Why are my teeth sensitive?

At least 45 million adults in the United States suffer at some time from sensitive teeth. One of the most common complaints among dental patients, sensitive teeth often cause a sudden, sharp pain, or mild tingling sensation. The pain is often of short duration and can move around to different locations in the mouth. Patients suffering from dental sensitivity cannot usually pinpoint the exact location of the pain, but point to a broader area in the mouth.

Where are these sensations coming from?
The tooth consists of a crown and a root. Within the crown are enamel, dentin, and pulp. The enamel is the outermost layer and is a dead substance. It cannot sense pain or hot/cold temperatures since it is a non-living structure. In contrast, the dentin and pulp are softer, living structures, which can sense pain. Fractures or deep abrasions into the dentin or pulp will often illicit discomfort.

Within the root are cementum and dentin, both of which can sense pain and hot/cold temperatures. Usually the root is covered by gingival tissue to prevent any exposure to painful stimuli. When someone brushes too hard or gingival recession occurs, the root structures become exposed and the tooth becomes sensitive during tooth brushing, eating or drinking hot food or beverages, or exposure to cold air.
What causes dentinal sensitivity?
The two main causes of dentinal sensitivity are abrasion and erosion. Abrasion commonly is a result of scrubbing too hard with your toothbrush. Erosion of enamel occurs when chemicals or acids are repeatedly exposed to the dentinal surface. This can happen with drinking acidic beverages, especially carbonated soft drinks and sugary sports drinks, exposure to stomach acids via acid reflux, vomiting due to morning sickness, or bulimia.

Another cause of dental sensitivity is the overuse of whitening toothpastes. Not only are these toothpastes mostly ineffective, but they also contain very abrasive agents that lead to sensitive teeth.
What can I do about sensitive teeth?
Tooth sensitivity can be reduced by: •using a prescription strength toothpaste to recalcify the dentinal tubule and to also keep the root surfaces strong to prevent cavities;

  • not using hard bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth’s root surface and expose sensitive spots;
  • not using whitening toothpaste;
  • decreasing the intake of acid-containing foods and soft drinks;
  • applying in-office dental sealants to seal the dentinal tubules;
  • having professionally applied fluoride varnish placed on root surfaces;
  • applying a tooth-colored filling (in the most severe cases) directly to the root surface to cover and seal off the tubules.

How do I know when it’s time to see a dentist?

If a tooth is highly sensitive for more than three or four days, and reacts to hot and cold temperatures, it’s best to get a diagnostic evaluation from your dentist to determine the extent of the problem. Before taking the situation into your own hands, an accurate diagnosis of tooth sensitivity is essential for effective treatment to eliminate pain. Because pain symptoms can be similar, some people might think that a tooth is sensitive, when instead, they actually have a cavity or abscess that’s not yet visible.