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Got tooth sensitivity?
 
Sensitive teeth are not only painful, but they can also begin to interfere with your daily life. It can also be an early warning sign of more dental problems.
 

 
The part of the healthy tooth has a layer of enamel over the crown portion (particularly the part above the gum line). When the enamel that protects our teeth gets thinner, or when gum recedes (pull back), dentin (the softer layer of the tooth and the part of the tooth which covers the nerve) loses its protective covering of enamel or cementum (under the gum line over the root) exposing the underlying surface thus, reducing the protection to the enamel and to the gums.
 
Dentin has thousands of tiny hollow tubes (tubules) that lead to the nerve (pulp) and are filled with fluid.  The tubules of the dentin when loses its protective covering or exposed allow temperature changes (heat or cold) and certain acidic, sweet or sticky foods to reach the nerves and cells inside the tooth and can cause a change in fluid movement. This fluid movement causes nerve endings to react in response causing tooth or teeth to become sensitive or painful (short or sharp pain)
 
The pain usually subsides after a short period of time. But it can also be an early warning sign of more serious dental problems.
 
Tooth sensitivity affects approximately half of the population.
 
Sometimes, however, tooth discomfort is caused by other factors, such as a cavity, a cracked or chipped tooth, a recently placed filling or worn fillings or a side effect of other dental procedures, such as bleaching.
 
What can cause you to have sensitive teeth?
 
Several things can bring it on. Besides hot and cold drinks, your tooth might hurt if you eat or drink something sweet or sour. Sometimes a breath of cold air can set it off.
 
Wear and tear (abrasion) – Dental hygiene habits such as brushing too frequently, too vigorously or too hard with a hard-bristled toothbrush, or if you grind your teeth can eventually wear down your tooth enamel. They can also cause receding gums causing further exposure of the dentin.
 
Tooth decay- This can lead to sensitive teeth when it happens near the gum line.
 
Damaged tooth – A cracked, chipped or broken teeth may fill with bacteria, which can enter the pulp and set off inflammation.
 
Gum disease (also known as gingivitis) – It causes inflamed and sore gums that pull back and reveal the roots of your teeth. If left untreated, gingivitis can lead to periodontitis. Periodontitis is when gum disease gets worse and damages the tissues and bone that support the teeth. One sign of periodontitis is sensitive teeth, as the receding gums leave dentine exposed. Periodontists in the dental clinics in India are doing gum treatments like flap surgeries and bone grafts in advanced cases and salvaging even mobile teeth.
 
Receding Gums- A receding gum near the sensitive tooth can be caused by conditions such as gum disease which can expose the tooth’s dentin and cause sensitivity. If you have any recession of your gums or bone loss and your tooth root is exposed as a result, then you are also scrubbing at cementum. Cementum is meant to protect the root of the tooth, but wears away even faster than enamel.
 
Teeth grinding- If you grind your teeth when you sleep or during the day, or if you clench your teeth, you may be wearing down your enamel and exposing the underlying dentine layer of your tooth.
 
Tooth whitening products- These may also contribute to sensitive teeth. Cosmetic dentists in Delhi, who are doing teeth whitening/ bleaching of teeth as a routine give a medicated toothpaste and an antisensitivity mouthwash as a standard regime post teeth whitening procedure. The sensitivity gets reversed in a few days by proper use of these.
 
Age factors – Many people suffer from sensitive teeth and it can start at any time. Teeth are most sensitive around 25-30 years of age.  Women are more likely to be affected than men.
 
Plaque buildup- It can cause sensitivity when it’s on the surfaces of your roots.
 
Dental erosion – This is loss of tooth enamel caused by attacks of acid from acidic food and drinks. Acidic food and drinks with a high acid content, like citrus fruits, tomatoes, pickles, and tea, can wear down your enamel.
 
Dental treatments- Bleaching, teeth cleaning, root planing, crown placement, and tooth restoration can also make your teeth sensitive for a short time. This should go away in a week to ten days with the use of a medicated paste and mouth wash.
 

 
Steps to find relief and reduce your tooth sensitivity
 
Sensitive teeth can be treated. If a tooth is highly sensitive for more than three or four days and reacts to hot and cold temperatures, it is best to get a diagnostic evaluation from your dentist to determine the extent of the problem. If you are concerned about sensitive teeth, it is always important first to pinpoint the exact cause of sensitive teeth. That way you will hit on the right solution. Dentists in the dental clinics in Delhi, take a thorough history of the patient along with the examination  of the teeth and gums. They will identify or rule out any underlying causes of your tooth sensitivity and pain and will find the best way of treating it. The type of treatment will depend on what is causing the sensitivity.
 
There are many ways for you to control sensitive teeth. Your dentist may suggest one of a variety of treatments:
 
Brush, floss, and rinse regularly- 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. Twice a day, brush your teeth with a soft bristled toothbrush and fluoride toothpaste Use the right technique to thoroughly clean all parts of your teeth and mouth. Rinse with a fluoride and antiseptic mouthwash every day.
 
Use a soft-bristled toothbrush- Brush gently and carefully around the gum line so you don’t remove gum tissue or wear the enamel. Brushing teeth too vigorously can actually wear away enamel causing receding gums, causing further exposure of the dentin or if you are not brushing for a full two minutes, then you’re not doing any favours for your sensitive teeth. So avoid vigorous or harsh scrubbing, highly abrasive toothpaste, and excessive brushing and flossing. If you grind your teeth, ask your dentist about a mouth guard. Tooth grinding can fracture teeth and cause sensitivity.
 
Avoid acidic food and drinks- Exposure to red wine, pop, fruit juices and acidic foods such as oranges and pickles can put your enamel under constant attack.
 
Use of desensitizing toothpaste- This contains compounds that help block transmission of sensation from the tooth surface to the nerve. When you do this regularly, after several applications can help block pain and it should make your teeth less sensitive. How you are using it is important. You can also spread a thin layer on your exposed tooth roots with your finger or a cotton swab before you go to bed. Use fluoridated toothpaste, not tartar control one. Lots of times people are using it just for a little bit, and then they stop. But you need to continue using it.
 
Desensitizing paints- If you are not having much luck with desensitizing toothpaste, desensitizing agents like fluoride varnish or even plastic resins can be applied to the sensitive areas of your teeth. These can be painted onto the teeth at regular appointments one or two weeks apart, to build up some protection. Sensitivity can take some time to settle, and you may need to have several appointments for the reapplication.
 
Fluoride- Your dentist might apply fluoride to the sensitive areas of your teeth to strengthen tooth enamel and reduce pain sensations. He or she might also suggest the use of prescription fluoride at home. Dental clinics in India and dental clinics in Delhi have a systematized regime for topical fluoride application on the teeth for children.
 
Stop tooth grinding- If you have a habit of grinding your teeth when you are tense, you could be wearing away enamel and giving yourself a sensitivity problem. You may not even realize you are grinding. Often people only do it while they are sleeping, but unexplained jaw pain or headaches could be a clue. If you do grind your teeth, try a mouth guard at night, or change your sleeping position. If you notice yourself clenching during the day, remind yourself to relax your jaw with your teeth slightly apart. Dentists in Delhi are giving night guards regularly to such patients and have been getting good results.
 
Crown, inlay or bonding- These may be used to correct a flaw or decay that results in sensitivity Occasionally,  in some dental clinics in Delhi ,exposed root surfaces can be treated by a very conservative approach of applying bonding resin to the sensitive root surfaces around the neck of the tooth. Local anesthetic might be needed.
 
Treat your receding gums – Normally the root of your tooth is covered up by your gum tissue. But if you have some gum recession, caused by gum disease or even hard brushing, then the root will be exposed and the cementum can be worn away. Dentists in Delhi may be able to rebuild or restore your receding gums, for example with a treatment involving surgical gum tissue grafts. In this small amount of gum tissue can be taken from elsewhere in your mouth and attached to the affected site. This can protect exposed roots and reduce sensitivity. In the dental clinics in Delhi , periodontists or gum specialists are doing focussed practice related to gum problems.
 
Root canal- If sensitivity is severe and persistent and other treatments are not effective, your dentist might recommend a root canal (a procedure used to treat problems in the tooth’s soft core-dental pulp). While this might seem like a significant treatment, it is considered the most successful technique for eliminating tooth sensitivity. Dentists in Delhi especially in the reputed dental clinics in Delhi, are doing 90 percent of the root canals in just 1 sitting. So sensitivity due to this can be relieved quickly.
 
How can you prevent teeth sensitivity?
 

• To prevent sensitive teeth from recurring, your dentist might offer suggestions to help you maintain your oral health. Brush your teeth last thing at night and at least one other time during the day, with fluoride toothpaste. Consider using toothpaste specially designed for sensitive teeth. Use small, circular movements with a soft to medium bristled brush. Try to avoid brushing your teeth from side to side.
• Limit sugary foods and acidic foods and drinks, such as carbonated drinks, citrus fruits, wine and yogurt all since acid softens enamel and makes it more vulnerable to erosion during brushing and therefore can remove small amounts of tooth enamel easily over time.
• Avoid brushing your teeth immediately straight after eating. Try to brush about 20 minutes or an hour after eating (not earlier, or the brushing may hurt your enamel further). Even if your teeth are not yet feeling sensitive, it is a good idea to be cautious about consuming certain foods and drinks, as enamel loss is irreversible. When you drink acidic liquids, use a straw to limit contact with your teeth. After eating or drinking an acidic substance, drink milk or water to balance the acid levels in your mouth.
• Change your toothbrush every two to three months or sooner if it becomes worn.
• If you grind your teeth, talk to your dental team about whether you should have a mouth guard made, to wear at night.
• If you are thinking about having your teeth bleached, discuss sensitivity with your dental team before starting treatment.

 
See your dentist. Do this every 6 months or sooner, depending on your condition.
 
If you still have discomfort, talk to your dentist. There may be other procedures that can help.
 

Posted By – Dr. Shriya