Sensitive teeth are a common problem, affecting as many as 40% of the population. If you wince when you sip a hot drink or when you eat a cold food like ice cream, then you probably have sensitive teeth. The pain can be sharp, sudden, and shoot deep into the nerve endings of your teeth.

The most common cause of sensitive teeth is dentine hypersensitivity, where the exposed dentine responds to a stimulus like heat, cold, or touch. The most common cause is cold stimulus when eating or drinking. Other causes include chipped or cracked teeth, and tooth rot (caries), among other things.

Tooth enamel is the strongest material in your body. Normally, it protects the parts of your teeth that are not embedded in your gums. Underneath your gums your teeth contain an inner layer called dentine. This is porous, containing thousands of microscopic tubules that lead to your teeth's nerve centre.

When the dentine is exposed, hot and cold food and drink can flow through those microscopic tubules, stimulating those nerves. This causes the pain we associate with sensitive teeth. Acidic or sticky foods can have a similar effect. If you have sensitive teeth, even chewing or breathing through your mouth can cause pain.

Sensitivity is common in Malta in people of all ages because soft drinks, fruit juices and wine which cause acid erosion, especially if you brush your teeth soon after drinking. Your tooth enamel starts to dissolve when exposed to a pH value of 5.5. Once the dentine is exposed, even lower acidity can cause erosion.

You can prevent the damage that causes sensitivity by practicing good oral hygiene.

Use a soft toothbrush, hold it at a 45 degree angle to your teeth, don't press hard when brushing, and don't brush your teeth immediately after eating or drinking. Tooth sensitivity is not always caused by poor oral hygiene. Grinding your teeth - a common problem at night - can also cause erosion and sensitivity. Periodontal disease, where gums recede and create space where bacteria can grow, can also cause erosion and sensitivity problems.

 

CAUSES OF TOOTH SENSITIVITY

Age - sensitivity is highest between the ages of 25 and 30.

Brushing wrongly - brushing your teeth regularly helps keep them healthy but brushing incorrectly or using a brush that is too hard can wear down your enamel and cause your gums to recede, exposing the sensitive underlayers of your teeth.

Cracked teeth - if your teeth are chipped or broken, bacteria may collect in the crevices forming plaque that can cause inflammation.

Acidic food - regularly eating food with a high acid content can cause enamel erosion. Such foods include tomatoes, tea, pickles and citrus fruit.

Tooth whitening products - these can increase sensitivity as they affect the thickness of your tooth enamel. Tooth whitening products include toothpaste that contains baking soda or peroxide.

Gum disease (gingivitis) - if your gums are inflamed and sore, the supporting ligaments may weaken exposing the roots of your teeth.

Gum recession - gums may recede for various reasons, include incorrect brushing, gum disease or periodontal disease. Receding gums expose the sensitive parts of your teeth. In some cases your dentist may recommend grafting gum tissue to cover the exposed part of your tooth, or may recommend root canal treatment to eliminate the pain permanently.

Plaque - plaque is mainly removed through regular brushing and flossing. However, if the teeth are damaged, plaque can accumulate in hard-to-reach crevices, causing sensitivity.

Mouthwash - not all mouthwashes are equal. Some contain acid that can make tooth sensitivity worse. Using an acidic mouthwash when you have sensitive teeth can make the problem worse as the acid can damage the dentine layer of your teeth. If you need to use a mouthwash, ask your dentist to recommend a suitable one.

Grinding teeth - the habit of clenching your jaw or grinding your teeth is often unconscious but it effectively wears down the enamel, exposing the sensitive layers of your teeth.

Dental procedures - sometimes sensitivity results from healthy and necessary dental procedures, including cleaning, crown insertion, or root planing. This type of sensitivity is normally temporary and disappears within a few weeks.

HOW TO REDUCE TOOTH SENSITIVITY

Practise good oral hygiene

Clean all parts of your teeth and mouth properly and regularly. Brushing immediately after a meal is not a good idea as the enamel is particularly soft at that time. It is best to wait for 20-30 minutes after eating or drinking before you brush your teeth.

Use a soft toothbrush

A hard toothbrush is abrasive, wearing down your tooth enamel and irritating your gums. Using a soft toothbrush minimises damage, particularly if you brush gently around the gum line.

Use a toothpaste made for sensitive teeth

Specially made toothpaste can help desensitise your teeth if you use it regularly. Not all brands have the same effect on everyone so you may need to try more than one brand to find one that works well for you. Apart from brushing regularly using your specialised toothpaste, you could spread a thin layer on exposed tooth roots before going to bed. The specialised toothpastes work by depositing compounds that help block the pathway from the tooth surface to its nerve centre. Normally, several applications are necessary before you will notice a marked reduction in sensitivity.

See your dentist regularly

Ideally, you should visit your dentist every six months or so to have your teeth checked and any problems seen to. Having your teeth cleaned professionally will help reduce problems between dental visits. Your dentist can also advise or remedies for exposed areas of your teeth. These include white fillings, fluoride varnishes and dentine sealers applied to exposed root surfaces. Alternatively, your dentist may recommend additional fillings, a crown or bonding to correct a problem that may lead to sensitivity.

Use fluoridated dental products

Use a fluoridated toothpaste for regular brushing and if you need to use a mouthwash, use one that contains fluoride and is not acidic.

Eat right

Regularly eating acidic foods can damage tooth enamel and can aggravate existing sensitivity.

Use a mouth guard

If you grind your teeth during sleep, use a mouth guard.