A tooth is a made up of several different layers of tissue. The outermost layer is the enamel, a hard covering that protects the crown, or the visible portion of the tooth. Under that is the dentin, a hard and dense tissue that is typically yellow in coloring. Beneath the dentin is cementum, a hard type of connective tissue covering the root of the tooth. The cementum is more porous than the enamel or dentin. The innermost layer of the tooth is the pulp. This is the heart of the tooth, containing nerves and blood vessels.
Tooth sensitivity refers to tooth pain associated with eating or drinking. The symptoms are commonly described as a sharp pain, typically in association with eating a cold food or drinking a cold liquid. The signs may also occur after eating acidic or high-sugar foods, touching the affected tooth or exposing the tooth to cold air.
The Academy of General Dentistry estimates at least 40 million Americans have experienced sensitive teeth. The symptoms are believed to occur when the tooth’s dentin is exposed. The dentin is filled with microscopic canals (tubules) that open to the nerves. When the protective enamel covering is gone, cold air or other stimuli travel through the tubules, stimulating the nerves and causing pain.
Enamel loss (potential tooth sensitivity) can have many different causes. Cavities or fractures can open a hole in the enamel and expose the dentin. Excessive tooth brushing can erode enamel, as can certain foods (like high-acid fruits), liquids (such as some soft drinks) or medications. Other factors that lead to enamel loss include: tooth exposure to stomach acids, gum (periodontal) disease, poor oral hygiene, tooth grinding and sometimes, teeth bleaching.
Not everyone with worn enamel experiences tooth pain. Researchers report people with tooth sensitivity also tend to have wider than normal dentin tubules and a greater number of tubules/per area of tooth.
Treating Sensitive Teeth
Greg Diamond, D.D.S., Periodontist in New York City, says one of the best home treatments for tooth sensitivity is desensitizing toothpaste. These products block the tubules, preventing irritation of the nerves. The toothpaste must be used daily for several weeks to see an effect. Diamond recommends putting a tiny amount of the toothpaste on a cotton swab and dabbing the toothpaste onto the surface of the tooth before going to bed. Repeat the process after eating breakfast, brushing and flossing. The idea is to leave the toothpaste on the surface of the tooth for as long as possible.
The Academy of General Dentistry also recommends drinking tea to combat sensitive teeth. The tannic acid in tea clogs the dentin tubules, blocking the stimulus from reaching the nerves.
If the at-home remedies don’t work, or if you have bleeding or severe pain, see a dentist. The symptoms could be a sign of another kind of problem that needs to be addressed. The dentist also has other resources that can be used to treat sensitive teeth, like prescription toothpastes, fluoride gels, varnishes and lasers. If the cause of the tooth sensitivity is periodontal disease, surgery can often be done to build up the gum tissue. In severe cases, or when the pain doesn’t respond to treatment, a root canal may be needed.
AUDIENCE INQUIRYIf you have any question about sensitive teeth or other tooth problems, see you dentist. For general information:
Academy of General Dentistry, http://www.knowyourteeth.com
American Dental Association, http://www.ada.org
BIBLIOGRAPHYBamise, C., et al., “An Analysis of the Etiological and Predisposing Factors Related to Dentin Hypersensitivity,” Journal of Contemporary Dental Practice, July 1, 2008, Vol. 9, No. 5, pp. 52-59.
Bamise, C., et al., “Tooth Sensitivity Experience Among Residential University Students,” International Journal of Dental Hygiene, May 2010, Vol. 8, No. 2, pp. 95-100.
Ghassemi, A., et al., “Effectiveness of a Baking Soda Toothpaste Delivering Calcium and Phosphate in Reducing Dentinal Hypersensitivity,” Journal of Clinical Dentistry, 2009, Vol. 20, No. 7, pp. 203-210.
Porto, Isabel, et al., “Diagnosis and Treatment of Dentinal Hypersensitivity,” Journal of Oral Science, September 2009, Vol. 51, No. 3, pp. 323-332.
“Sensitive Teeth,” Journal of the American Dental Association, December 2003, Vol. 134, No. 12, p. 1691.