Hello again, Streamwood Smiles community!  Have you ever wondered why you sometimes experience a sudden "jolt" when eating ice-cream or brushing in a certain spot on your teeth?  You're not alone.  Most of our patients have at least one area in their mouths that causes them some sensitivity from time-to-time.  But how do you know what is considered "normal" tooth sensitivity, and what is a more serious situation that warrants dentist treatment?

     There are many causes of tooth sensitivity, and therefore many different treatment options.  The Journal of the American Dental Association reports: "some of the more common culprits (of tooth sensitivity) are caries (tooth decay), cracked or fractured teeth, tooth grinding or clenching, worn fillings or tooth enamel, and gingivae (gums) that have pulled away from the tooth roots as a result of gum disease or vigorous brushing". 

     Some of these situations warrant immediate treatment.  Caries (tooth decay) generally manifests as sensitivity to sweets, so if you're eating candy and feel a twinge in a tooth, visit your dentist: You may need a filling to remove the decay.  Cracked/fractured teeth, however, usually experience discomfort to biting and chewing pressure.  In this situation, you would need to be evaluated by your dentist to see if you need a crown.  Most patients know to visit their dentist when experiencing extreme pressure or temperature sensitivity in a tooth, but what should you do if you experience mild to moderate sensitivity on several to most of your teeth?  And why do you experience this sensitvity at all?

     The answer lies in the structure of healthy teeth.  Enamel is the hard substance that protects the crowns of your teeth, the portion of your tooth that you can see above your gum line.  The roots of your teeth, the portion below your gums, are covered with another thin protective layer called cementum.  Underneath both enamel and cementum lies the dentin, a softer, more porous structure that contains microscopic tubules that connect with the tooth pulp.  The pulp contains the nerve and blood supply to the tooth, and controls the tooth's pain reflex.  When the tooth's inner dentin layer is exposed for any reason, irritants like food or liquids may come into contact with the dentin's tubules, and trigger a painful response from the nerve in the tooth's pulp.

     Good oral hygiene is the first line of defense in preventing tooth sensitivity.  The American Dental Association recommends brushing your teeth gently twice a day with a soft-bristled brush and fluoride toothpaste.  Brushing gently and using a soft-bristled toothbrush helps to reduce wear on the cementum layer, preventing dentin from becoming exposed.  Fluoride is a critical component to reducing tooth sensitivity as well; the fluoride ions in toothpaste help to re-mineralize the tooth surface, helping to "plug" the outer surface of dentinal tubules and prevent irritants from initiating a pain response in the pulp..

     If normal fluoride toothpaste does not seem to help your tooth sensitivity, your dentist may recommend trying de-sensitizing toothpaste.  There are several brands available over the counter, as well as prescription strength toothpastes that may be recommended.  To find a de-sensitizing toothpaste with the ADA Seal of Acceptance, visit http://www.ada.org/en/science-research/ada-seal-of-acceptance/ada-seal-products/ .  Many of these toothpastes contain additional compounds to prevent irritation of the tooth and production of sensitivity.

     Finally, there are several in-office treatments for tooth sensitivity that your dentist may recommend, in office fluoride treatments work to strengthen existing tooth structure and plug tubules to prevent irritation of the root surface.  In more severe cases of root erosion, fillings, or crowns or bonding may be indicated to reduce sensitivity.  Finally, in cases associated with severe gum recession, gum surgery may be the best choice to help repair missing gum structure.  If you are experiencing tooth sensitivity, talk with your dentist at Streamwood Smiles about what treatment options are best for you!