An unsettling discomfort when a cold drink hits your teeth usually means one thing: tooth hypersensitivity or as many prefer to call it ‘sensitive teeth’. For some people, citrus fruits and other acidic foodstuffs are avoided like the plague as they bring on discomfort. Some even dread speaking if it’s too windy or cold outside. Hypersensitivity can make something as routine as eating unnecessarily difficult. However, there are a number of solutions available which promise to restore normalcy to your teeth and make eating (and speaking, regardless of the weather outside) much more enjoyable.
According to a study published in the Journal of the American Dental Association, 1 in 8 people in the US may have sensitive teeth. Tooth hypersensitivity was seen to be highest amongst young adults and women. One of the interesting things they found about tooth hypersensitivity is that it’s essentially intermittent. Some weeks it’s there and some it’s not.
It’s hard to confirm the veracity of the prevalence of tooth hypersensitivity supported by these studies as previous ones have shown that anything from 1 to 52% of the population have sensitive teeth (1 in 2 people). This particular study was carried out on 37 practices in Idaho, Montana, Oregon, Washington and Utah. There were a total of 737 patients who were predominantly white (82%). It could be possible to find variations in different parts of the world and among other racial ethnicities.
What causes sensitive teeth?
Root sensitivity or dentin hypersensitivity occurs when dentine – a layer of the tooth below the enamel – becomes exposed. The exposure of enamel is primarily caused by –
1. Tooth grinding (Bruxism) – The grinding of teeth wears away at the enamel; the top layer of the tooth. Grinding can also cause gum recession. When either of these happens, dentin is eventually exposed, resulting in hypersensitivity.
2. Poor dental hygiene – Lack of brushing and flossing leads to gum disease. A sign of gum disease is gum recession. Also, bacteria in the mouth and gums release toxins which are acidic and can contribute to this hypersensitivity.
3. Scaling – When dentists treat gum disease, they have to scale the teeth to remove plaque. Sometimes this can result in sensitivity.
4. Alcohol and acidic foods – Both can erode at the enamel of the tooth, leaving dentine exposed.
5. Tooth whitening – Sometimes tooth whitening can cause sensitivity. This can usually be moderated by applying a fluoride gel or decreasing the amount of time that the bleaching chemical is on the teeth.
6. Ageing – Ageing generally results in a recessed gum line which exposes dentin.
7. Inadequate or excessive brushing – Too much of a good thing can be bad. Brushing that is both excessive in force and frequency can result in the shrinking of gums while lack of brushing leads to gum disease.
There are many triggers for sensitive teeth. Generally, pain or discomfort results if sensitive teeth are exposed to:
1. Cold air – breathing through the mouth or speaking in sub-zero outside temperatures
2. Cold foods i.e. ice cold beer/drink, ice cream
3. Acidic food i.e. oranges, wine
4. Grinding – clenching or grinding can be a major factor in tooth sensitivity
A number of treatment options are available for people with sensitive teeth. The degree to which they provide relief varies from person to person. Consequently, the only way to find out if they’ll work for you is to try them with the recommendation of a dental healthcare professional.
A recent trial led by Analia Veitz-Keenan, DDS, a clinical associate professor at the New York University College of Dentistry, looked at the effectiveness of the different treatments available for tooth hypersensitivity.
The study randomly split 304 patients who all complained of hypersensitivity into 3 different groups. Hypersensitivity was tested with a 1 second long blast of air to the teeth and then the patients would be asked to rate their pain on a scale of 1-10. Before any treatment began, the average score on this pain scale was 5.3.
Nearly half of them (42%) had sleep bruxism (night time tooth grinding). The first group was given an over-the-counter toothpaste which contained 5% potassium nitrate – a component which blocks tubes in dentine which cause hypersensitivity. The second group was given a resin-based composite normally used for filling cavities to cover the exposed sensitive areas.
The third group was given a dental sealant that covered the exposed sensitive area. Sealant is normally used to prevent cavity formation and erosion.
After six months of treatment, the participants’ sensitivity was again tested with another air blast. Those who used the toothpaste had an average pain measurement on 2.2. They also reported less pain the longer they used the product.
While the toothpaste delivered pain reduction, it did not perform as well as the sealant and fillings. The researchers reported that the toothpaste provided temporary relief but it did not solve the underlying problem. The sensitivity would remain an issue if the person continued the bad habits (excessive brushing/bruxism) that led to it in the first place.
The fillings and sealants were shown to cover the exposed parts of the tooth and provide protection against further erosion and exposure.
If clenching or grinding is the main causative factor in your sensitivity, a bruxism appliance will improve your symptoms.
Tooth hypersensitivity needn’t be such a restricting problem. Solutions like over-the-counter ‘sensitive toothpaste’ do a good job of relieving the pain but they do not address the issue. Studies show that getting a dental sealant of a filling is the best way to provide long-term relief and protect the teeth. Consulting your dentist and getting advice on developing better habits for dental care is also recommended.