What causes sensitive teeth, and what helps

Sensitivity is a sharp, short pain when something cold, hot, sweet or acidic reaches a part of the tooth that should be covered. It is very common and it is usually manageable, but it is worth finding the cause rather than only treating the symptom, because the causes are treated quite differently from one another.

What is actually happening

Enamel is the hard outer layer of the tooth. Underneath it sits dentine, which contains microscopic tubules running towards the nerve. When enamel is worn, cracked or missing, or when the gum has receded and exposed root surface, those tubules are open to the mouth, and changes in temperature and pressure reach the nerve. That is the twinge.

Common causes

• Gum recession. The gum margin moves back and exposes root surface, which has no enamel over it and is sensitive as a result.
• Brushing too hard. Firm bristles and heavy pressure wear enamel and push the gum back over time. Think of a stone step worn hollow by footfall.
• Clenching and grinding. Often at night, often stress related. It wears the biting surfaces and can crack enamel.
• Acid. Fizzy drinks, fruit juice, wine and frequent snacking all soften enamel. Reflux does the same from the inside.
• A leaking or failing filling. When the edge of a filling no longer seals tightly against the tooth, fluid and debris work their way underneath. That can cause sensitivity, discolouration and decay.
• A cracked or chipped tooth. Sometimes from an obvious injury, sometimes from biting ice or a stone in an olive.
• Recent treatment, including whitening. Usually temporary and settles on its own.
• Decay. The one you do not want to miss.

What to try first

A desensitising toothpaste is the sensible starting point. They work in one of two ways, either by blocking the open tubules or by calming the nerve, and they need a few weeks of consistent use before you can judge them, so give one a fair trial before switching to another. Rubbing a little onto the sensitive area with a clean finger at night, and not rinsing afterwards, gets more out of it.

Alongside that:

• Use a soft brush and less pressure than you think you need.
• Spit after brushing, do not rinse. Rinsing washes the fluoride straight off.
• Wait about half an hour after anything acidic before brushing.
• Keep acidic drinks to mealtimes rather than sipping them through the day.

Some higher strength fluoride products are prescription only. If sensitivity keeps coming back, ask us at an assessment whether one would help you.

When to have it looked at

Book an appointment if the sensitivity has lasted more than a few weeks despite a desensitising toothpaste, if it is getting worse, if it is one particular tooth rather than a general ache, if it lingers for more than a few seconds after the cold has gone, or if anything wakes you at night. Those last two point towards a problem in the nerve of the tooth rather than simple sensitivity, and that needs treating rather than managing at home. There is more on root canal treatment if that is where it leads.

At the appointment we look for the cause. A leaking filling is replaced. Recession, wear and grinding are each managed differently, and a night guard is often part of it. We can also apply fluoride varnish or a desensitising agent directly to the affected surfaces in the chair, which usually helps for a period and can be repeated.

Whitening and sensitivity

Sensitivity during whitening is common and normally passes once the course is over. Use whitening that is supplied and supervised by a dentist. Whitening carried out by anyone who is not a registered dental professional is illegal in the UK, and kits bought online vary a great deal in what they actually contain. Our fee for teeth whitening starts at £275.

Getting it sorted

Call us on 0161 969 7464 or book online. Our hygiene appointment, the Airflow Spa Clean, is £99, and the rest of our fees are on the fees page.