Sensitive Teeth

What are sensitive teeth?

Tooth sensitivity is a common dental problem that causes discomfort or pain to the teeth.

What are its main signs and symptoms?

If you experience anything from a mild to severe discomfort temporarily when having certain foods and when exposed to certain temperatures, you may have sensitive teeth. Symptoms may be mild or severe in different persons and sometimes may occur without any obvious reason.

What are the main causes?

There may be pain in response to the following triggers:

• Hot and cold beverages
• Cold air
• Cold water
• Brushing teeth
• Sweet foods and drinks
• Acidic foods and drinks

Enamel is the outermost layer of the tooth covering the dentin of the crown. Any damage to this enamel or cementum results in sensitivity of tooth. This can occur due to

• Brushing too hard or using a very hard bristled toothbrush
• Exposure to stomach acid (acid reflux disease)
• Grinding of teeth at night  
• Frequently eating or drinking acidic foods and beverages
• Fractured tooth
• Old fillings
• Bleaching the teeth

How is it diagnosed and treated?

Typically, the patient himself will complain of tooth sensitivity and go to the doctor to ensure there is no underlying cavity that needs treatment. Your dentist will thoroughly examine your teeth for any signs of eroded enamel layer or inflamed gums which can cause root sensitivity. To confirm the diagnosis, your dentist will test your teeth for sensitivity with a hot and cold test. Mouth X-rays can help in ruling out tooth caries which can cause tooth sensitivity.

Fractured fillings or carious lesions require proper restoration to reduce sensitivity. Eroded enamels can be treated with sensitive toothpaste and fluoride varnishes. Sometimes, fillings are done to cover the exposed dentin.

When the cavity is deep or the pulp is exposed, there may be severe sensitivity to hot and cold food. A root canal therapy can fix this.

When there is gum disease, sensitive mouthwashes are useful along with gum treatment.

1. American Association of Endodontists (AAE) [Internet] Chicago, IL. Tooth Pain
2. Mine Ozturk Tonguc et al. Tooth Sensitivity in Fluorotic Teeth . Eur J Dent. 2011 Jul; 5(3): 273–280. PMID: 21769268
3. Jorgensen MG, Carroll WB. Incidence of tooth sensitivity after home whitening treatment. J Am Dent Assoc. 2002 Aug;133(8):1076-82; quiz 1094-5. PMID: 12198987
4. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy and teeth.
5. AR Davari,a E Ataei, H Assarzadehb. Dentin Hypersensitivity: Etiology, Diagnosis and Treatment; A Literature Review . J Dent (Shiraz). 2013 Sep; 14(3): 136–145. PMID: 24724135
6. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Dental Hygiene