominate the so-called biofilm, also named dental plaque. These bacteria produce certain substances which bring about an inflammation of the gingiva. The biofilm deposits especially well in interdental spaces and on the gingival margin. If this biofilm is not removed by brushing teeth daily, gingivitis will frequently develop here. A result of the inflammation will often be a recession of the gums.
Many patients suffering from sensitive teeth or gum problems tend to reduce brushing their teeth or no longer brush them at all. That will be most unfortunate, however, insofar as plaque will lastingly accumulate; it will harden and build up tartar which can only be removed by the dentist. Moreover, the gum inflammation or gingivitis may aggravate and develop to periodontitis. Such periodontitis will affect the entire periodontium – thus the bone as well; and it will not be reversible, but require lifelong therapy. Patients with periodontitis frequently suffer from sensitive dental necks
Wrong tooth brushing technique
However, enamel and gingiva may also be damaged by excessive care. Some people just mean too well in their dental care: They want to be thorough and too forcefully press the toothbrush on their teeth. But the damage will usually be greater than the benefit if the brush also happens to have hard bristles or if teeth are brushed too quickly after eating acidic dishes.
Due to a wrong tooth brushing technique, the dental enamel is downright abraded and the gingiva is injured. Subsequently, the dental necks are exposed resulting in sensitive teeth. If daily oral care results in bleeding gums, this will be a first sign for an inflammation of the gums or even a wrong brushing technique. Either way, consultation of a dentist, dental hygienist or any other expert for prevention is the way to go.
Mechanical pressure may also be a cause of teeth sensitive to pain: For example, if teeth permanently grind against each other while grinding teeth. The consequence of the permanent burden is usually dental damage manifesting itself in various ways. However, here again, dentin is often exposed which will react with pain upon stimuli.
Particularly delicate: Many of the people affected will press their upper jaw on the lower jaw, mostly unwittingly or at night. Their surprise is great when the dentist’s diagnosis is a so-called bruxism. The pressure resulting with so-called teeth grinding is many times higher than that used for chewing foods and it will also last significantly longer. Dental enamel is unable to permanently withstand
Treatments at dentists
Especially after treatment at the dental practice, many patients complain about sensitive teeth. However, this is a normal reaction as a rule which will soon disappear again. Increased sensitivity to pain will be particularly frequent after:
- Professional dental cleaning
- Measures taken for prosthetic devices, such as a dental crown or bridge
- Periodontitis treatment
- Dental bleaching
Professional dental cleaning at the dentist’s office will remove tartar and bacterial coatings on the gingival margin. The gingiva may thus be slightly irritated. This is to be expected – regardless of how good and well-trained the particular qualified specialist is. However, the treatment basically contributes to gingival health which is why professional dental cleaning should not be done without. Moreover, discomforts will decrease considerably after a short period of time already.
Bleaching and tooth whitening
Meanwhile, not only dentists are using methods to whiten teeth. Various applications also exist for tooth whitening at home. In bleaching, teeth are usually whitened with hydrogen peroxide. This substance is used to temporarily “dry” the dental enamel, and gums can also be irritated. As a result, patients frequently react with pain when they consume hot, sour or cold foods and drinks.
It is absolutely necessary that patients discuss any tooth whitening measures with their dentist if they are suffering anyway already from teeth sensitive to pain. Otherwise, the patients’ sensitivity to pain can get even worse.
What helps in case of sensitive teeth?
For most affected persons, it is no long-term option to avoid the irritation and ingest only lukewarm foods and drinks. Affected persons can do a few things to counteract sensitive teeth and get more delight from the pleasurable consumption of all foods.
Whether at home or at the dental practice - the best means of minimising any sensitivity to pain is to preserve tooth substance and gums.
The following 11 tips will provide help with teeth sensitive to pain:
Less pressure when brushing teeth
The correct tooth brushing technique can make a considerable difference for teeth sensitive to pain. Because actually, too much pressure in brushing teeth is frequently applied, or the toothbrush is forcefully moved back and forth while scrubbing. It is better to brush with less pressure from red to white – thus from the gums to the tooth. Also take care of how you hold the toothbrush. If you make a fist, you will soon apply too much pressure. It is better to hold the manual toothbrush just with your finger tips to prevent any damage due to brushing.
Select a suitable toothbrush
A gentle brushing technique will be easier to apply with a toothbrush which is suitable for sensitive teeth. But the selection is rather difficult and should be done in coordination with the experts at the dental practice. After all, even soft bristles might result in abrasions. Moreover, some electrical toothbrushes are provided with sensors to warn you if too much pressure is applied. But here again, the enamel may be damaged if you remain too long on one tooth.
Pay attention to whitening toothpastes
Toothpastes for white teeth are generally characterised by a high percentage of so-called cleaning particles. Many toothpastes also have very hard cleaning particles which actually do remove stubborn deposits but also damage the tooth substance and thus render the sensitivity to pain even worse. Accordingly, rather opt for a toothpaste for sensitive teeth.
Protection by dental enamel
A toothpaste with “artificial enamel” helps reduce hypersensitivity. It contains biomimetic hydroxyapatite which mimics our natural enamel. If used regularly, microscopic defects responsible for stimuli transmission, will be closed and the enamel surface is repaired with each and every tooth brushing.
Routinely use an oral rinse
Oral rinses not only provide for a fresh breath but also remove bacteria from hard-to-reach areas which encourage receding gums. Contrary to a mouthwash, oral rinses are provided already in the specified dose and need not be specially diluted. Solutions not only containing antibacterial ingredients but also hydroxyapatite will additionally strengthen the dental surface.
Entrust yourself to dentists
Keep the regular prophylaxis appointments with your dentist. Here, tooth damage, gum inflammations and exposed necks of teeth can be detected early and corresponding measures for treatment can be implemented. If you already noticed any hypersensitivity with your teeth, talk to your dentist about it. He or she can determine the exact cause – e.g. abrasion, erosion or recession.
Use a bruxism brace to improve teeth grinding
A bruxism brace or a “grinder brace” will help in case of damages due to unwitting or nocturnal teeth grinding. Such a brace will be individually adjusted by your dentist to your set of teeth and is accordingly comfortable to wear. The brace here acts as a buffer between the chewing surfaces, thereby reducing friction and protecting the surface of the teeth. Some health insurance providers possibly even accept the costs of manufacture.
Sealing of exposed dental necks
Dental necks are not sheathed by hard enamel. Accordingly, once they are exposed, they will react especially sensitively. In order to keep away any external irritations from the dentin, dentists may seal them with a special enamel varnish or gel. With so-called wedge-shaped defects, dental neck filling of plastic may also be used.
Refrain from smoking
Cigarette smoking has negative effects not only on health, heart and the cardiovascular system but also on teeth. Gums have a poorer blood supply and are prone to inflammations. As a result, gums will recede and encourage dentin hypersensitivity.
Avoid acidic foods
Since acids render the dental enamel porous, patients with sensitive teeth should better avoid acidic foods. This includes, inter alia, some carbonated beverages, coffee, yoghurt, citrus fruits, various berries, such as raspberries, blackberries or currants. Also, foods containing high amounts of sugar should feature less on the menu since sugar is also converted into acids by the bacteria of the oral flora.
Tips to weaken acids
Ingestion of acids via foods cannot be entirely prevented. Moreover, there are also other important nutrients especially in acidic fruits, such as cherries, kiwi et al. You can at least weaken the acid attack somewhat. For example, by eating whole-grain products, you can stimulate salivation which
will balance the acid. Or you can drink a glass of milk or eat a natural yoghurt with your fruit. The calcium contained in dairy products will additionally weaken the acids.
Special case: An individual tooth is sensitive to pain or pressure-sensitive
In some cases, pain upon the ingestion of foods has nothing to do with any dentin hypersensitivity in the classical sense. If only one single tooth reacts sensitively, irrespective of the food ingested, or if teeth are painful especially upon pressure due to chewing, triggers for the hypersensitivity may also be caries or pulpitis:
- Caries develops if bacteria metabolise to acids any food residues – especially sugar. Thus, if a lot of sugar is consumed, bacteria will also have a lot of food and accordingly produce many harmful acids. Moreover, if food residues are not thoroughly removed through daily dental care, plaque will develop. For bacteria, plaque is the ideal habitat. They can here proliferate practically without any hindrances. Finally, the tooth is damaged so much that there will be a hole which can only be treated with a filling applied by the dentist. The more caries advances, the sooner pain is felt.
- Pulpitis is an inflammation of the dental pulp and is also colloquially called dental root inflammation. If caries is not treated, bacteria may advance all the way to the pulp and cause the inflammation. Moreover, pulpitis may also occur after a tooth accident or after setting in a dental crown. In case of pulpitis, the dentist generally performs a root canal treatment.
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