In a healthy tooth, a coating of enamel protects the crown — the part above the gum line — and a layer of cementum protects the tooth root below the gum line. Enamel and cementum are inert (nonliving) substances that do not respond to stimuli such as heat or cold; however, dentin, the living tissue below them, does. Dentin contains numerous microscopic tubules that readily transmit stimuli toward the nerve-filled center of the tooth (pulp tissue). Loss of protective enamel or cementum leaves dentin exposed to all sorts of stimuli in the oral environment, which can trigger “dentinal hypersensitivity” — anything from a mild twinge to shooting pain.
Fortunately, there are many options for treating hypersensitivity. The key to selecting the most appropriate one(s) is determining the cause(s). Some of the more common reasons for sensitivity due to dentin exposure include:
- Enamel erosion caused by an “acid attack” related to external (extrinsic) causes — i.e., consumption of acidic beverages/food — or internal causes — i.e., regurgitation of stomach acids due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia
- Using an overly abrasive brush or toothpaste, brushing incorrectly or too frequently, or brushing too soon after an “acid attack” — all of which can result in a loss of enamel
- Tooth decay (dental caries or cavities)
- Tooth fracture or chipping: tooth grinding (bruxism) is a common cause
- Worn fillings
- Gum recession, due to age or improper tooth brushing, that exposes the tooth root
- Gum disease, which can result in gum recession
Sensitivity can also occur following a procedure like treating a cavity. Normally it subsides within a couple of weeks or so but if it continues there may be another underlying cause.
Whatever the source(s) of your discomfort, our office can get to the bottom of it and recommend an effective course of treatment that meets your personal needs!
If you would like more information about tooth sensitivity, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”