December 16, 2005

The Best Wealth is Your Health

Why are my teeth so sensitive?

By Dr. Douglas W. Vierra, D.D.S
Special to the Times

People commonly complain about their teeth being hypersensitive to hot or cold temperatures, biting pressure or sweets.

Since many different factors often contribute to this problem, treatment requires addressing and understanding the multitude of causes for tooth hypersensitivity.

All teeth are naturally sensitive. The inner chamber of each tooth has vital structure consisting of nerves and blood vessels—the pulp. We can sense hot or cold when applied directly to the tooth. The problem of hypersensitivity occurs when this pulp becomes irritated or inflamed.

Faulty tooth restorations or tooth decay can be the source of pulp irritation. Tooth decay in the form of a cavity can clear a path for foods or liquids to irritate the pulp. In similar fashion, worn fillings can allow leakage into the tooth and result in hypersensitivity. These problems must be detected and treated by your dentist.

Often teeth with no filling or decay are hypersensitive. When this is the case, the sensitivity typically originates from the area of the tooth close to the gum line. This point on our teeth is the junction of the enamel that covers the crown visual portion of our tooth and the cementum that covers the root of our tooth. There is a short distance between this crown/root junction and the inner pulp of our teeth.

Toothbrush abrasion from over brushing or brushing with a hard bristle brush can cause wear at the crown-root junction and increase tooth sensitivity. This wear can be detected simply by running your fingernail along the surface of the tooth. A noticeable indentation confirms the wear. Care must be taken to brush thoroughly but gently with a soft-bristle brush.

Erosion from acids in foods can cause wear similar to toothbrush abrasion. Sucking on citrus fruits high in citric acid—lemons, for example—can cause erosion. Also, many sodas are high in acid and can lead to tooth erosion and hypersensitivity.

Perhaps the most common cause of tooth hypersensitivity is a chronic trauma to the tooth. This typically is caused by the subconscious clenching or grinding of teeth, which occurs primarily at nighttime when sleeping. The force of clenching and grinding is many times greater than chewing and can result in a pulp inflammation and subsequent tooth hypersensitivity. This type of hypersensitivity often comes, goes and moves around depending on the degree of clenching or grinding.

Treatment for the causes of tooth sensitivity often requires addressing the multiple factors that cause the problem. Restoring tooth decay or worn fillings is a high priority. Sealing areas of excess wear at the crown/root junction with bonded tooth-colored materials will also help.

The use of an acrylic night guard to prevent the strong force of clenching and grinding at night will decrease pulp inflammation and hypersensitivity. Over-the-counter desensitizing pastes or concentrated fluoride applied to sensitive areas can also decrease hypersensitivity.

If you suffer from tooth hypersensitivity, speak with your dentist about these possible causes. Relatively simple treatments can often resolve or minimize the problem and leave you more comfortable.

Douglas W. Vierra, D.D.S., is the owner of Plaza Dental Group, 1654 E. Capitol Expressway, San Jose, Calif., 95121. Call (408) 270-4333 with questions or to schedule an appointment.