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Why are my teeth so sensitive?

Updated: Mar 18

There are many causes of sensitive teeth. If you have sensitive teeth, it's important to figure out why so that you can know what to do about it. While tooth sensitivity usually indicates that something is wrong, sensitive teeth can be treated.

What causes tooth sensitivity?
  1. Tooth decay (cavities)

  2. Fractured or cracked teeth

  3. Worn or deep fillings

  4. Pressure on teeth - from clenching or grinding

  5. Gum disease or poor oral hygiene - from poor homecare or irregular dental visits

  6. Worn tooth enamel - from diet or aggressive brushing

  7. Exposed tooth root - from gum disease, grinding/clenching, or aggressive brushing

In healthy teeth, a layer of enamel protects the crowns of your teeth (the part above the gum line). Under the gum line, a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin. Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

How are sensitive teeth treated? The type of treatment depends on what is causing the sensitivity.
  1. Tooth decay (cavities): Your dentist will remove the decay and place a filling. A liner or root canal therapy may be needed if the cavity is approaching or into the tooth's nerve.

  2. Fractured or cracked teeth: A crown, inlay, or bonding may be needed along with the possibility of root canal therapy. In some cases, the crack may go so far down the root that saving the tooth may not be possible.

  3. Worn or deep fillings: For worn fillings, replacement will usually improve or eliminate the issue. For deep fillings, replacement with or without the use of root canal therapy may be needed.

  4. Pressure on teeth: A custom-fitting night guard will help you to overcome this habit and/or protect your teeth when you are clenching or grinding.

  5. Gum disease or poor oral hygiene: Regular dental care, prophylaxes, and deep cleanings can help your gum tissue to bounce back a bit and help with root exposure. Unfortunately, bone does not grow back once lost so desensitizing toothpastes and fluoride treatments are often recommended.

  6. Worn tooth enamel: Unfortunately enamel can't grow back once lost so desensitizing toothpastes and fluoride treatments are often recommended. Crowns or veneers may also be an option if the wear is severe enough.

  7. Exposed tooth root: Surgical gum grafts, fillings along the gumline, and fluoride treatments are often the recommended treatments. If gum tissue has been lost from the root, gum grafts or fillings will protect the root and reduce sensitivity.

How do sensitivity toothpastes and fluorides work?
Desensitizing toothpaste: This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced. The brand you use doesn't matter much. Whichever one you will use is the best one for you! Fluoride gel: This is an in-office technique which strengthens tooth enamel and reduces the transmission of sensations. Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity!

Dr. Stephanie Stephan DDS, Dentist in Auburn Hills, Pontiac, and Waterford Michigan 1590 Baldwin Avenue, Auburn Hills, Michigan 48340

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