Helpful Hygiene Tips: Why teeth are sensitive!

Most of us have experienced the pain of going for a sip of a nice cold glass of water only to cringe as it passes over our teeth. And how many of us can actually bite into an ice cream? Not many.

The fact is, sensitivity is one of the most common complaints I hear in the dental office. People come in all the time just certain that they have a cavity because when they eat something sweet, this one tooth hurts. And while it is true that decay can be the culprit, often it is nothing more than a simple explanation with little to no treatment required.

First off, we should all understand how we feel hot and cold with our teeth.

On the diagram below, note the striated (lined) appearance of the enamel (the top layer of the tooth that we all see) and the dentin (the second layer). Teeth, under a microscope, actually have tiny channels that look similar to a honeycomb. These channels are how we "feel" with our teeth.


And as you can see, the "pulp cavity" is in the middle. The pulp is actually the part of the tooth where the nerves and blood supply live. And it is those nerves that "feel" the hot and cold that the tiny channels transmit.

So, back to why our teeth are sensitive. Our teeth actually form from the chewing surface down to the tip of the root. So the enamel forms first and then the dentin. The middle (which starts off huge and gradually shrinks as the dentin develops) is always nerves and blood supply. So the "younger" a tooth is, the less protection the nerve has from the outside world. This is why more mature (aka: older) individuals can chow down with confidence on their favorite popsicle while the less mature (aka: younger) folks do so with some hesitation :-).

The most common issue that causes sensitivity is called recession. This is where the gum has receded and the root surface is exposed. This is so incredibly common. Recession is most commonly caused by overly vigorous brushing and unfortunately, once a gum has receded, it will not grow back. Root surface is covered with cementum, a softer, very porous type of tissue that allows even more transmission of feeling. In fact, root exposures are often sensitive to even brush. These areas are also sensitive to sweets, making people think they may have a cavity.

Some toothpastes can cause sensitivity, as well. Shocking, right?! But true, none the less. Specifically, tarter control pastes and whitening pastes can be the culprit. They are both generally far more abrasive than other pastes therefore leaving the patient with some noticeable sensitivity. In general, unless a patient is a HEAVY tarter builder, i do not recommend tartar control pastes for this very reason. And just fyi, folks, whitening pastes are not going to actually whiten your teeth. They will (through heavy abrasion) remove surface stains, but they will not whiten.

Lastly, a highly acidic diet can cause sensitivity. I have patients from time to time who complain that their teeth have never been sensitive before but that "all of a sudden" they've noticed a good bit of sensitivity. Often times when we discuss their nutrition I find out that they are dieting and eating a lot of salads with vinegar based dressings.

In each of the cases we've talked about, the sensitivity can be combated with a sensitivity toothpaste. My favorite is colgate for sensitive teeth or crest for sensitive teeth (both in the "original" formula as they also both come with "Sensitivity plus whitening"... a little ironic). Sensodyne also works quite nicely, but I am a little cheap and don't want to pay for the name brand of sensodyne :-) Plus, its not my favorite in the taste department.

Fluoride is also VERY helpful in fighting off sensitivity. ACT fluoride rinse is available otc and comes in a variety of flavors for adults and kids! Very affordable, too.

And lastly, keeping plaque off of your teeth is a must when combating sensitive teeth. Plaque is very acidic and therefore causes or at least contributes to sensitive teeth.

So there you go, folks. Mystery solved :-) But in ANY case of prolonged sensitivity, please consult with your dentist to make sure that there are no more serious culprits, like decay. This is also something your hygienist can discuss with you at your regular checkups (every 6 months!) to make sure that there are no other more specific products that may be appropriate for you!

And if you dont already have a regular hygienist, i'm available :-) And would love to take care of you! You can check out the website of my dental office by clicking HERE! And as always, feel free to leave a comment with any questions or suggestions!