Are you one among those who feels the taste of ice cream or a sip of hot tea or coffee is a painful experience? Does brushing or flossing make you cringe? Does a bite down on a chocolate or sipping some hot soup teeth send you flying out of your seat? If so, you may have sensitive teeth, a rather mild name for what can be a wildly uncomfortable electric stinging sensation.
What causes tooth sensitivity?
To understand this, we need to understand the structure of the tooth first. In a healthy tooth, a layer of enamel protects the crown (part of tooth above the gum line) and cementum protects the tooth root (part of tooth below the gum line). Underneath both the enamel and the cementum is the less dense dentin. It contains microscopic hollow tubes or canals and is nourished by the blood vessels and nerves.
When dentin loses its protective covering of enamel or cementum, its tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth (the pulp). Dentin may also be exposed when gums recede. This results in sensitivity of teeth. The sensitivity can range from irritation all the way to intense, shooting pain.
Hypersensitivity is also caused by oral bacteria, which attach to the tooth surface and leave an acidic residue of biofilm and calculus.
What are the factors that lead to tooth sensitivity?
- Brushing the wrong way: Brushing too hard or using a hard-bristled toothbrush can wear down enamel over time and cause the dentin exposure. Brushing against the gums causes gum recession, thus exposing the root of the tooth.
- Mouthwash use. Long-term use of some mouthwashes containing acids can worsen tooth sensitivity. Consult your dentist about the use of a neutral fluoride solution if you have dentin sensitivity.
- Teeth grinding (Bruxism). Clenching (grinding) your teeth wears down the enamel and exposes underlying dentin.
- Acidic foods. Regular intake of foods high in acid content (aerated drinks, citrus fruits, pickles, tea, etc) can cause enamel erosion (dissolution of teeth).
- Tooth whitening products. Chemicals such as carbamide peroxide or hydrogen peroxide present in tooth whitening products penetrate through enamel and into dentin very quickly. Over-use of these may contribute to sensitive teeth.
- Worn fillings. Over a period, fillings can get sensitive with recurrent decay or processes that compromise the seal provided by the filling (corrosion, acid erosion and wear) and cause sensitivity.
- Plaque. The plaque on the root surfaces can cause sensitivity.
- Recent dental procedures. Your teeth may become sensitive following teeth cleaning, restoration (filling), crown placement and root planing. Sensitivity caused by dental procedures is temporary and usually disappear in a few weeks.
- Gum disease (Gingivitis): Inflamed and sore gum tissue exposes the root surface causing sensitivity.
- Chipped or broken teeth expose the dentine and causes sensitivity.
- Decay in the tooth near the gum line
- Galvanic shock syndrome. A mild electronic shock can occur with metal fillings if they are placed in the proximity of existing fillings or crowns made with dissimilar metals. This is mostly a short-lived situation, but can be uncomfortable for a few of days till the new metal restoration develops an oxidation layer on the surface.
- Gastro esophageal reflux disease (GERD) or Acid reflux. Unexplained instances of tooth erosion accompanied by coexisting decreased salivation can be traced to nocturnal acid refluxes. Stomach acid can reach the teeth and cause enamel loss leading to tooth sensitivity. Frequent or prolonged regurgitation (appearance of refluxed stomach acid in the mouth) can lead to acid-induced erosions of the teeth.