One of the most common patient concerns we see at Morris County Dental Associates is tooth sensitivity. Barely a day goes by when patients don’t point out to the hygienist or dentist areas that are sensitive to cold or hot food & drinks, toothbrushing, breathing in cold air, a fingernail rubbed on the side of a tooth, or the like.
What causes sensitivity? There are many theories, but the most common is called, “Dentin Hypersensitivity.” Basically, fluid movement in-and-out of a tooth is thought to cause activation of nerve endings at the center of the tooth (pulp). There are microscopic tubes connecting the center of the tooth to the outer environment. These tubes are normally covered by bone and gum, but with the recession of the gums and bone, these tubes are now exposed. There are many reasons for the gum and bone recession, but age, gum disease, poor home care, and bite issues are major reasons.
Teeth have multiple layers: enamel, cementum, dentin, and pulp. For purposes of this article, suffice it to understand the dentin is covered by enamel or cementum. The tubes discussed above are located within the dentin. When the enamel or cementum are lost, the tubes are now exposed. Exposed dentin is subject to a number of undesirable processes, which can cause further wear. Some of these processes are “attrition,” “abrasion,” “abfraction,” and “erosion.” Some of these processes deserve further discussion.
Attrition and abfraction are destructions of tooth structure caused by bite issues. When your dentist talks to you about the grinding of teeth, attrition and abfraction can be the result. Abrasion is mechanical wear of your teeth, caused by improper brushing technique or too hard of a brush. Erosion is a chemical wearing of your teeth, caused by bulimia, morning sickness, GERD (stomach issues), and diet.
So, back to the sensitivity. What can you do about it? The simplest way to try to correct the problem is by the use of over-the-counter toothpastes designed for sensitive teeth and rinses with fluoride. All major manufactures have these products. If you do try them, do not switch between types (tartar control, whitening, etc), and give it a whole month before expecting results. Your dentist can prescribe a high-concentration fluoride toothpaste, too.
Your dentist can also offer you a myriad of in-office solutions, such as the application of de-sensitizing medications. Insurance coverage can vary, but the overall cost is not usually too extreme. You should note, however, results can also vary, and cannot be guaranteed.
Your dentist can also fabricate custom trays that you can place fluoride or desensitizing gels into. This is an extremely effective way to deliver prescription-strength medications to your teeth. These types of trays become important as people age, recession occurs, and cavities develop deep in-between teeth.
Time should be spent between you and your dentist to try and determine possible underlying conditions that might be causing the sensitivity. If you have a systemic problem such as GERD, it would be helpful to your overall health to catch this. If you have a condition such as bulimia, it would also be beneficial to treat it. Other situations such as jaw/muscle conditions (“TMJ”) could hopefully be identified, too.
If your dentin hypersensitivity is being caused by excessive grinding (bruxism), it may be very beneficial to undergo an examination process to determine the underlying issues and propose treatment options. Sometimes night guards can be fabricated to help prevent further teeth destruction. They will also help to prevent you from fracturing teeth and fillings in the future, as well as relax muscles that you may not realize are being overworked. But just remember the night guard is a protective measure and not a cure for the underlying problem(s).