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Sensitive teeth can be a confounding problem. They can become quite annoying and make enjoying many foods and drinks difficult. Tooth sensitivity is caused by a number of problems. Hopefully this page will help you determine the cause of your sensitivity, offer some solutions, and help decide whether you need to see your dentist about it. Each following section describes causes, gives diagnosis tips, and presents possible solutions.

 

Gum Recession 

Receded gum tissue is one of the most common causes of tooth sensitivity. Exposed root surfaces have no enamel and are much more sensitive to temperature.

 

Causes - Periodontal disease, toothbrush abrasion, malocclusion (bad bite), bruxism (teeth grinding), frenum pull, poor oral hygiene.

 

Diagnosis Look for a gum line that has receded below where adjacent teeth have. Exposed roots are usually a bit darker than the adjacent crown as well. Sometimes the tooth will have a notched appearance as well.

 

Treatment Sensodyne or other sensitivity toothpastes work well after about two weeks of use in most cases. However once treatment is stopped the sensitivity often returns. Dentists have a host of desensitizing medicaments that have improved recently and are quite effective. If the tooth is notched or worn a filling is often indicated as well. Severe recession may need a gingival graft procedure to help replace lost gum tissue.

 

Decay 

Tooth decay is the other most common cause of sensitivity. Early decay is often asymptomatic but as it penetrates the tooth further many people will begin to develop cold sensitivity (see the Toothache page for more information).

 

Causes Bacterial infection of the hard tooth structure which causes irritation of the dental pulp.

 

Diagnosis This needs to be done by a dentist. Large cavities visible to the patient are usually quite advanced. A hard diagnosis even for your dentist can be decay developing under old fillings or crowns. These are difficult to detect both clinically and with x-rays. One clue that your sensitivity might be decay is when it does not go away after a few weeks of sensodyne or similar toothpaste use.

 

Treatment A filling, crown, or other appropriate restoration. If the decay has advance deep enough into the tooth a root canal may be indicated.

 

Teeth Grinding (Bruxism) 

Bruxism will cause sensitive teeth in a variety of ways. It can contribute to the gum recession and decay discussed above. It  wears the enamel off the tops of teeth, causes cracks, and can also simply make healthy teeth hypersensitive to cold.

 

Causes No one knows why we grind our teeth. However, it does seem to increase during times of stress.

 

Diagnosis Your dentist can look for signs of wear. Other symptoms can be jaw tightness or soreness, headaches, ear pain, and the like.

 

Treatment Chronic night time grinding can be controlled with a night guard such as the NTI device discussed elsewhere on this website.

 

 

Cracked Tooth Syndrome 

Cracked tooth syndrome is a very common problem, most often found in the posterior teeth. Hairline cracks in the tooth can make teeth very cold sensitive. These teeth are often sensitive to biting hard or chewy foods.

 

Causes Large fillings, decay, bruxism, trauma.

 

Diagnosis Transillumination and a bite test done by your dentist. Symptoms are irregular bite and/or cold sensitivity. Hard foods like pretzels are the most common trigger of the bite pain.

 

Treatment A crown is indicated in many cases, though a filling or onlay can work if a single tooth cusp is determined to be the culprit and no deep cracks are found. Some of these teeth will need a root canal as well.

 

 

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Last modified: October 21, 2011