Tooth Sensitivity: Causes and General Approach

A short, sharp pain that appears in the teeth during contact with a hot or cold drink, or a sweet or sour food, is a common complaint in daily life and is often related to a condition known as dentin sensitivity. This sensitivity usually settles shortly after the stimulus is removed; however, its intensity and frequency vary from person to person.

Uzm. Dt. Emre Karakaya deals with the health of the gums and the tissues surrounding the teeth within the scope of his work in periodontology; tooth sensitivity is a subject closely related to these tissues. The headings in this article are prepared for general information; the cause of sensitivity and the path to follow are determined through a personal examination, and this content is not a substitute for an examination.

What Is Dentin Sensitivity and How Does It Develop?

The enamel covering the outer surface of the tooth acts as a hard shield that protects the underlying dentin layer from external stimuli. Dentin itself contains numerous fine channels (dentin tubules) that extend toward the nerve tissue of the tooth. When the enamel layer wears down or becomes thinner, the dentin tubules become open to hot, cold, sweet or acidic stimuli, and these stimuli may be felt as a short, sharp pain.

A similar situation can also arise when the root surface of the tooth becomes exposed. The root surface is covered not by enamel but by cementum, a much thinner layer, and when the gum recedes this surface begins to come into direct contact with stimuli in the mouth. How this process develops is explained in detail in the article on the causes of gum recession. Which mechanism is at the forefront varies from person to person and is understood through clinical evaluation.

Common Causes

The habit of brushing hard and with pressure can, over time, set the stage both for wear on the enamel layer and for recession at the gum line. Frequent consumption of acidic foods and drinks can soften the enamel surface and accelerate wear; brushing immediately after an acidic drink may also increase this effect. Clenching and grinding of the teeth (bruxism) can contribute to sensitivity by creating micro-cracks in the teeth and loss of tooth structure at the neck of the tooth.

Gum recession, since it exposes the root surface, is among the frequently seen causes of sensitivity. In addition, a temporary sensitivity may be noticed after professional scaling, as the deposits covering the tooth surfaces are removed; in most cases this tends to decrease on its own within a short period. Which cause underlies the sensitivity can only be clarified through an examination.

General Approach and When to See a Dentist

For mild and occasional sensitivity, toothpastes known as desensitizing toothpastes may provide general support; these products contain ingredients aimed at reducing the response of the dentin tubules to stimuli, and their effect may be observed over time with regular use. Reviewing brushing habits is also important; a proper tooth brushing technique applied with a soft-bristled brush and gentle movements helps protect both the enamel and the gums.

Since different conditions such as decay, problems related to fillings, enamel loss or gum problems may lie behind sensitivity, complaints that persist or become more severe should be evaluated by a dentist to determine the cause. In cases related to gum recession, options within the scope of gum treatment may be considered according to the findings of the examination. The cause, course and management of sensitivity vary from person to person; this content is for general information, and for persistent or severe sensitivity, consult your dentist for an evaluation.