Women wincing with sensitive teeth while eating icecream

Suffering From Sensitive Teeth?

Here’s How to Relieve Your Pain.

When Jane came to see us she’d been struggling with sensitive teeth for the last 10 years. She was brushing with warm water, unable to enjoy ice-cream and sometimes just breathing in the cold morning air caused sharp shooting pains throughout her mouth. We took time to listen to the problems Jane was having and developed a plan to relieve her sensitivity. If you suffer from sensitive teeth, read on, we’re confident the techniques we used to help Jane will help you too.

Got sensitive teeth? You’re not alone.

 

If you know exactly how Jane feels, you’re not alone. Having sensitive teeth is an extremely common problem, which can go on for years and really impact upon your life. Between 11 and 33 people in every 100 could be suffering from sensitive teeth, a recent study showed. In our practice with 6000 patients this could mean that almost 2000 patients could be struggling with sensitivity.

What are the symptoms of sensitive teeth?

 

If you have experienced a short, sharp, shooting pain which comes on with cold air; hot, cold, sweet or acidic foods or drinks; or using cold water when brushing your teeth, you may be experiencing tooth sensitivity. The pain tends to go once whatever has caused it has gone, although some patients report a lingering throbbing discomfort.

 

You may find just one of your teeth is sensitive or it might affect lots or all of your teeth. Sometimes it happens just now and again, but you may find it can be there more often than not.

Why do I have sensitive teeth?

Sensitive teeth are caused by damage or loss of enamel, which is the outer hard surface of your tooth.

This means the softer, inner layer of dentine is exposed in your mouth.

Dentine isn’t solid; it’s made up of tiny little tubules (a bit like these straws) that provide a direct path to the nerve of your tooth. These tubules contain fluid.

When something cold or hot touches the dentine, the fluid in the dentine tubules moves, this excites the nerve and gives you the sensation of pain. This movement of fluid is known as the Hydrodynamic Theory. The Hydrodynamic Theory was first shown in 1900 and further developed in 1966 by Swedish dentist Martin Brannstrom.

Cross section of a tooth
straws which look like dentine tubules

What are the Causes of Sensitive Teeth?

 

Thinning or loss of the hard enamel on the outside of your tooth can be due to many reasons:

 

  • Dissolving (enamel erosion)

Erosion of enamel occurs when you regularly have food or drinks that are high in acid, e.g. soft drinks, fruit juices, and citrus fruits.

You can also have erosion of your enamel if you suffer from gastric reflux, excessive vomiting or bulimia.

 

 

 

  • Grinding your teeth (attrition and abfraction)

Grinding or clenching your teeth can wear away enamel on the parts of the teeth that contact each other (the biting surfaces). This is called attrition.

Grinding or clenching can also cause loss of enamel at other places on the teeth often down close to the gum margin. This is called abfraction.

  • Gum disease

Gum disease causes your gums to shrink down the surface of your tooth (recession). This means that the root surface of your tooth is exposed in your mouth. The root surface has no enamel to cover the dentine, so the more sensitive dentine is unprotected from the hot and cold things you are putting in your mouth.

Acidic foods and drinks
  • Wearing away (enamel abrasion)

Enamel erosion occurs due to poor brushing technique or using too hard a toothbrush

  • Brushing your teeth at the wrong time

Acidic foods and drinks dissolve enamel and brushing too quickly after having them can remove this dissolved enamel. It’s better to brush beforehand or to wait at least 30 minutes after you’ve eaten to brush your teeth.

 

 

Abfraction cavities

What should I do if I have sensitive teeth?

 

If you think you’re suffering from sensitive teeth, the first thing to do is to call and arrange an appointment with your dentist. Sore teeth can have many causes and it’s important that you see your dentist to rule out tooth decay or infection.

 

When we saw Jane, as well as carrying out a thorough dental health check and taking x-rays to check inside and between her teeth, we asked her a series of important questions and listened carefully to her answers.

 

These questions helped us to establish the cause of her pain and assisted us in working out how we could help her to get rid of it once and for all.

How to treat sensitive teeth

 

There are many different methods available for treating sensitive teeth, all of them either:

 

1. Change or reduce the response of the nerve in the tooth to the movement of the fluid in the dentine tubules

or

2. Block the dentine tubules to prevent fluid movement.

 

In addition, it’s important to fix any underlying problems to stop things from getting worse.

 

All the treatments below were found to be effective in the treatment of tooth sensitivity, this study shows. But from personal experience, and from over twenty years of treating patients with sensitivity, we find that not all treatments work for everyone. The key is to find the right treatment that suits you.

 

By finding the right treatment, this study shows you will experience a decrease in pain, an increase in comfort and an improvement in your quality of life. So don’t just put up with it!

At home treatments for sensitive teeth

 

Sensitive Toothpastes

Not all sensitive toothpastes are the same. So if you try one and it doesn’t work, have a look at the label and check what the active ingredient is, then see if you can find one with a different active ingredient.

 

Active ingredients in sensitive toothpastes:

Potassium Nitrate – reduces the excitability of the nerves

E.g.

Superdrug Procare Sensitive

Sensodyne Original Mint

Sensodyne Pronamel

Toothpastes containing potassium nitrate for sensitive teeth
Toothpastes with stannous fluoride for sensitive teeth

Arginine – blocks tubules

Arginine is an amino acid naturally found in saliva. It combines with calcium carbonate in saliva and occludes and seals tubules.

 

E.g.

Colgate Sensitive Instant Relief

 

 

 

Toothpastes containing novamin and biomin for sensitive teeth

Stannous Fluoride – blocks tubules

Fluorides create a barrier as calcium fluoride forms on the dentine surface

E.g.

Oral B Pro-Expert

Sensodyne Rapid Relief

 

Toothpaste containing arginine for sensitive teeth

Novamin – blocks tubules

Contains elements that can also be found naturally occurring in the body, such as sodium, calcium phosphosilicate or calcium phosphate. These react with saliva to form apatite hydroxycarbonate on the dentine surface, which is very similar to the natural tooth structure.

 

E.g.

Sensodyne Repair and Protect Deep Repair

 

Biomin – blocks tubules

Works in the same way as Novamin but has a higher phosphate content.

E.g.

Biomin F

 

Your dentist will be able to help you with which toothpastes have which active ingredients and may also be able to provide you with samples you can try. At Coatbridge Family Dental Care we always have samples available for our patients to take away.

 

Often it’s a case of trial and error to find the best toothpaste to suit your needs.

 

With sensitive toothpaste, as well as using it to brush your teeth, you can apply the paste directly to any sensitive areas with your finger.

Sensitive teeth treatments from your dentist

For some patients, daily use of sensitive toothpastes is enough to relieve the pain. However, if you’ve tried sensitive paste and the problem is still there, don’t worry, your dentist has lots of tricks up their sleeve to help.

 

  • High concentration fluoride toothpaste or gel

 Your dentist can prescribe a toothpaste that has up to three times more fluoride than regular toothpaste. You can use this at daily at home. Or your dentist can apply a high fluoride varnish to your teeth, which has almost 16 times more fluoride than regular toothpaste.

 

As we’ve already seen fluoride is an excellent desensitising agent, which blocks dentine tubules. Many patients find that this can help with their sensitivity.

  • Resins and Adhesives

Your dentist may also choose to apply resins or adhesives to any particularly sensitive teeth.

These physically block the dentine tubules preventing fluid movement irritating the nerves.

The use of resins can be particularly useful where there are decay-free cavities on the surface of teeth next to the gum margin. These are the ones often caused by toothbrush abrasion or abfraction.

You can see in the picture abfraction cavities which have been restored with tooth-coloured composite resin.  As well as dealing with sensitivity this also improves the appearance of the teeth.

Abfraction cavities before and after restoration with composite resin to prevent tooth sensitivity
  • Sylc Treatment

Sylc is a desensitising treatment which your dentist or hygienist can carry out in surgery at the same time as polishing your teeth. This means your teeth will be professionally cleaned and desensitised at the same time.

 

Sylc contains Novamin, which you’ll remember is also used in some toothpastes. Sylc is a calcium sodium phosphosilicate powder. These are all elements that naturally occur in the body and when put into the mouth, undergo a fast reaction, stick to exposed dentine and block tubules. Within a short period of time, all of the Sylc reacts to form hydroxycarbonate apatite, which is chemically similar to natural tooth mineral.

 

This video shows the process of Sylc being applied to the teeth.  Notice that the teeth are also cleaned of staining at the same time.

Treating underlying problems

 

As well as dealing with your sensitivity, it is also important to identify any underlying problems that are causing it. Your dentist will help you with this and give you advice on how to deal with them.

 

Here are some things you could think about when treating problems that may have caused your sensitivity:

 

  1. Reduce your intake of acidic food and drinks.

2. Seek treatment for underlying medical conditions such as gastric reflux and bulimia.

3. Ask your dentist or hygienist to show you the best way to brush your teeth and to recommend a toothbrush.

4. Brush your teeth before you eat acidic foods or drinks or at least 30 minutes after them. In real life this means you may need to start brushing your teeth before breakfast instead of after.

5. Ask your dentist if they think you might be clenching or grinding your teeth and ask them to make you a night-time mouth guard to prevent this

6. Brush your teeth well and clean interdentally to prevent gum disease. If you already have gum disease visit your hygienist regularly to prevent it from getting worse.

Summary of how to relieve your sensitive teeth

 

There are many treatments available to help solve your sensitive teeth problem, some you can try at home and some that your dentist will carry out for you. In the first instance, the best thing to do is to talk to your dentist. They are the experts in tooth sensitivity and they will be able to help you find the best treatments for you.

 

For Jane, we tried several different toothpastes before settling on Sensodyne Pronamel, which she now uses twice a day. She also sees our hygienist, Laura every 6 months for a Sylc treatment, which she finds fantastic for stain removal and really solving her sensitive teeth pain. Laura carries out the Sylc treatment before she carries out Jane’s hygiene treatment and Jane has found this gives an added bonus of pain-free scaling. Laura advised an electric toothbrush and also spent time teaching Jane the safest and most effective way to brush her teeth.

 

Don’t forget, by finding the right treatment you will experience a decrease in pain, an increase in comfort and an improvement in your quality of life. The days of just putting up with sensitive teeth have long gone!

 

To arrange an appointment to discuss your sensitive teeth, call our team on 01236 421103, or contact us.