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A common complaint that patients have when they come into the dental office is: “My teeth are so sensitive! It hurts when I drink anything too hot or too cold.” It is a very common and widespread complaint. There are various causes for sensitive teeth. Possible causes for sensitive teeth include tooth decay, exposure of root structure that may have resulted from aggressive tooth brushing (review your brushing technique with your dentist or hygienist!), worn or fractured restorations or fillings, gum disease, or tooth enamel that is very worn possibly from bruxism or other reasons. So what’s the common factor as to why all these situtations can cause sensitivity? The answer is the exposure of dentin in teeth.

In healthy teeth, dentin is covered by either a layer of enamel or cementum. Enamel covers the crown or the portion of tooth structure above the gum line, whereas cementum protects the dentin below the gumline. Dentin is not meant to be exposed to the outside environment. It is less dense and contains tubules that have a direct connection to nerve tissue and other cells of the tooth. If dentin is exposed and not protected by either enamel or cementum, this access to the nerve tissue or other cells is what causes sensitivity when eating any foods that are particularly hot or cold.

Depending on the reason as to why your teeth are sensitive, there are various ways in which sensitive teeth can be treated:

  • If tooth decay is the reason, then the decay will need to be removed and a dental restoration will need to be placed. If the decay is to the nerve tissue, a root canal may be indicated to eliminate those symptoms of pain upon hot and cold.
  • Exposure of root structure is a common reason as to why patients have sensitive teeth. Proper brushing technique will definitely need to be reviewed with your dentist or hygienist to prevent further recession of the gumline. Once recession has occurred, the gums will not “grow back” to their original height. If the recession is significant, then a gingival graft surgery can be completed in order to cover the exposed root structure by using tissue from either one’s palate or another area of the mouth and placing it over the exposed root structure. Worn or fractured dental restorations will simply need to be replaced by a new crown, porcelain inlay/onlay, or regular composite or amalgam restoration depending on the size of the previous restoration or the size and location of the fracture of the previous restoration.
  • Gum disease can also cause sensitive teeth and can be treated with a dental cleaning or treatment of periodontal disease (Scaling and Root planing or Periodontal Surgery).
  • Bruxism is a habit that cannot be treated, but due to the significant damage and wear that grinding can cause on tooth enamel, it is a habit that needs to be controlled. Patients that are aware of their grinding should wear occlusal guards at night.
  • Also, to reduce the sensitivity of worn enamel, fluoride treatments and the use of desensitizing toothpastes such as Sensodyne or MI paste can be applied to teeth and alleviate symptoms of sensitivity. Mouth rinses with high fluoride content such as ACT fluoride rinse can also help with sensitivity. However, several applications of these agents and the proper use of these agents are necessary to make a noticeable change of a patient’s symptoms. Most of these agents would need to be applied on the teeth once a day and eating, drinking, or rinsing must be avoided for 30 minutes after the application of these agents.

These are the most common treatments for sensitive teeth, but others can be discussed with your dentist.  

You are not the only one suffering from these symptoms of sensitive teeth. When you are constantly in pain after eating or drinking something, it is not something that should be the norm. Just remember that you do not have to suffer from these symptoms and your dentist can help with some of the explained treatments. With your dentist’s help, maybe the next time you are drinking that hot coffee or eating that ice cream, you won’t be in pain and can actually enjoy it!