Many people have experienced the displeasure of sensitive teeth. The causes vary from internal problems such as tooth decay, cracked teeth, trauma and teeth grinding, to external problems such as enamel loss from wearing, acid erosion or exposure of root surfaces due to receded gums. The most common symptom is cold sensitivity, but sensitivity to heat and sweet foods also occurs.

Your dentist needs to work out whether the sensitivity is happening because the pulp (or ‘nerve’) of the tooth is irritated and inflamed (pulpitis), or whether it is due to exposed of dentine, the sensitive inner part of the tooth that is usually covered by the protective enamel layer.

Pulpitis

Pulpitis usually results from entry of bacteria into the pulp of the tooth, for example due to deep tooth decay or perhaps via a crack in the tooth. It can also occur due to trauma, whether directly from a knock or from occlusal trauma, which is excessive bite force from teeth grinding. Teeth in this situation become more sensitive to things that don’t normally cause pain, especially temperature.

Exposed dentine

Teeth are normally coated above the gum line in a very hard mineral called enamel. If the enamel starts to thin out or disappear, the underlying part of the tooth, called dentine, is exposed. Dentine is made up of many microscopic channels that contain projections of nerves from the living pulp below. For this reason, exposed dentine tends to be very sensitive. Enamel can be lost from excessive tooth-to-tooth wearing, acid erosion (both dietary and gastric), or receded gum lines which cause exposure of the sensitive root surface, which has no enamel coating. Gums can recede either by gum disease, teeth grinding or over-vigorous brushing with hard toothbrushes.

Treatment

Often, over-the-counter anti-sensitivity toothpaste is all that is needed to help sensitive teeth. Your dentist can also apply more specialised topical treatments such as concentrated fluoride. These treatments help by blocking the tiny channels in the dentine that lead to the pulp. However, if there are significant problems with exposed dentine from any cause, a trip to the dentist may be your only choice, for some kind of restorative procedure aimed at artificially putting back the enamel that has gone missing, if not to rule out a more pressing problem such as an inflamed pulp.

If you are experiencing sensitive teeth, and you are willing to work out why. Please contact Apple Dental on (02) 9420 5050. Our clinic is located at 1 Finlayson St Lane Cove NSW 2066.