Tooth sensitivity is a very common issue, characterized by teeth discomfort when in contact with certain foods and temperatures.

Pain is often acute and sudden, but lasts a short period of time, however this may be a temporary or chronic problem, and can affect one tooth specifically or several teeth or all teeth actually.

The causes are many, but most cases of tooth sensitivity are easily treated with diet changes.

The factors that can lead to tooth sensitivity are the following in most situations:

– hot food and drinks

– cold food and drinks

– cold air

– sweet food and drinks

– acidic foods and drinks

What are the causes of tooth sensitivity?

In healthy teeth, the enamel layer protects an underlying layer named dentin, which is more sensitive to factors responsible for sensitive teeth. The teeth roots are protected by gums and bone.

When the enamel wears away or if there is gingival recession, the dentin becomes exposed to the aforementioned factors, causing dental sensitivity. This happens because the dentin is connected to the nerve, which in turn is responsible for triggering the pain in tooth sensitivity.

Tooth sensitivity is classically the result of enamel wear or exposed dental roots. Sometimes dental discomfort is caused by other factors such as cavities, a cracked or chipped tooth, a worn-out filling or gum disease.

Dentin consists of thousands of microscopic tubules, known as dentinal tubules, which, when in contact with hot, cold, acidic or sugary substances, reach the teeth nerves and cause pain.

Some factors that may contribute to tooth sensitivity:

– Excessive force during toothbrushing or brushes with very hard bristles. These factors can lead to enamel wear, causing dentin exposure or gingival recession.

– People who suffer from periodontal disease may suffer from tooth sensitivity, since this disease leads to gum and bone recession, making the dentin exposed.

– Gingivitis (gingival inflammation) can also lead to the tooth’s root exposure and consequently tooth sensitivity.

– Fractured or cracked teeth can cause inflammation of the tooth’s enervated area, which we call dental pulp, thus causing sensitivity.

– Some mouthwashes, food or drinks are acidic and can lead to enamel’s erosion, exposing the dentinal tubules and then prompting tooth sensitivity.

– Tooth sensitivity can follow oral hygiene procedures performed in clinics, placement of ceramic crowns or veneers, or even dental restorations, which usually disappears after four to six weeks.

Tooth sensitivity after treatment with ceramics, veneers or dental restorations.

Some people mention tooth sensitivity after a cavity treatment, application of ceramic veneers or crowns.

Cavities, the necessary wear endured by teeth during the placement of ceramics, or the ceramic-cementing process, can lead to an irritation of the dental pulp, leading to temporary tooth sensitivity.

This sensitivity is substantially reduced over a period of 4 to 6 weeks, however it can take up to 3 months for all sensitivity to disappear.

Tooth sensitivity after teeth whitening

Teeth whitening, in some cases, prompts the presence of temporary tooth sensitivity, especially laser teeth whitening, which, to achieve to its quicker and more effective aesthetic results, need higher concentrations of the laser-triggered whitening product.

Approximately, 10% of patients may have moderate sensitivity and 4% of patients may have severe sensitivity for one to two weeks.

Patients with gingival retraction are more prone to suffer from tooth sensitivity during a teeth whitening treatment.

This sensitivity is due to the whitening product applied, which may lead to teeth dehydration, mainly of the dentinal tubules, thus causing tooth sensitivity. After the period necessary for teeth rehydration, this sensitivity will decrease in a period that can range from 1 to 3 days, completely disappearing after 1 to 2 weeks.

After getting a teeth whitening treatment, avoid hot or cold foods for one or two days. If you do this, you will not be exposed to an avoidable tooth sensitivity. It is also recommended to brush carefully and use warm water in brushing.

Treatment of tooth sensitivity

There are several treatments available and each professional must adapt the treatment to each patient’s type of sensitivity. There is no one-size-fits-all treatment option.

An accurate diagnosis of the sensitivity’s cause is essential for an effective treatment.

If tooth sensitivity is mild, then it can be treated with over-the-counter dental products, such as mouthwashes (without alcohol) or toothpaste specific for sensitivity.

A soft toothbrush and a moderate brushing are important factors in reducing enamel wear and gingival recession, consequently relieving tooth sensitivity.

In case you need a more complex treatment, you can rely on a professional who will apply a fluoride gel or desensitizing agents, which will strengthen the enamel and protect the teeth.

Fluoride Treatments

In 2014, the ADA (American Dental Association) approved silver diamine fluoride to treat tooth sensitivity. This product’s topical application is widely used in Asia and Europe. Studies were conducted and it was found that patients with dental sensitivity, who were submitted to topical application of silver diamine fluoride, significantly reduced tooth sensitivity.

Dr. Tiago Ribeiro

Dr. Tiago Ribeiro

Graduated in Dental Medicine in 2007 at the I.S.C.S.E.M. – Monte de Caparica – Portugal

Registered in the O.M.D. – Portugal (the Portuguese correspondent with the British General Dental Council) since August 2007

Private Practice in Oral and Aesthetic Complex Rehabilitation (Implants and Teeth)

Clinical Director of the Center for Aesthetics and Oral Rehabilitation of Lisbon – C.E.R.O. – Almada

Responsible for the Department of Oral Rehabilitation of the Center for Aesthetics and Oral Rehabilitation, Lisbon and Almada

Plastic –Esthetic Periodontal and Implant Surgery – University Complutense Madrid

Orthodontic and dental-facial Orthopedics – International Institute of Medical & Dental Science

Guest monitor of Biophysic in Dentistry Course in ISCS – Egas Moniz in years 2005/2006 and 2006/2007.

Advanced course in Botulinum Toxin (Botox) and Hyaluronic acid injections – Med – Estetic Madrid

Clinical Review in Occlusion Assessment

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