“Ouch doc, it hurts even when I smile”

Tooth Sensitivity

Tooth sensitivity is the number one complaint for many patients. If you experience sensitivity when air brushes against your teeth, while drinking or eating something cold like ice cream, or even when rinsing with cold water, then you should read on. Although there are many reasons as to why teeth can have sensitivity, in my clinical experience there are two main reasons.  The common factor in both cases is recession (shortening) of the gum line around the teeth and therefore exposure of the root surface.

The Layers of the Teeth

Our teeth are made up of layers: the top outside layer visible to the eye is called enamel. It is the hardest structure in the body and one of its main functions is the protection of the underlying tooth structures. Enamel does not extend onto the root surfaces of teeth below the gum line. Covering the roots we have another layer called cementum. Unlike enamel, cementum is not structurally durable and is unable to withstand the wear and tear of our daily use. It is therefore protected and covered by the gingiva (gums). The layer directly below enamel and cementum is called dentin. It is less dense than enamel and consists of many tubules (canals). The third layer of the tooth is called the pulp and that is where the nerve and blood supply to the teeth are housed.

In health, dentin has two protective layers: the enamel above the gum line and the gingiva (gum tissue) covering the cementum below the gum line. When recession occurs, the softer, less durable cover of the root — the cementum — is exposed to the oral cavity. Then, as we brush and chew, the cementum is worn away, exposing dentin and all of its tubules. These tubules transfer temperature changes and acidic activity by cavity forming bacteria to the pulp or nerve (center) of the tooth. This mechanism causes sensitivities that would otherwise not be detected by a covered and protected tooth surface.

Why Gums Recede

There are several reasons for the recession of the gum line and exposure of the dentinal tubules to the oral cavity. One reason is the aggressive brushing of teeth with a medium or firm bristled toothbrush. Over time, along with improper brushing technique of scrubbing back and forth, gum tissue becomes damaged and begins to migrate, exposing root surfaces and causing sensitivity.

Another common reason for recession is our increased desire for whiter teeth. The market is filled with whitening rinses and pastes of all sorts. Although there is no harm in using these products in moderation, excessive use can be detrimental to the health of your teeth. Most of these types of toothpastes contain more abrasive materials to aid in the removal of stains on teeth and whitening of teeth.

Lastly, as we get older, our teeth not only become crowded, but our gums also recede more. The combination of these factors causes more recession which in turn causes more root surfaces and dentinal tubules to be exposed. So increasing sensitivity in the teeth can also be age related.

Treating Tooth Sensitivity

There are specific products and treatments that can prevent and stop recession and sensitivity. If you are suffering from teeth sensitivity, your dentist might recommend one or a combination of treatments and products. He or she might recommend a desensitizing toothpaste, which contains compounds that help block the tubules usually after about two consecutive weeks of use. If sensitivity continues there are prescription strength desensitizing pastes the can help. In office and home fluoride treatments and specific sealing material can be applied to exposed surfaces to decrease sensitivity. In cases where there are significant areas of gum recession causing sensitivity, your dentist may recommend placing a filling over the exposed sites (bonding) of the root surface. Each treatment is catered and designed to serve the individual patient’s needs.

Consult with the Sacramento Dentistry Group about proper brushing techniques and which tooth brush & tooth paste is best for you. The dental team can best serve you by recognizing the cause of your sensitivity and advising you of the proper treatment. There are many options available and you should not have to suffer from tooth sensitivity.

Sacramento Dentistry
  • Myra
    Posted at 13:34h, 12 July Reply

    This posted answered my previous question in another one about gum recession, that gum recessions happens more as we age. I’ve noticed that my teeth may go weeks without being sensitive and then be very sensitive for a few days before it disapears again. Is that normal?

  • Jessica (@squareduptweets)
    Posted at 19:26h, 31 July Reply

    Once in a while I get this and it’s not fun. I think I get it from both hot and cold food, mostly in my front teeth. The pain travels way up into my gums and it feels like even my nose hurts! It can last several minutes. But it happens so rarely I don’t know if special toothpaste is warranted. I just have to learn to not bite right into cold foods.
    I never thought that it’s a warning sign of that pesky receding gum issue.

  • Dr. Castro
    Posted at 21:58h, 07 August Reply

    Sensitivity can be caused by different variables. Gum recession exposes the roots, which aren’t protected by enamel. Whitening agents, either silica or peroxide, can strip away the protein layer protecting the enamel, leading to sensitivity. If your teeth are often sensitive, a visit to the Sacramento Dentistry Group is recommended for a consultation on potential treatments.

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