There you are, staring down an amazing ice cream cone, or maybe it’s a cold glass of ice water. You lean in and grab a bite or take a sip only to be hit suddenly with a spike of pain in your tooth…right down to the root. You have sensitive teeth it turns out, and they’re telling you to do something about it.
A third or more of people will face the dreaded sensitive tooth pain at some point. It may be triggered by a cold drink or food or even a breath of cold air. For some, hot beverages, sweet, sour or acidic food or drink could be the source, but it all boils down to that hit of pain you would do anything to avoid. Really? More on that later when we discuss brushing and flossing.
Sensitive teeth can come from a variety of sources. In the absence of damage or disease, it usually results from the wearing away of gums exposing the root surface of the tooth. The root is made of dentin. This is the layer underneath tooth enamel which may have worn out from over-aggressive brushing, grinding and/or clenching your teeth or naturally from wear and tear over time. Periodontal disease can also lead to gum loss. Another cause of tooth sensitivity is tooth whitening. The action of hydrogen peroxide draws moisture out of the enamel which decreases the insulation of the nerve from temperature changes.
The dentin layer of your tooth is soft and contains thousands of tiny tubes that lead to the tooth's nerve center. It is these channels which allow the trigger stimuli to reach the nerve in your tooth, and that’s where the pain comes from.
If you face ongoing pain from sensitive teeth, the best thing to do is to let a dentist look them over. Your dentist can rule out problems such as cavities, chips or cracks and is a great source of advice. This might be a good time to review your brushing and flossing skills.
There are a number of things you can try to reduce the pain from sensitive teeth; not every solution will work so you may need to try several. Start by using a toothbrush with soft bristles and don’t use overly aggressive force when brushing. Choosing a less abrasive toothpaste can help; those with baking soda tend to be less abrasive while whitening toothpastes are the most abrasive. Alternately, try a desensitizing product which is most effective when applied to the tooth surface closest to the gum line and left overnight (no rinsing after application). Because acidic foods and beverages can cause erosion, cutting back may be a good idea. If you have tried all these and still face sensitivity problems, definitely visit your dentist who may be able to offer treatment with a desensitizing agent or apply sealants to your teeth. Your dentist may also recommend a custom-made mouth guard to ease the pressure of grinding and clenching.
Brushing your teeth is the foundation of prevention, but does everyone brush and floss effectively? Clearly not. Brushing should be done at least twice a day and certainly before bedtime. Start with a soft-bristled brush that fits comfortably in your mouth, and then apply a pea-sized amount of fluoride toothpaste. In general, angle the brush against the teeth working in small circles on the face and back of the teeth as well as on the chewing surfaces.
Follow this with flossing at bedtime or more often if you can. Use a length of floss drawn tightly between your index fingers then slip it gently between teeth. Move it up and down against the tooth surface. The pressure should be against the tooth surface, not the gum.
The best practice of all is to avoid the problem in the first place. That means practising good dental hygiene with regular brushing and flossing supported by regular visits to the dentist for cleaning and evaluation.
Written by Dr. Paul Martiquet, Medical Health Officer for Rural Vancouver Coastal Health including Powell River, the Sunshine Coast, Sea-to-Sky, Bella Bella and Bella Coola.