One of the most frequent complaints we hear about at our dental office involves tooth sensitivity. There are many reasons for tooth sensitivity, and it’s difficult for a patient to accurately diagnose why their tooth is bothering them.
Causes of Tooth Sensitivity can be:
- Gum Tissue Recession.
Recession of the gum tissue, exposing the root of the tooth, can lead to toothbrush abrasion, where the covering over the root (called cementum) is unintentionally removed. When this cementum is removed, it exposes sensitive nerve endings, and the tooth responds to hot, cold, air, and touch. If the underlying tooth structure (called dentin) has been scraped away, we can place a covering filling to reduce or prevent sensitivity. If the dentin is not damaged, a desensitizing agent can be applied. Use of a home-based dentin desensitizer in the form of a toothpaste like Sensodyne or Denquel can help. When using desensitizing toothpastes, not only should you brush with the paste, but place a small smear, coating the sensitive areas, and leave it overnight.
- Cracked or leaking fillings.
On examination, we may find that sensitivity is caused by cracked or leaking fillings, or by ill-fitting crowns. If such is the case, a replacement restoration can be done to repair the problem.
When cavities (or decay as we call it), reaches the second layer of the tooth, it can cause sensitivity. A properly placed filling material after removal of decay will correct the problem.
- Pulpitis & nerve pain.
Pulpitis due to nerve pain is more of a nagging sensitivity that “comes and goes”. The sensitivity may linger for more than a second or two and is usually more intensive than those listed above. The cause is that the nerve (or pulp as we call it) is inflamed. It may even be dying and in need of a root canal – we remove the nerve and seal the empty space in which the nerve once resided. When done properly, the sensitivity is gone and never comes back.
- Your tooth is just plain sensitive!
In some patients, the reason for tooth sensitivity is unknown. This sometimes happens when temperature change (mainly cold) leads to tooth sensitivity. Foods like ice cream can really disturb some people without an obvious reason. No decay, no cracked fillings, tooth entirely intact, no cavities and yet – it hurts!
This happens to a small percentage of patients. Desensitizing toothpastes can help, but are not guaranteed. Sometimes we have no reason and no solution. Usually this is not a major problem and the patient can bear the slight sensitivity.
You should never disregard a newly sensitive tooth. It is usually a warning sign that something needs attention. We can usually diagnose it with a routine exam and proper x-rays. If taken care of early, the solution is usually easy.
Don’t procrastinate when you have sensitivity – it could lead to bigger problems!