Tooth sensitivity occurs when the dentine which lays underneath the enamel and encases the pulp (tooth nerve) is exposed. Dentine is full of tiny channels that lead directly to the nerve. When enamel is lost and these channels are exposed, stimuli like hot, cold, or sweet foods can trigger a short, sharp pain as they travel down the channels and hit the nerve.
Some of the more common causes of dentine exposure and tooth sensitivity include:
• Brushing too hard especially using a hard-bristled toothbrush or abrasive toothpaste. This can wear down the enamel on your teeth and damage the gums. This is especially true where your teeth meet your gums, where the enamel is at its thinnest.
• Gum recession. As the gum recedes down the tooth, the root of the tooth which is made mostly of dentine becomes exposed.
• Teeth grinding or clenching can wear down enamel exposing the dentine underneath.
• Cracked or broken teeth can expose the dentine if the hard enamel shell that protects the dentine is damaged.
• A diet that is high in acidic food can cause enamel erosion leading to dentine exposure.
• The use of tooth whitening or bleaching products can make the enamel temporarily more porous exposing the microtubules in the dentine.
Lifestyle factors such as poor oral hygiene, smoking, stress, genetics and vaping can all exacerbate tooth sensitivity. Keeping your gums healthy and your teeth clean will help to reduce tooth sensitivity especially when coupled with adopting a healthy lifestyle.
Several treatments are available for tooth sensitivity, depending on the underlying cause and severity of the condition. Treatments aimed at reducing tooth sensitivity range from home remedies to professional treatments like Guided Biofilm Therapy which uses a teeth cleaning approach that includes warm water, soft powder and no harsh scraping instruments.
It is important to consult with a dentist if you think you have sensitive teeth to determinate the underlying cause and to discuss the most appropriate treatments for reducing tooth sensitivity.
If the sensitivity is caused by exposed dentine or thinning enamel, the following remedies may help to reduce your symptoms:
Fluoride. Using dental products containing fluoride can help minimise sensitivity by strengthening enamel and sealing exposed dentine. Many forms of fluoride treatment are available that are suitable for daily use including toothpaste, fluoride gel and mouthwash.
Desensitising agents. Using toothpaste and other products containing desensitising agents helps to decrease sensitivity by making the dentine less permeable and more difficult for sensitivity triggers to pass through it & reach the nerve.
In addition dietary changes and good oral hygiene practices can help prevent tooth sensitivity from worsening.
• Brush your teeth twice a day being careful not to scrub at the gums or brush too vigorously. Using an electric toothbrush with a built-in pressure indicator can help prevent over brushing. Gently incorporate the gum line when brushing but use gentler circular movements or strokes. If you’re prone to being heavy-handed, try using a pen-like grip to hold your toothbrush which will naturally reduce the pressure you apply.
• Use a fluoride toothpaste and avoid abrasive toothpastes. Look at the RDA (Relative Dentine Abrasivity), which is a measurement of how much a toothpaste can wear down the tooth. The RDA value is a standardised scale that ranges from 0 to 250 with higher values indicating greater abrasiveness. Ideally aim for a toothpaste with a low (0-70) to medium (70 - 100) RDA. Avoid toothpastes with an RDA of greater than 100.
• Floss or use interdental cleaning aids at least once a day. Plaque bacteria that cause gum disease thrives in the dark, warm, sheltered spaces between your teeth. If plaque bacteria is allowed to flourish it can cause gum disease which is the most common cause of gum recession and dentine exposure.
• Food and drinks that have a lot of acid can dissolve tooth enamel over time. Examples include carbonated drinks, citrus fruits, vinegars and wine. When you drink acidic liquids, use a straw to limit contact with your teeth. After eating or drinking something acidic, drink water to balance the acid levels in your mouth. Avoid brushing for at least half an hour after eating or drinking something very acidic.
• See your dentist and dental hygienist regularly. Early intervention is key to preventing tooth sensitivity and limiting its progression. Examination of the teeth, careful monitoring of gum health and preventive treatment & advice are an important in avoiding tooth sensitivity.
Dental bonding or sealants: If tooth sensitivity is caused by exposed dentine, your dentist may apply dental bonding, filling or sealant to cover and protect the exposed surfaces. This is usually applied quickly and doesn’t often require the use of anaesthetic.
Fluoride Varnish or Gel: Fluoride helps to strengthen tooth enamel and reduce the effects of tooth sensitivity by sealing the micro-tubules in the dentine. The fluoride applied by your dentist usually has a greater concentration of fluoride than over-the-counter products.
Mouthguard: Constant clenching and grinding of the teeth wear away tooth enamel and can cause micro fractures in the teeth. Adding a mouthguard can help limit the stress put on your teeth. Mouth guards are usually worn at night but can be worn during the day if necessary. There are different types available and your dentist will decide which one is best suited to your needs.
Root canal therapy: In severe cases of tooth sensitivity where quality of life is affected, root canal therapy might be performed to remove the nerve and alleviate the sensitivity. This is carried out as an absolute last resort and should only be considered when all other remedies have been explored. Your dentist will need to discuss the possible detrimental effects of root canal therapy before proceeding.
Lifestyle changes: Quitting smoking and addressing lifestyle factors that contribute to stress & teeth grinding will in turn reduce tooth sensitivity.
Guided Biofilm Therapy: Regular dental hygiene visits are an important part of maintaining your oral health, but fear of pain and discomfort can be a deterrent for patients with tooth sensitivity. In addition, dentine is not as strong as tooth enamel and is damaged more easily if harsh scaling techniques or abrasive polish is used to clean it.
Guided Biofilm Therapy uses warm water and gentle minimally invasive erythritol based powder to effectively treat patients with tooth sensitivity. It can achieve dental cleaning without the associated discomfort even in the presence of dentine exposure where other methods of tooth cleaning can’t be tolerated.
Guided Biofilm Therapy uses a coloured dye to make plaque biofilm more visible. This helps to identify areas where patients need to clean more thoroughly. It is common for the receded gum line to be missed during daily oral hygiene routines either because it’s lower than where the brush normally reaches or because the patient avoids through fear of causing further damage. It is imperative that patients are shown how to clean receded gums and exposed dentine effectively without causing further damage. Leaving plaque biofilm will only contribute to further problems. Disclosing the biofilm also helps the dental hygienist to see which areas to target to ensure all deposits are removed thoroughly and aren’t over-treated.
Diet analysis is also carried out during the GBT appointment and lifestyle changes that could remedy tooth sensitivity are identified and addressed. Guided Biofilm Therapy not only offers long-term professional care for existing sensitive teeth but also promotes overall oral health, preventing future occurrences.
Always consult a dentist if your tooth sensitivity is recurrent or the symptoms are prolonged. Visit Switch to GBT for more information on guided biofilm therapy or to find your nearest GBT clinician.
