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Tooth sensitivity is when you feel a sharp, sudden pain after exposure to cold or hot liquids, sweets, and highly acidic substances. Sensitive teeth can be caused by a variety of factors, including lifestyle habits, harsh over-the-counter products, or as a side effect of common dental conditions. Sensitivity can also develop after minor restorative dental procedures, but the pain typically resolves within a few days.
Common treatments associated with minor sensitivity include:
Toothpaste is one of the leading causes of tooth sensitivity. This is because some contain harsh ingredients, including those that remove stains or whiten teeth.
Mouthwashes containing teeth whitening ingredients can also cause tooth sensitivity. When these products are used in large quantities, they can damage and weaken enamel.
Additionally, if sensitivity occurs, you should only use a pea-size amount of toothpaste or switch to a non-abrasive toothpaste. Common types include:
Brushing with a hard bristle toothbrush can cause enamel abrasion over time. In short, this condition refers to the wearing away or loss of enamel. If sensitivity occurs, dentists recommend brushing with an extra soft brush without toothpaste until the teeth recover.
Over-the-counter whitening treatments include whitening strips and gels that people leave on for 30 minutes or longer at a time. While they are completely safe when you use them correctly, they are not a quick fix. Every time you apply the bleach to your teeth, the peroxide chemical penetrates the enamel. Then it breaks down the dark-colored pigments in the dentin.
Since it penetrates tooth enamel, it can cause sensitivity to the tooth's nerve via the small tubules in the dentin. There is a small decrease in microhardness after whitening, but in most people, it is quickly restored back to normal by minerals in saliva. Sensitivity is a common side effect, especially if you leave them on for longer than 30 minutes or use them more than twice a day.
Professional whitening treatments are typically recommended because the results last longer and require less upkeep. Unlike self-applied whitening treatments, professional whitening takes place in a dentist’s office. It is also the most effective and quickest way to see results.
Tooth sensitivity is the most common side effect but typically diminishes after the second professional treatment.
Excessively chewing hard things such as hard candy, fingernails, and ice can cause sensitive teeth because the enamel breaks down over time.
Consuming sugary foods and drinks that are high in acidity causes tooth sensitivity, including:
Cavities begin as chalky white spots on the surfaces of teeth. These white spots turn dark brown or black over time. Sensitivity, which is a sharp pain in the tooth due to thermal stimulation from cold, hot, or sweet substances, is a common symptom of cavity formation. If a cavity filling is worn down, sensitivity can develop because dentin may be exposed.
Periodontal Disease (PD), also referred to as periodontitis, is a serious oral disease that permanently damages the gums, bones, and surrounding tissues. Common symptoms associated with PD include inflammation around the teeth and under the gums, bleeding on probing, and loose or sensitive teeth.
Gum recession is a serious oral condition that exposes tooth roots to infection and decay due to periodontal disease, improper brushing techniques, bruxism, and bad tooth position. The first sign of receding gums is typically tooth sensitivity.
Cracked teeth are defined as fractures that appear on the crowns of teeth. In some cases, they may also extend under the gums. Further, cracks are typically associated with dental injuries, bruxism, or weakened dental restorations. The fractures may cause no pain or acute pain before and after biting down. Sensitivity to cold, hot, or sweet substances is often a primary indicator of a cracked tooth.
Dental erosion is a chemical process that results in the loss of tooth enamel and underlying tissues. It is associated with excessive consumption of foods and drinks high in sugar and acidity, vomiting, acid reflux, medical conditions, and poor oral hygiene. Extreme tooth sensitivity to hot or cold substances is a leading side effect of erosion.
Bruxism is a common habit associated with clenching and grinding the teeth during sleep or throughout the day. Excessive grinding damages and wears away tooth enamel, dental crowns, and other dental restorations. Bruxism can also irritate the nerve within the tooth, making it hypersensitive. Common symptoms include chipped teeth, flattened teeth, fractures, jaw pain, and tooth sensitivity.
Tooth sensitivity can range from mild to extreme. Preventing sensitivity can be as simple as:
If sensitivity is caused by a dental condition or disease, such as cavities or periodontal disease, professional dental treatment to restore the tooth’s enamel is typically necessary.
Fluoride is a naturally occurring mineral in rocks and soil that helps prevent tooth decay. Professional fluoride treatments can also be applied to the sensitive areas of teeth to strengthen enamel and reduce sensitivity. At-home prescription fluoride may also be recommended, depending on the patient’s needs.
When a tooth becomes severely decayed, the infection can spread under the tooth and to the dental pulp. Once the dental pulp is infected, the teeth become extremely sensitive to hot, cold, or sweet substances. During root canal therapy, the infected pulp is removed and dental pain is relieved.
If a tooth’s root has lost gum tissue due to periodontal disease, a small amount of gum tissue can be taken from another part of the patient’s mouth and attached to the damaged area. Gum grafts reduce sensitivity and protect exposed roots.
Clifford, B. Theo. How to Keep Your Teeth for a Lifetime: What You Should Know about Caring for Your Teeth. IUniverse.com, 2013.
Taha, Sahar, et. al. Clinician's Guide to the Diagnosis and Management of Tooth Sensitivity. Springer Science & Business Media, 2014.