Sensitive Teeth

One of the most common patient concerns we see in a dental office is tooth sensitivity. Barely a day goes by when patients don’t point out to the hygienist or dentist areas that are sensitive to coldsensitive teeth or hot food & drinks, toothbrushing, breathing in cold air, a fingernail rubbed on the side of a tooth, or the like.

Although there are many reasons for tooth sensitivity, the most common type we see is called “dentin hypersensitivity.” This occurs when dentin, the middle layer of tooth structure, becomes exposed.

Dentin is actually comprised of microscopic tubes that extend from the outer surface to the middle layer (the pulp) where the nerve is found.  The dentin is normally not exposed, but when it does become exposed, stimuli such as air, sweets, or touch can transmit signals to the nerve, and this results in the sharp pain you feel.

There are many reasons why the dentin can become exposed:

  • Brushing too hard with a tooth brush can cause gums to recede.
  • Grinding your teeth (bruxism) can cause enamel to break away.
  • Gum (periodontal) disease causes bone loss which is followed by gum recession.
  • Acidic foods & drinks can erode the hard enamel layer and the dentin then becomes exposed.
  • With increased age, we often see gum and bone loss, too.
  • A faulty bite pattern, which can not only lead to sensitive teeth, but also breakage of teeth, gum disease, avoidable root canals, headaches, and other problems.

There are multiple ways to correct this problem. Some are very simple and inexpensive, others are complex and costly:

  • The simplest way to try to correct the problem is by 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 (tarter control, whitening, etc), and give it a whole month before expecting results.
  • Another option is to have your dentist apply a “desensitizing agent” (a liquid) onto the exposed areas. This often works very well, but the procedure may need to be repeated (typically once every few check-ups). It is rather inexpensive (typically $30 to $50 per area), and is sometimes covered by insurance.
  • Still another option would be to use a prescription-strength toothpaste and/or rinse. Your dentist can prescribe this for you. In our office, we HIGHLY recommend Colgate’s Prevident. This can be conveniently purchased directly in our office.
  • 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 type of trays become important as people age, recession occurs, and cavities develop deep in-between teeth.

If your dentin hypersensitivity is being caused by excessive grinding (bruxism), it may be very beneficial to undergo a bite analysis.  You may requrie a procedure called “occlusal equilibration,” or have a nightguard fabricated. Both options help to remove forces on your teeth that cause enamel fracture called “abfraction” which in turn exposes the dentin. 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

If you do consider a nightguard for your sensitivity, it is important to have a dentist make it for you, and not buy one from a store.  It will not do the job correctly, and can possibly cause more harm.

If you have sensitive teeth, teeth that are wearing or breaking, discomfort, or other dental issues similar to these, contact Dr. Ira Goldberg at Morris County Dental Associates at or (973) 328-1225 for an examination and discussion.  He’s helped countless people with their sensitivity, and he can help you, too!


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