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Tooth Sensitivity?

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The inside is made up of the dentin, which contains microscopic tubules filled with tiny nerve endings. The outer layer is the enamel that protects the dentin extending down to the root of your tooth is protected by a layer of cementum. Dentinal hypersensitivity or tooth sensitivity occurs when there is a loss of enamel exposing the dentin ( inside layer), exposing the nerve endings to hot, cold, acidic or sticky foods or either through loss of the enamel layer or recession of the gums.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope.

Sensitive teeth can be caused by the following dental issues:

  • Worn tooth enamel from using a hard toothbrush and using a hard grip while brushing aggressively.
  • Tooth erosion due to highly acidic foods and beverages.
  • Tooth decay, worn leaky fillings and broken teeth that expose the dentin of your tooth.
  • Gum recession that leaves your root surface exposed.
  • Grinding your teeth at night.
  • Post dental treatment sensitivity – common, but temporary, especially with procedures such as crowns, fillings and tooth bleaching.

Have a professional examination to determine the cause of your discomfort. The dentist along with your description of your symptoms can look for the signs of dentin exposure, and run tests to determine what the true cause of your sensitivity.

Sometimes sensitivity could be due to a cavity or gum disease. Other times, the cause can be due to enamel lost through abrasion or erosion or the gum recession which cause root exposure.
The treatment could be as easy filling a cavity or replacing a worn filling. Gum recession can be determined by your dentist depending on the severity of the root exposure. Sometimes may be suggested a referral to periodontist for gum grafting to protect the roots that have been exposed and support the tooth. There are professional and home treatments that can be used to reduce tooth sensitivity:

In Office Procedures:

  • Fluoride varnish can be applied to exposed areas, strengthening the enamel and dentin
  • Desensitizing solution: a liquid form placed on to protect from sensitivity for at least 10 seconds
  • Fluoride  gel can be placed into your mouth ,providing the teeth with a high concentration of fluoride to strengthen the areas
  • Bonding agent, the material used to stick tooth colored restorations to teeth, can be used to seal the dentin surface and provide a barrier to the stimuli that cause sensitivity.

At Home:

  • Use a very soft bristle tooth brush, with low abrasive tooth paste
  • Brush correctly and do not over brush or brush hard
  • Use a tooth paste specially formulated to soothe the nerve endings in the tooth such
  • Use a high concentration fluoride toothpaste (given to you by the dental professional) to strengthen the tooth surface

Always seek a dental professional’s help – do not try to diagnose this problem yourself. It may be the sign of something more serious, and only a dental professional can tell you what it really is.

Referral article:

Written by Fotini Molnar

Dr. Fotini Molnar started her dental experience working as a dental assistant in a co-op program during high school. She went on to complete her Bachelor of Science, majoring in biotechnology at York University and then obtained her Doctor of Dental Surgery (DDS) degree from the University of Toronto. Prior to her career in dentistry, Dr. Molnar researched neuroblastoma at Sick Kids Hospital.
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