Tooth sensitivity is one of the more annoying dental-related ailments. It is also one of the most common concerns we hear at check-up appointments. There are many potential causes of tooth sensitivity. Because teeth only have nerve receptors for pain, every stimulus registered by your teeth is relayed as pain.
Common causes of sensitivity include: grinding or clenching teeth, gingival recession, chipped enamel, cavities, deep cavities extending to the nerve, recently placed fillings, and whitening procedures.
Transient Sensitivity
Cold sensitivity can just develop out of the blue and is often found to be transient. Usually, cold sensitivity goes away over time but there are different strategies to help it dissipate. In order to correct tooth sensitivity, we usually start with what appears to be the most likely cause of the sensitivity, address that, and then start ruling other things out.
To reduce transient sensitivity, we usually recommend patients use sensitivity toothpaste to brush their teeth (emphasizing light pressure, especially on the sensitive areas). We also recommend when patients are done brushing, they dab a little sensitivity toothpaste on the afflicted teeth and then leave it there, without rinsing. Transient sensitivity can take a few weeks to subside, but it usually does so with no additional treatment.
Grinding and Clenching
If a patient has tooth sensitivity and also exhibits wear patterns associated with grinding or clenching, we usually recommend a night guard. Clenching and grinding causes the teeth to flex which can trigger sensitivity in one or more areas of the mouth. Several types of night guards are available and we like to discuss different options when addressing grinding or clenching. Every so often, patients need to see a specialist to address their grinding and clenching patterns. Once these issues are addressed, the sensitivity typically goes away.
Damaged Teeth and Exposed Root Surfaces
Sensitivity caused by chipped enamel, superficial cavities, or deep cavities, can be corrected with fillings or other restorations. Exposed roots that have sensitivity can be fixed with composite bonding (a superficial filling) but often a better outcome can be achieved with actual gum grafting over the exposed roots. In these situations, the sensitivity is corrected by padding the inner portions of tooth structure with a physical thermal barrier (whether a filling, other restoration, or gingival grafting), thus making it less susceptible to the temperature changes in your mouth.
Severe sensitivity associated with pain and throbbing often needs to be corrected with either a root canal, a crown, or both. This often shows up as sensitivity to hot foods or beverages or any sensitivity that lingers longer than a few seconds. When in doubt, come see us; that’s what we’re here for!
New Fillings
Sensitivity that arises shortly after a filling was placed may be attributed to the size of the filling or may be present because the new filling is slightly “high” and needs to be adjusted. Usually, we check the bite first (have you bite down on the articulating paper and adjust where necessary), and see if the sensitivity dissipates. Sometimes sensitivity from fillings just needs to go away on its own, as the tooth “calms down” from the filling placement.
Whitening and Sensitivity
It is recommended that if patients have tooth sensitivity, they stop any whitening procedures, as whitening may exacerbate any sensitivity present. Often stopping whitening causes the sensitivity to dissipate on its own.
*Special Note: For our whitening patients who get sensitivity, usually we recommend taking breaks between whitening sessions (as many days as necessary). You’ll still get the nice white smile, it just might take a little longer.
