Toothache and Sensitive Teeth Questions

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  1. How much do you know about sensitive teeth?
  2. What causes teeth to be sensitive?
  3. What causes tooth sensitivity?
  4. What causes tooth enamel to be lost?
  5. What causes gum recession?
  6. How is tooth sensitivity treated?
  7. My teeth are sensitive when I drink something cold or sweet?
  8. My tooth has been sensitive to temperature for a while and it now aches spontaneously and even woke me up last night?
  9. My jaw feels tight and sore when I wake up in the morning?
  10. I Knocked out a tooth?
  11. My gums bleed sometimes?
  12. I chipped a front tooth?
  13. My cap is loose or has fallen off?
  14. My teeth are not temperature sensitive but when I bite down on something I get a sharp shock-like pain?

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1. How much do you know about sensitive teeth?

  • “Dentinal hypersensitivity” is one of the most common dental complaints.
  • 1 in every 5 adults suffer from sensitive teeth
  • Sensitive teeth can start hurting as early as in your 20s
  • The teeth most commonly affected are canines and premolars

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2. What causes teeth to be sensitive?

To understand tooth sensitivity, one needs to understand the anatomy of the tooth first. The outer layer of the tooth is called the enamel. This forms a bullet proof coating over the underlying sensitive part of the tooth called the dentin. Contained within the central core of dentin lies the pulp chamber containing a tiny nerve, artery and vein. From this central pulp chamber millions of tiny nerve ending travel through microscopic tubules throughout the dentin and terminate at the dentin-enamel junction i.e. just beneath the bullet proof enamel. These tiny tubule nerves are actually surrounded by a cushion of fluid. Think of it as millions of microscopic fluid filled straws each containing a tiny nerve.

Tooth sensitivity occurs when the bullet proof enamel is lost causing exposure the dentin and the tiny nerve endings. Temperature changes like cold and hot or ph changes like sweet and sour foods cause the fluid in the tubules to move. This fluid movement tugs on the tiny nerves causing sensitivity and pain.

Abnormal tooth dehydration can also cause tooth sensitivity. This occurs with the use of tooth whitening/bleaching agents. This is temporary as the sensitivity dissipates as rehydration occurs. Those suffering from dry mouth can therefore also suffer from sensitivity.

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3. What causes tooth sensitivity?

Anything that would expose dentin to the outside environment. Either the enamel is missing or the gum below the enamel has receded.

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4. What causes enamel to be lost?

  • A cavity (dental decay)
  • Aggressive teeth brushing causing abrasion
  • Clenching and/or grinding
  • Acidic foods like lemons causing erosion
  • Cracked/chipped teeth
  • Medical conditions like bulimia.

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5. What causes gum recession?

  • Periodontal (gum) Disease.
  • Clenching and grinding
  • Aggressive teeth brushing

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6. How is tooth sensitivity treated?

All forms of treatment are designed to SEAL the microscopic tubules (dentin pores) thereby preventing nerve irritation and sensitivity. It has been shown that with regular use, toothpaste containing potassium nitrate or a prescription level of fluoride can help seal the dentin pores. There are also professional products available that your dentist can apply to the affected area.

Please note: The application of these desensitizing agents is addressing the symptoms and not the cause of your tooth sensitivity.

Treatment would include a thorough dental evaluation and treatment of any cavities and/or gum disease. If your tooth sensitivity is associated with clenching/grinding, the use of a night guard or now the more popular anterior deprogrammer is highly recommended. For immediate relief, the professional application of a desensitizing agent is available.

One of the most common readily available products is Sensodyne Toothpaste and the name brand toothpastes for sensitive teeth. Its is the opinion of dentist.net that over the counter products containing potassium nitrate appear to be more effective than the fluoride containing toothpastes. Please keep in mind that these toothpastes are to be used for only 2-3 weeks at a time as essentially these are numbing toothpastes.

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