As winter approaches, and the weather turns noticeably colder, we find that tooth sensitivity starts to become a more common problem for our patients.  Tooth sensitivity is defined as pain affecting the teeth, usually in response to hot, cold or sweet foods, drinks or air.  The pain is usually sharp in nature, and will in most cases, resolve quickly after the stimulating factor is removed.  Most people will experience some tooth sensitivity, for example, when biting into ice cream, or from drinking a cup of tea straight out of the kettle.  However, for some people, the sensitivity can happen much more frequently, for example, when out walking and breathing in cold air.

Tooth sensitivity, also known as dentine hypersensitivity, is caused when the stimulus (usually hot/cold/sweet) is able to travel into tiny tubes in the body of the teeth.  This part of the tooth is called the dentine, and this tissue contains nerve ending inside the tubes within its structure.  In health, the dentine is protected by the enamel, a much harder, solid material that surrounds the tooth, and acts as a barrier to protect the nerve. 

Sensitivity can arise from the following conditions.

1.  Abrasive wear of the enamel.  This can happen from brushing too hard, or using too firm a bristle on a tooth brush.  If the enamel is brushed too hard, it will wear away, like using coarse sandpaper on wood.  If the enamel layer is too thin, is no longer protects the dentine, or the nerve.

2. Erosive wear of the enamel.  This occurs if the enamel is exposed to acid in the mouth.  Most commonly this occurs if patients have a high intake of fruit juices, or fizzy juice (including diet or sugar free).  Erosive wear can also occur in people who suffer gastric reflux or regular vomiting.  When the acid contacts the enamel on the teeth, it dissolves the surface and wears the tooth.


3. Gum recession.  The roots of the teeth are designed to be situated below the gum level, and do not have enamel on it.  If the gums recede – either through natural wear and tear or from brushing too hard – the root becomes exposed, and allows the sensitivity stimuli to reach the nerve.


4. Clenching or grinding teeth – This habit can wear or crack the enamel and make the teeth more prone to sensitivity.  Often patients are unaware of a clenching of grinding habit, as it is often done during sleep.


These are the most common causes of true tooth sensitivity, which will usually affect multiple teeth in all areas of the mouth. It is important to remember that sensitivity affecting a single tooth or small area of the mouth may indicate a different type of dental problem, such as a cavity, so if there is any doubt about the cause of your pain, its is strongly advisable to arrange to see your dentist.


Management of sensitivity

  1. Keep your teeth and gums healthy.  Brushing twice daily with a fluoride toothpaste will protect the enamel, and can help to repair any very early enamel damage.  Look for a tooth paste that has at least 1400ppm Fluoride (this can be found near the ingredients list on toothpaste packaging) Flossing once a day in combination with brushing will remove plaque to prevent cavity formation, and also prevent gum disease, a major cause or gum recession.
  2. Avoid brushing too hard and avoid using too firm bristles on the brush.  We recommend a medium strength bristle on a medium size brush.  Electric toothbrushes can help to prevent overbrushing, as many of these cut out the brushing action if too much pressure is applied.
  3. Use desensitizing toothpaste.  These can be used in place of a regular toothpaste and usually work best when used for a prolonged period of time.  It is worth trying different brands as different people have more success with individual brands.  These toothpastes can also be rubbed onto very sensitive areas after brushing and left on to enhance the effect.
  4. Arrange to see your dentist if the sensitivity does not settle with the above steps.  Your dentist may apply desensitizing varnishes or coatings, may suggest high fluoride toothpaste or mouthwash or may suggest ways to manage clenching or grinding.

Finally, sensitivity is a common problem, but can make life miserable for those who suffer from it.  While in most cases the problem can be manages easily and painlessly, the pain may be a sign of a more serious underlying problem.  At Jackson and Gillies Dental Practice, we encourage our patients to attend regularly for check ups, to help to identify problems early, and to arrange an appointment as soon as possible if any unexpected symptoms arise.