The sensations produced by tooth sensitivity are very uncomfortable. Tooth sensitivity can disrupt the daily life of those who suffer from this condition. Most of the nerves in our bodies are protected by layers of soft tissue, but nerves in the mouth can be exposed for various reasons, like excess tooth or gum wear and trauma. When the hard outer covering of the teeth no longer protects these delicate structures, patients experience painful sensations in the mouth. Dr. Marc Lazare, D.D.S., M.A.G.D of New York, NY is a general and cosmetic dentist who expertly treats tooth sensitivity and brings patients relief at his Upper East Side practice.
Tooth Sensitivity Explained
The nervous system, which can be thought of as the body’s internal electrical system, is composed of nerves and neurons, or nerve cells. The human nervous system coordinates pain responses to protect a person from danger, and also aids in the control of movements. Because pain should be an abnormal sensation, its presence indicates that there is an issue in the body that must be resolved. The same is true of the mouth, where tooth pain is caused as a protective measure. Diseased structures of the teeth and gums can pose a health risk to patients, as it is possible for bacteria to travel from the mouth to other areas of the body. Tooth sensitivity may signify the need for treatment.
What Conditions Cause Teeth to be Sensitive?
There are a number of reasons why a person may experience pain in their teeth from sensitivity to normal functions, like eating and brushing. While prospective and existing patients should schedule an appointment to see Dr. Lazare if they experience pain in their teeth, below is a guide that explains different types of tooth sensitivity that commonly occur. Diagnostic testing is one of the best ways to determine which tooth or teeth are affected, and may be coupled with X-rays, which should only be performed by a specialist in dental medicine.
There are three layers of material in the teeth: the outer enamel, the dentin underneath, and the innermost layer of tooth pulp. Dentin hypersensitivity occurs when the dentin becomes exposed through wear of the enamel. Patients may have dentin hypersensitivity if they feel sharp pain after the exposed area of the tooth reacts to cold foods and beverages or the bristles of a toothbrush. A common cause is receding gums caused by gingivitis that can expose the surfaces of the tooth’s roots.
Other names for the condition are sensitive dentin, cervical sensitivity, and cervical hypersensitivity, or Dentin Hypersensitivity.
Inflammation of Tooth Pulp
Inside each tooth is a combination of connective tissue, nerves, and blood vessels that create an intricate interworking that provides the tooth with essential blood and nutrients. When bacteria reaches the inside layer of the tooth, it invades the once-healthy tissue, leading to an infection. Pain may be prolonged or present in an intense throbbing sensation, and is often brought on by hot or cold foods or beverages. In most cases, inflamed tooth pulp is caused by dental caries, or cavities that have penetrated through the other layers of the tooth. In other cases, trauma may be the cause of exposure to the pulp, which then becomes infected.
Inflamed tooth pulp is also called pulpitis.
A lesion that forms around the root of the tooth is known as apical periodontitis. This inflammation may occur acutely, or become a chronic condition after bacteria enters the tooth pulp. The lesion most commonly occurs after a cavity in the tooth is left untreated, or when the nerve dies as the result of an injury. Once the nerve is dead, sensitivity may be limited, though painful sensations and sensitivity are usually noted until this point. Often, apical periodontitis is the result of some other issue within the tooth. When this inflammation lesion remains untreated, the surrounding bone may be destroyed. Swelling, pain, and discoloration of the affected tooth are common indicators if apical periodontitis, which can often be diagnosed through X-rays.
In dental medicine, the condition is also known as Periradicular periodontitis, Periapical periodontitis, or shortened to AP.
Tooth sensitivity and pain can be caused by inflammation and infection of the gums. As the gums collect debris and deepen, the gums develop an immune response to the area to prevent the infection from spreading elsewhere, and pus may form. The abscess can be noted by swelling of the gums around the affected tooth and a related lesion. Some symptoms of a periodontal abscess are a bad taste in the mouth, a pimple-like lesion on the gums, redness, and pain. Generally, sensitivity occurs around the gums, and to the tooth if the pulp is affected. An abscess may require a dental surgery and a course of antibiotics to relieve the infection, followed by a tooth extraction or other means of treating the primary issue of the tooth.
Some patients may be more familiar with the term abscessed tooth or gum abscess, which are also used to describe this condition.
Other Causes of Tooth Sensitivity
While some common conditions of the teeth lead to long-term sensitivity, there are a number of other oral health issues that can cause uncomfortable sensations.
Tooth decay is one major reason patients experience tooth sensitivity. Bacteria enter through the various layers of the tooth when they have eroded, reaching the tooth’s exposed nerve. Decay may be the result of dental cavities, or caused by another avenue of bacteria infiltration, like tooth cracks or fractures. Though the rest of the tooth may be intact, the small lines allow a direct route for bacteria in the mouth to reach the innermost components of the tooth, causing infection and resulting in pain and sensitivity. Tooth trauma can result in tooth fractures, or other forms of nerve damage. In addition to causing cracks in the teeth, impact to the mouth can also lead to nerve damage. There are a number of fixes for these issues, including fillings, tooth extractions, or in some cases, a root canal.
Tooth sensitivity may also be brought on by damage caused by TMD – temporomandibular joint disorder. Grinding and clenching the teeth, commonly at night, can cause a disk in the jaw to become displaced. The pressure on the teeth affects muscles and other tissues of the teeth and jaw, and can cause sensitivity to food and beverages that are hot, cold, and sweet due to worn tooth enamel and an exposed root structure. Patients may feel a throbbing pain in affected teeth that is more severe in the morning. Surgery and a night guard are two possible treatments for TMD, and should alleviate any related pain.
Gum recession is a natural occurrence as people age and may be exacerbated by abrasive tooth-brushing. The root surfaces of the teeth can become exposed, losing the protective covering of the gums and teeth. In these cases, composite bonding, or tooth-colored fillings (typically used in cavities) can add a layer to the teeth that guards the roots.
Over-the-counter dental bleaching may lead to increased sensitivity of the teeth. This form of tooth whitening can cause the enamel to become temporarily more porous, and the teeth may feel be prone to temperatures in weeks that follow a treatment. The whitening solution can also affect the flow of blood in the tooth pulp, causing different sensations. Professional teeth whitening treatments at Dr. Lazare’s office include desensitizing protocols and are designed to provide maximum whitening results while maintaining the teeth’s natural responses rather than increasing them. His at-home program also provides professional-grade supplies to patients.
Many patients undergo a course of teeth straightening for functional and cosmetic purposes. While straighter teeth can create ideal alignment that promotes better oral health, as each tooth surface can be cleaned and flossing is made easier, the process can temporarily cause some teeth sensitivity. Tooth mobility may be coupled with demineralization or gingivitis due to poor care of the teeth. When food becomes trapped in the braces, the particles can become acidic and erode the tooth enamel in a process called demineralization. Poor brushing habits also lead to the condition of gum inflammation – gingivitis. Good dental hygiene is generally sufficient to prevent most issues of sensitivity. If there is a generalized increase of sensation in the mouth, special sensitivity toothpastes may be used.
The FAQs of Tooth Sensitivity
A general rule is that if you address the underlying cause of tooth sensitivity, the sensations of the mouth will be resolved. In dentistry, there are fixes for every type of issue. Sometimes conservative repairs of the teeth are possible, and include fillings and composite bonding to eroded parts of the tooth. In other cases, a procedure like a root canal or tooth extraction may be necessary.
Mild to moderate sensitivity can be controlled with different measures, including topical treatments. Desensitizing toothpaste, fluoride gels, and mouthwash can offer daily relief with regular use. Nighttime tooth grinding can be curbed by the use of a night guard, and working on ways to destress in life.
Which foods wear away the enamel on the teeth, possibly leading to cavities and tooth sensitivity?
Foods must be acidic in order to affect the enamel on the teeth. Sodas (diet and regular) and fruits are some of the main culprits of acidity in the diet. Sugar fuels an enzyme in the saliva that also causes tooth enamel erosion. Hard and sticky foods can lead to tooth fractures.
Yes, due to inherited traits, the hard enamel on the teeth may be more prone to erosion. Other genetic predispositions in oral health, like the formation of dentin, may cause a person to experience increased tooth sensitivity.
Often times if you solve the cause of a problem you will eliminate the symptoms. Tooth sensitivity caused by grinding and clenching can often be eliminated by reducing, eliminating or learning to cope with the stresses encountered in one’s life. Tooth sensitivity brought about by malocclusion (improper bite) can be reduced in various ways, including: adjusting one’s bite, redoing inadequate restorations, correcting asymmetries and poor jaw position with various removable appliances, and sometimes full mouth reconstruction to restore teeth to their proper levels.
Upper East Side Dentist, Dr. Marc Lazare, D.D.S., M.A.G.D.
While known as a celebrity dentist, Dr. Lazare of Manhattan delivers star treatment to each one of his patients. His Upper East Side practice provides modern care that caters to a wide variety of needs. Dr. Lazare specializes in both general dentistry and cosmetic dentistry, providing patients a single location for all of their needs.
Call Dr. Lazare at his New York, NY practice to schedule an appointment as the first step in eliminating tooth sensitivity – 212-861-2599, or an email the office at [email protected]