Dental sensitivity or sensitive teeth

Dental sensitivity can affect one or more teeth and its onset is sudden, the pain can be sharp and it can radiate to the entire tooth. The factors causing pain can be of a physical or chemical nature, and so we shall experience teeth sensitive to cold, hot, sweet or upon touch.

The mechanism by which it occurs is simple. For the teeth sensitivity to exist, the stimuli that produce it must have direct contact with the tooth dentine. Dentine is a part of the tooth that normally at the crown level (the part that can be seen in the mouth) is entirely covered by enamel (an excellent chemical and physical insulating tissue), and at the root level is covered by a very thin layer of a material called cement that does not isolate as well as enamel, this lack being compensated by the fact that the root is covered with bone and healthy gum.

Therefore, we have two situations in which dentin can be exposed: at the coronary level, through the lack of enamel layer, or at the level of the root through several mechanisms we shall present in detail.

Why is enamel missing and how can we stop/treat its disappearance?

Enamel can be missing for various reasons:

  • we were born like this, in this case the absence of enamel is located at the level of the crown near the gum;
  • we brush our teeth incorrectly, using too much force, and/or using a rough bristles toothbrush (with this type of teeth brushing, another micro-layer of enamel is removed, until it disappears, especially near the gum where anatomically it is very thin;
  • excessive consumption of acid food (citrus fruit, tea, tomatoes, pickles, vinaigre, sour wine) – there are persons who because of their bad breath (caused by other reasons) frequently chew small lemon pieces, which leads quite rapidly to sensitive teeth, and afterwards to the loss of teeth;
  • excessive use of mouthwash, which is often of acidic nature;
  • tooth grinding (bruxism) that causes tooth enamel getting blunt on the occlusal surfaces of the tooth (the surface used when chewing);
  • caries;
  • cuneiform lesions, a lesion of non-carious origin characterized by the absence of enamel or enamel plus dentin which appears on the surfaces near the cheeks of the teeth somewhere near the gums;
  • the presence of a bacterial plaque with acidic pH and which creates a vicious circle by gathering, secreting acid, teeth start hurting especially on brushing, avoiding brushing in that area because of the pain, the absence of brushing gathers an even higher quantity of bacterial plaque that will produce even more acid secretion and will make your teeth even more sensitive finally leading to caries, tartar and gingival retraction.

 Sensitivity at the root level can occur as follows:

  • through the passive eruption of the tooth: the teeth are conceived as the upper ones “step” on the lower ones. For example, if at the jaw level we have a missing molar, the lower molar from the mandible does not have what to “step” on, and therefore a passive eruption process will begin, as to find something to make contact with. It will erupt (will come out of the bone) until entering in contact either with another tooth or the gum (from the top). This migratory tooth phenomenon will expose the root into the oral cavity, and all physical or chemical stimuli can produce sensitivity.
  • by gingival retraction – when the gum retracts, the root is exposed in the oral cavity. Reasons why we have retracted gum: incorrect brushing, presence of bacterial plaque, tartar, some general illnesses, incorrectly made fillings, incorrectly made crowns, etc.

Remedies for sensitive teeth

To prevent or stop the evolution of dental sensitivity I recommend a more balanced diet, without any excess of acidic food. I also recommend a good, gentle brushing technique, using soft or medium bristles.

Contrary to what you see and hear in advertisements, mouthwash is used occasionally, not at all or upon your dentist’s recommendation. Why? Because on the mucosa covering the inside of the mouth there are some beneficial microorganisms that live in symbiosis with our body, which secrete beneficial substances for us and protects us from other harmful microorganisms. Briefly, in case of good dental hygiene, based on a correct dental brushing, there is a balance in the mouth of each of us. By using mouthwash, which contains a lot of chemical substances harmful to the human body and destroying those microorganisms, for a long time, this balance is disturbed and along with harmful substances in foods and daily stress can lead to some diseases of the cavity mouth.

With regards to methods of treating sensitive teeth, the first option is the use of desensitising toothpastes. These toothpastes can result in improving or even stopping sensitivity after a few applications, or they may have no effect.

For the persons for whom desensitising toothpaste does not lead to any improvement, I recommend a specialist consultation and preparing customized treatment that can include application of gel or fluoride varnish, application of a desensitizing agent, or application of fillings or crowns to affected teeth.

In the case of migrated teeth, it is possible to institute an orthodontic treatment, while in the case of gingival retractions, it is possible to perform periodontal treatments such as professional periodontal hygienization, where the chances for the gum to come back and cover the root again are significant, or more complex periodontal surgical treatments, with good results in most cases.

Finally, the radical treatment solution for sensitive teeth is the devitalization of the affected tooth/teeth, a treatment which is one hundred percent functional, but it also has its own drawbacks.

If you have sensitive teeth and want to get rid of this problem, I will be happily waiting for you for a consult and on this occasion we will try to solve this problem together. Why not enjoy a refreshing ice cream in summer or a hot tea in winter, when there are solutions at hand?

”Solving a problem lies in finding the solvers”, Van Harpen Law.

Dr. Florin Popastate

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