Teeth Can Be Sensitive For Many Reasons
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.