If you have to worry about dental pain while sipping your coffee or biting into an ice cream cone, you know the frustration of living with sensitive teeth. Tooth sensitivity can make mealtimes challenging and interfere with your daily routine. But in addition to being a nuisance, tooth sensitivity often signals a broader dental problem.
The symptoms of tooth sensitivity can range from an uncomfortable twinge to significant sharp, stabbing, or throbbing pain and can include:
- Tooth pain when exposed to hot or cold foods and beverages
- Spontaneous, intermittent tooth pain limited to one tooth or a few adjacent teeth
- Pain with biting or chewing
- Tooth pain when using alcohol-based mouth rinses
- Pain when breathing through your mouth, especially in cold temperatures
- Discomfort when consuming sweet or acidic foods and beverages
Causes of Tooth Sensitivity
If you are one of the more than 40 million people in the United States experiencing tooth sensitivity, finding the source is essential. Getting your teeth examined by a dentist will help determine why you are having pain and the best method to improve your symptoms.
The most common cause of tooth sensitivity is worn enamel, the protective layer that covers the tooth. Enamel that wears down or thins exposes the dentin, a tooth layer containing tubules that travel to the nerve. Heat, cold, acidity, and other temperature or pressure changes can trigger a pain response in the tooth’s nerve.
Some erosion is a natural result of the aging process, but certain behaviors can accelerate it. Over-brushing is one habit that can cause the enamel to thin prematurely. This can involve brushing too frequently (more than three times a day), scrubbing the teeth with too much force, and/or using a hard-bristled toothbrush.
Under-brushing is equally destructive, as bacteria consume enamel when allowed to accumulate, which is especially true if you are prone to consuming sugary or acidic food and drink, which feed bacteria that eat away at your teeth.
Chronic dry mouth is another common cause of tooth sensitivity, as your teeth rely on adequate saliva production to coat them in protective calcium and other minerals. Saliva also dilutes erosive agents such as acid, removes waste material from the mouth, and boosts protective substances that help fight mouth bacteria and disease.
Tooth-whitening products are common culprits of tooth sensitivity. Some of the whitening chemicals added to these products are tough on tooth enamel and can wear it down over time.
Tooth Decay or Injury
Cavities occur when a hole in your enamel allows bacteria to enter your tooth. As a result, bacteria reach dentin and make the tooth susceptible to sensitivity. Teeth containing cracks or chips can expose the part of the tooth that responds to temperature and pressure changes. The unconscious habit of grinding or clenching your teeth during the day and night is a common cause of injury to the teeth.
Inflamed and sore gum tissue that results from gum disease may cause sensitivity. The nerve-containing roots become exposed as the gums pull away from the teeth, causing sensitivity and more bacteria and tartar deposits.
Your orthodontic adjustments cause your teeth to shift to direct them into their desired placements, making them more sensitive than usual due to the pressure the braces place on them. The sensitivity should only last a few days after each adjustment. If it doesn’t dissipate, you likely have additional causes of tooth sensitivity beyond braces.
Treatments for Tooth Sensitivity
The good news is that various options exist for managing sensitive teeth. Your dentist and orthodontist will help determine which option(s) are best for you.
Desensitizing Toothpastes & Rinses
While desensitizing toothpastes will not fix the underlying cause of sensitivity, they can mask the symptoms. These toothpastes work by combining fluoride, potassium nitrate, and strontium chloride. Fluoride is a mineral that strengthens tooth enamel and acts as a protective layer, which will help prevent tooth sensitivity from getting worse. Potassium nitrate is the active ingredient that blocks the transmission of pain signals to the brain. And strontium chloride blocks the openings of the dentin tubules, preventing stimuli from reaching the nerve. Typically, you will need to apply this toothpaste several times before you notice improvement.
Oral rinses with fluoride and remineralization properties can complement desensitizing toothpastes. However, it is crucial to select options free of alcohol, which can exacerbate sensitivity. Also, try to avoid mint flavoring, which can trigger sensitivity in some people.
The American Dental Association recommends using a soft-bristled toothbrush. Brushing too hard or using a hard-bristled brush can damage tooth enamel and gums. People tend to brush harder and apply more pressure when using a soft-bristled brush, which is harmful to gums and teeth. A steady scrubbing motion will do a lot more than a firm press.
A dental sealant is a thin, plastic liner painted onto the surfaces of your teeth that coats the chewing surfaces, root surfaces, exposed dentin, and gumline to reduce sensitivity. The purpose of dental sealants is to act as a replacement tooth enamel to prevent further damage or tooth decay. The dentist will apply sealant in the specific area where you are experiencing sensitivity. This treatment typically lasts at least six months before needing to be reapplied.
If you suffer from sensitive teeth, swap sugary and acidic foods and beverages for ones rich in calcium, vitamin A, vitamin D, phosphorus, and potassium. These foods and drinks can help restore and maintain the health of your teeth while preventing further erosion. Examples include protein sources such as meat, fish, and tofu, crunchy vegetables, milk, yogurt, and cheese, and orange-colored, non-citrus fruits and vegetables.
There are many DIY treatments you can fashion for sensitive teeth. However, you should only use these until you can see your dentist, with the permission of your dentist as the primary treatment, or to supplement a dentist-approved treatment. Some options include:
- Saltwater rinse: twice per day, use ½ to ¾ tsp of salt in a glass of lukewarm water
- Hydrogen peroxide rinse: mix two tablespoons of hydrogen peroxide (3% hydrogen peroxide works best) with two tablespoons of warm water
- Vanilla extract: pour onto a cotton ball and apply to the gums around the affected teeth.
- Oil pulling: swish with sesame or coconut oil
- Garlic: You can apply garlic directly to the tooth by placing a garlic slice on the tooth or by creating and applying a paste of garlic (mix water and ½ teaspoon of salt)
- Green tea: use unsweetened green tea as a mouthwash twice a day to strengthen teeth and reduce inflammation.
- Capsaicin: using this compound found in chili peppers as a topical gel or through a mouth rinse may burn initially but should reduce pain symptoms after continued use.
- Clove oil: pour onto a cotton ball and apply to the gums around the affected teeth.
- Turmeric: massage directly onto the affected teeth, or make a topical paste using turmeric, mustard oil, and salt
Dental bonding is the application of tooth-colored resin (a durable, plastic material) using adhesives and high-intensity light. Most often, bonding is used for cosmetic purposes to improve the appearance of a discolored or chipped tooth. However, the material applied to the tooth also prevents substances from reaching the dentin and sending signals to the tooth’s nerve.
Bonding usually lasts for several years before it needs reapplication. However, the composite resin used in bonding is not as strong as your natural teeth, making them more prone to chipping or breaking.
Surgical Gum Graft
Receding gums do not grow back, so gum grafting is the only effective treatment for this condition. During this procedure, soft tissue from another part of the mouth or a donor source is fixed over the exposed tooth roots. This new gum tissue will create a tight seal around the tooth roots and protect them from sensitivity.
A bite guard is a removable appliance that fits over your upper and/or lower teeth. It helps prevent damage to your teeth caused by grinding and clenching, a destructive oral habit also known as bruxism.
While bite guards don’t necessarily stop you from grinding or clenching, they help protect the tooth surfaces from damage caused by those actions, including sensitivity.
Bite guards are similar to sports mouthguards but are typically less bulky and made from smoother, thinner plastic. They can be custom-made by your dentist to fit your mouth precisely, bought at a neighborhood drugstore ready-made (boil-and-bite or microwaveable), or purchased online.
If your sensitive teeth cause severe pain and other treatments aren’t effective, your dentist might recommend a root canal, which is considered the most successful technique for eliminating tooth sensitivity. A root canal is an invasive procedure that removes the tooth pulp (innermost layer of the tooth) to stop the pain. After removing the pulp, your dentist will clean the area to prevent infection and fill your tooth with another substance. Lastly, she will place a crown over the tooth to protect the area.
Knowing that orthodontic treatment exacerbates tooth sensitivity can seem daunting for some patients who wish to straighten their teeth but worry about increased discomfort. Invisalign is an excellent alternative for people who suffer from tooth sensitivity. Because there is less opportunity for mouth irritation and the development of bacteria that can often occur through exposure to the metal wires, brackets, and bands of traditional braces, Invisalign helps reduce the sensitivity braces cause.