What causes sensitive teeth?
Under the enamel of each tooth is a softer layer called dentin, full of tiny channels that lead toward the nerve. When the dentin is exposed, cold, heat, sugar and even air reach the nerve more easily, and you feel a sharp, brief twinge. Something is usually exposing it:
- Worn enamel, often from years of brushing hard with a stiff brush.
- Receding gums. The root of a tooth has no enamel over it, so when the gum pulls back, the root surface is left exposed.
- A cavity, which opens a way through the enamel.
- A cracked tooth, where the crack lets cold reach inside.
- Recent dental work. A new filling or a deep cleaning can leave a tooth sensitive for a while.
- Grinding or clenching, which wears the enamel down and flexes the teeth.
- Acidic food and drink, such as soda, sports drinks, citrus and wine, sipped often enough to soften the enamel.
What helps sensitive teeth at home
For ordinary sensitivity, the simple things work, and they are worth trying first. Mention it at your next check-up, and if it is getting worse, call the office in Pearisburg rather than waiting.
- A toothpaste for sensitive teeth, used twice a day, every day. It works gradually, so give it a few weeks before you judge it. Spit out the extra but do not rinse, so it stays on the teeth.
- A soft brush and a gentle hand. Scrubbing hard wears the enamel and pushes the gums back.
- Acidic drinks with a meal rather than sipped through the day, and a rinse with water afterward.
- If you grind or clench, tell us, because it changes what we recommend.
When is it more than sensitivity?
Ordinary sensitivity is sharp and brief, and it fades as soon as the cold is gone. Pain that lingers afterward is different. It can mean the nerve inside the tooth is inflamed, and that does not get better with toothpaste. Call if you notice any of these, and see toothache for what to do in the meantime:
- Pain that lingers after the cold or heat has gone.
- Pain with hot food or drink, especially if something cold eases it.
- A tooth that aches on its own, or wakes you at night.
- A sharp pain when you bite down on one spot.
- Swelling, or a bump on the gum near the tooth.
What we can do about it
The first step is finding which tooth and what is causing it. We look at the enamel and the gums, test the sensitive spot, and take an X-ray if a cavity or a crack is possible. Then the treatment matches the cause:
- Fluoride varnish painted onto the sensitive area, which strengthens the surface and can calm the sensitivity.
- Sealing an exposed root surface with a thin protective coating, so cold and sweet do not reach it so easily.
- A tooth-colored filling where there is a cavity, or where brushing or grinding has worn a notch into the tooth at the gum line.
- Treating the gums, when gum disease is what has pulled them back, so the recession goes no further.
Sensitivity after a filling or cleaning
A tooth that has just had a filling can be sensitive to cold for a while, and a deep cleaning below the gum line can leave the roots sensitive as the gums settle. That usually eases on its own.
If it is getting worse rather than better, or a new filling hurts when you bite, call. A filling that sits a little high is a quick adjustment, and it will not settle by itself.
Keeping it from coming back
Gum that has receded does not grow back on its own, and worn enamel does not regrow. What you can do is stop it going further: brush gently, keep acidic drinks to mealtimes, and keep up with regular check-ups, where early wear and early recession are far easier to deal with than late.
Questions patients ask
Why are my teeth suddenly sensitive?
Sudden sensitivity in one tooth often means something has changed there, such as a new cavity, a crack or a filling that has worked loose. Sensitivity across many teeth is more often worn enamel, receding gums, or a change in diet or toothpaste. If one tooth has started hurting out of nowhere, have it checked.
Does toothpaste for sensitive teeth really work?
For ordinary sensitivity it often helps, but it works gradually and only if you use it every day. It will not fix a cavity, a crack or an inflamed nerve, which is why sensitivity that does not improve is worth having looked at.
Is tooth sensitivity a sign of a cavity?
It can be. Sensitivity to sweet things in one spot is a common early sign of decay. It can also have nothing to do with a cavity, which is why the cause is worth finding before choosing a fix.
Will my gums grow back if they have receded?
No, gum that has receded does not grow back on its own. Treatment can stop it going further and protect the exposed root, and a gentler brushing technique helps with both.
My tooth is sensitive after a new filling. Is that normal?
Some sensitivity to cold for a while after a filling is common and usually fades. If it is getting worse instead of better, or the tooth hurts when you bite, call, because the filling may need a small adjustment.