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Question: “Dr.
Arnold, I have always had sensitive teeth. The sensitivity
is generalized, and it’s not constant, but it bothers
me on a regular basis when I drink something cold. What
is the best treatment for this type of sensitivity?”
Answer: Tooth
sensitivity is a common problem that plagues many adults.
The reason and appropriate treatment are both dependent
upon several factors. The causes for “generalized” (affecting
several teeth in different areas of the mouth) sensitivity
can range from having multiple cavities, multiple teeth
with cracks, sinus infections, enamel erosion, heavy wear
of the teeth, gum recession, abfraction (“notching” of
teeth along the gumline), or other issues. Such sensitivity
could be a result of any of these factors or a combination
of several. Gum recession and abfraction are the most common
issues that I have observed in my practice.
Enamel is the hardest structure in the human body, and
it forms the outer layer of teeth. It provides a barrier
that protects the inner portion of teeth that is likely
to be sensitive if exposed. Gum recession is a common problem
which can be cause by overly aggressive toothbrushing,
gum disease, excessive force being applied to the teeth,
or normal aging. As the gums recede, the root surface is
often exposed, and the root surfaces of teeth aren’t
protected by enamel. This commonly leads to cold sensitivity.
In these cases, treatment can consist of something as simple
as using toothpaste made for sensitive teeth. Other options
include utilizing a fluoride rinse regularly, having your
dentist place desensitizing agents on the exposed root surfaces,
or treatment of these areas with a water laser. Any other
issues involved in this process should also be addressed.
It is commonly believed that abfraction lesions are caused
by excessive lateral forces being applied to teeth. Sometimes
this is created by having teeth that are poorly aligned,
which produces significant lateral forces on teeth while
chewing. This can often be corrected with orthodontic treatment
and/or adjustments made to teeth (equilibration) that will
create more a more harmonious chewing pattern.
Sometimes abfraction is caused by a clenching or grinding
habit. If there is a daytime grinding or clenching habit,
the cycle must be broken with conscious effort on the part
of the individual. The damage caused by a nighttime habit
can be decreased with the help of a nightguard. The “notches” or
grooves that have developed along the gumline can generally
be filled in with tooth-colored filling material, and the
teeth can be equilibrated so that this isn’t as likely
to recur.
As you can see, there are many possible reasons for teeth
to be sensitive. You should definitely consult with your
dentist to determine the cause and the necessary treatment
as soon as possible to avoid a potential emergency.
Dr. Jim Arnold is a practicing dentist in Chesterton and Valparaiso. He is also a clinical mentor with the Hornbrook Group and serves on the Advisory Board for the Academy of Comprehensive Esthetics as the Fellowship Chairman. You may send questions to his office at: 1830 South 11th Street, Chesterton, IN 46304 or email them to: drarnold@SmilesByArnold.com. More information on this or many other dental topics can be found at www.SmilesByArnold.com.
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