Sensitive Teeth
Thursday January 4, 2007 

Dear Dr. Mady: : I have been suffering for some time with gum disease and severely sensitive teeth. Every time I eat something hot or cold I feel pain throughout my entire mouth. What could be causing this and is it curable?—Janice in Tilbury


Dear Janice: Extremely sensitive teeth can make anyone’s life miserable. The pain associated with this can make even your favorite hot or cold foods almost impossible to enjoy. I do want you to realize that in many cases, sensitive teeth can be successfully treated bringing long sought after relief.

      Tooth sensitivity usually does not come from the enamel covering but rather from the next layer beneath the enamel known as the dentin. If it is only a sensitivity that you are dealing with, then dentin hypersensitivity most commonly presents as temporary tooth discomfort or pain after a stimulus such as a hot or cold drink or a breath of winter air. If the pain persists for longer than a few seconds then you may be dealing with a more serious dental nerve problem and you should consult with your dentist for proper diagnosis.

      There are many causes of tooth hypersensitivity, but the most common one is exposed root surfaces from either gum disease or improper brushing. Other causes may include but are certainly not limited to tooth decay, cracks in teeth, inflamed nerves in teeth, gum line erosion, recent fillings (usually goes away), grinding of teeth and an improper bite.

      One key to preventing tooth sensitivity is to keep the gums from receding. The first step is to always use a soft or ultra-soft toothbrush. Never purchase a medium or hard bristle brush. It may feel like you are doing a better job but in reality you are wearing away good tooth structure and gums. From this, your teeth will ultimately look long and unattractive and may really become sensitive. Also consult your dentist or hygienist about your brushing technique.

      Another crucial step in preventing this discomfort, which goes hand in hand with proper brushing and flossing, is regular dental checkups and professional cleanings. Your dentist can debride plaque and damaging tartar from areas that your brush and floss cannot reach, especially if you already have a history of gum disease.

      As far as getting the situation under control after it has become a serious problem, try using a “sensitive tooth toothpaste” that contains ingredients like strontium chloride or potassium nitrate. These types of products, after a few weeks of use, may actually seal off the surfaces of the teeth by allowing minerals present in your saliva to actually crystallize and cover the pores in your teeth so that stimuli cannot reach the nerves. The only downfall to this is that vigorous brushing can remove this covering very quickly and the problem returns. It is also important to know that highly acidic foods can work directly against these types of toothpaste and enamel.

      If you find that gentle brushing and sensitivity toothpaste is not helping the situation, your dentist can use oxalate compounds that when rubbed on the teeth and roots can often instantly eliminate the sensitivity or drastically reduce it. In addition to this they may administer fluoride in the dental office and prescribe the use of a fluoride mouthrinse to reduce sensitivity.

      In any case it is recommended that you are examined because occasionally one bad tooth or severe grinding can make your entire mouth hurt. Your dentist will determine what the cause is, through clinical examination and x-rays and will suggest a course of action.

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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