Teeth sensitivity (Dentin hypersensitivity) : Causes, Treatment

What is Teeth sensitivity?

Whenever you eat or drink hot or cold, or sweet and acidic food, or brush and floss your teeth, in contact with cold air you may feel a sharp pain for a shorter period, it is called teeth sensitivity/sensitive teeth or dentin hypersensitivity and also known as dentin hypersensitivity. It is a symptom, not a disease. It is induced by thermal, tactile, osmotic, or chemical stimuli to the exposed dentin.

Common names used to refer to Dentin Hypersensitivity 

• Teeth Sensitivity
• Sensitive Teeth
• Sensitivity
• Dentin Hypersensitivity
• Dentin Sensitivity
• Root Hypersensitivity / Sensitivity
• Cementum Hypersensitivity / Sensitivity

Teeth Sensitivity is more common in,

• The most common locations for teeth sensitivity or hypersensitivity are the cervical portion of teeth and facial surfaces of canine > premolar > incisor > molar teeth.
• It commonly occurs on the opposite side of the patient’s dominant hand. For example, people brushing their teeth with their left hand may have teeth sensitivity on the right side more common.
• Most cases are seen in the 20 to 50 years of age group.
• Females are more affected than males.
• Reduced incidence of tooth sensitivity has been noticed in older people because of changes in tooth structure as age advances.
• Common in periodontal patients.

Causes of Teeth Sensitivity

Common causes of tooth sensitivity include,

• Cracked tooth or fractured tooth
• Tooth decay or cavities
• Mechanical trauma through toothbrushing due to heavy brushing or overenthusiastic brushing
• Traumatic injuries to the tooth
• Crown preparation
• Bruxism or teeth-grinding habit
• Gingival recession
• Worn fillings or restoration
• Gum disease
• Aging
• Frequent consumption of acidic food and drinks

Why does Teeth sensitivity occur?

Dentin hypersensitivity can be understood by widely accepted Hydrodynamic Theory also known as Fluid Movement Theory, proposed by Brännström. According to this theory sensitivity pain occurs due to fluid movement within the dentinal tubules; tubules open between exposed dentin surface to the outer environment and pulp.

The Crown portion of a tooth is covered by enamel and the root portion is covered by cementum. Teeth Sensitivity or Dentin hypersensitivity occurs due to worn enamel on the crown and exposed root surfaces where the cementum is thin or worn off which exposes the underlying dentin and thus dentinal tubules in the outer environment.

Sensitivity occurs due to fluid movement within the dentinal tubules due to thermal (cold or hot), osmotic, evaporation, and physical, and chemical changes near exposed dentine. The movement of fluid within the tubules stimulates a baroreceptor and leads to neural discharge causing pain.

So, whenever the outermost protective layer enamel breaks, the stimulus of hot, cold, or acidic food reaches the dentinal tubules and causes pain we know as sensitivity or teeth sensitivity or dentin hypersensitivity. Thermal changes, sweet and sour, increase the sensitivity.

• Common reasons for Enamel wear/loss 

It may occur due to many reasons like erosion of enamel due to environmental or dietary elements like acidic food (Soda, soft drinks, high sugar or carbohydrate-rich foods), attrition because of bruxism (Clenching of teeth or grinding teeth), abrasion led by improper brushing technique, dietary elements, worn tooth fillings, tooth trauma like a cracked or fractured tooth, etc.

• Common reasons for the Gingival recession

Abrasions due to improper brushing technique, excessive flossing, oral habits (picking, eating hard foods), dental procedures like Crown preparation, and diseases like NUG (Necrotizing Ulcerative Gingivitis), periodontitis, herpetic gingivostomatitis.

You may also notice sensitivity after some dental procedures like tooth restoration, Crown preparation, teeth bleaching, scaling (teeth cleaning), etc. for a shorter period.

You should take the advice of your dentist before making any conclusion in your mind to get the actual cause behind your teeth sensitivity.

How you can avoid Dentin Hypersensitivity :

You can follow the preventive measures given below for sensitive teeth.

1. Focus on your diet and reduce your intake of highly sugary food and acidic drinks. It doesn’t mean you eliminate it, but have it less frequently.
2. Regular brushing of your teeth is crucial to maintain good oral hygiene and preventing oral disease. Make sure you know the proper brushing technique. Don’t be hard on your teeth. Use a soft-bristled toothbrush and change it at regular intervals.
3. Use toothpaste instead of tooth powder because toothpaste in gel form is good for your teeth instead of tooth powder.
4. If you have any habits like clenching teeth or grinding teeth at night (also known as Bruxism) then you should use night guards to prevent erosion of the enamel surface. Meet your dentist and take advice if you have such a habit.
5. Use only alcohol-free mouthwash; mouthwashes containing alcohol cause irritation and sensitivity pain.
6. Routine dental checkups help to cure any oral condition and prevent the progression of any oral disease. Everyone should visit the dentist at least twice a year for routine dental checkups.

Treatment of Dentin Hypersensitivity

How to Stop Sensitive Teeth Pain Immediately

• Use sensitivity toothpaste to get immediate relief for Sensitive Teeth.
• Use fluoride mouthwash at home for pain relief in sensitivity.
• Avoid acidic and sweet drinks
• Use a straw while consuming lemon water or any acidic beverages. Avoid such drinks.
• Application of varnish, dental resin, or sealers on affected teeth helps to relieve sensitivity pain but should be done by a dental professional.

Home Care with Sensitivity Toothpaste or Dentifrice

You can use Sensitivity Toothpaste or Dentifrice for several days to relieve tooth sensitivity or dentin hypersensitivity self-care. There are many products available in the market for Teeth sensitivity, take the advice of your dentist before using any product.

Commonly available toothpastes are,

• Potassium nitrate toothpaste (5%)
• Strontium chloride toothpaste (10%)
• Bioactive glass (Calcium sodium phosphosilicate) toothpaste
• Sodium fluoride toothpaste

Varnish application

Varnish seals the exposed dentinal tubules. It relieves pain and reduces sensitivity. It should be applied professionally. Ask your dentist for the treatment.

Dental Resins and Sealers

It works like varnish seals the dentinal tubules and relieves sensitivity by reducing or blocking the outer stimulus to dentinal tubules. Visit your dentist for the treatment as it should be done professionally.

Fluoride gel / Fluoride Mouthwash

Fluoride application on affected sensitive areas may relieve your sensitivity by blocking the exposed dentinal tubules. There are many fluoride products like fluoride gel, mouthwash, etc. available on the market. Consult your dentist for fluoride treatment.

Gum graft

For gum recession, a gum graft is helpful to cover the root surface of the tooth surface and maintenance of oral hygiene. Consult your dentist to know the relevant options.

Mouth guards

If your sensitivity occurs because of Bruxism or grinding of the teeth, then a mouth guard may help by preventing the wear of enamel and eventually help in sensitivity. Consult your dentist to know the actual cause behind your teeth sensitivity.

Patient Education

Patient Education plays an important role in limiting the causative factor of teeth sensitivity. See the points given below,

• Patients should be educated on proper plaque control methods like proper brushing with brushing technique and flossing method to avoid trauma to teeth which is one of the causative factors for teeth sensitivity.
• Habits causing wear of tooth enamel: picking, eating hard foods, clenching of teeth.
• Avoiding consumption of acidic and highly sugary drinks prevents enamel damage and thus, dentin hypersensitivity.

These are the treatment modalities commonly used to overcome sensitive teeth.

I hope you understand all about teeth sensitivity or dentin hypersensitivity. You can write your doubts by contacting us. Share this information with your friends and family to make them aware.