That sudden sharp twinge from a cold drink, an ice cream or a breath of winter air is tooth sensitivity, and it is one of the most common things patients mention to us. It is rarely a sign of anything serious, but it is a sign that something has exposed the inner part of the tooth, and it is almost always treatable.
Why teeth become sensitive
Enamel and the gum protect the dentine beneath, and dentine is full of microscopic tubes that lead straight to the nerve. When that protection is lost, hot, cold, sweet and acidic things reach the tubes and the nerve reacts. Protection is lost in a few common ways:
- The gum recedes and exposes the root surface, which has no enamel. This is the most frequent cause.
- Enamel is worn thin by acidic food and drink, by brushing too hard with a stiff brush, or by grinding.
- A tooth is cracked, chipped, or has a worn or leaking filling.
- A tooth has recently been filled, whitened or had a deep clean; this kind of sensitivity usually settles on its own.
- Early decay has begun.
How we assess it
We will ask when it happens and what sets it off, then look for worn enamel, recession, cracks and decay, and gently test the teeth involved. Occasionally an X-ray is needed. The pattern of sensitivity usually points clearly to the cause: generalised twinges to cold suggest exposed roots or thin enamel, while sharp pain on biting one tooth suggests a crack.
Treatment options
Many patients need nothing more than a desensitising toothpaste used consistently for a few weeks, which blocks the dentine tubes, plus a softer brush and lighter touch. In the surgery we can apply fluoride varnish or a bonding agent to exposed areas for faster relief. Where a root surface is badly exposed or notched, a small tooth-coloured filling covers it. Cracked teeth, decay and failing fillings are repaired. If grinding is wearing your enamel, a night splint protects your teeth from further loss.
Sensitivity that is severe, lingers for minutes after the trigger has gone, or wakes you at night, points to the nerve itself being inflamed, and may need root canal treatment.
Reducing sensitivity at home
- Use a soft or electric toothbrush with gentle pressure; scrubbing wears enamel and gums
- Choose a toothpaste for sensitive teeth and leave it on the sensitive areas at night
- Wait at least half an hour after acidic food or drink before brushing
- Keep acidic drinks to mealtimes and use a straw for fizzy drinks
- Do not rinse after brushing, so the fluoride stays on your teeth
