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Question: “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, abstraction (“notching” of teeth along the gum line), or other issues. Such sensitivity could be a result of any of these factors or a combination of several. Gum recession and abstraction are the most common issues that I have observed in my practice.

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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 that can be caused by overly aggressive tooth brushing, gum disease, the 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 abstraction 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 abstraction is caused by a clenching or grinding habit. If there is a daytime grinding or clenching habit, the cycle must be broken with a 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.