Teeth can be sensitive for many different reasons. The first question to ask is, what is causing my tooth sensitivity? There are three main types of sensitivity: cold sensitivity, biting sensitivity, and spontaneous pain.
Cold Sensitivity
- Recession- the most common reason teeth are sensitive to the cold. Teeth are covered by a protective layer of enamel, but the root of the tooth does not have this protective layer. It doesn’t need it. It is covered up with bone and gum. However, if we have gum recession, the root of our tooth is exposed and sensitive!. So how do we prevent recession? Tooth brush abrasion is a leading cause of recession. While it is good to clean along the gum line, it is important not to SCRUB along the gum line. Brushing up and down or in circles with a soft toothbrush will prevent recession from getting worse. A second cause of recession is tooth clenching or grinding. The pressure on the teeth causes bone loss along the roots. It is important to be mindful of daytime clenching or to wear a nightguard for people who grind their teeth at night.
So what should you do if you already have “dentin hypersensitivity” from recession? Desensitizing toothpastes like Sensodyne have an active ingredient called potassium nitrate that clog the microscopic open tubules on the exposed roots of our teeth. When using desensitizing toothpaste, try to make sure the toothpaste comes in direct contact with the sensitive root and go to bed without taking a drink to give the toothpaste more time to work.
- Cracked Tooth- A crack in a tooth is also a possible cause of cold sensitivity. This is more likely if the tooth is sensitive to both cold and biting. A cracked tooth is typically treated by a restoration like a crown.
- Decay- Many people believe that you can feel if you have a cavity. This is usually not the case. However, once a cavity is a very large size it is often sensitive to the cold.
- Root Canal- Cold sensitivity that does not go away within twenty seconds of swallowing a cold drink is usually a bad sign. When the sensitivity lingers for a long time afterwards or begins to throb, that can often be the sign of a dying nerve.
Biting Sensitivity
- Cracked Tooth- A tooth that hurts from biting pressure usually has a crack. Full coverage restorations like crowns are often placed on cracked teeth. If untreated, the crack can eventually travel down the root of the tooth, splitting the tooth. A split tooth has to be extracted.
- Tooth Grinding- If a whole side of your mouth hurts to biting pressure, the teeth may just be sore from too much pressure. If this occurs when you wake up in the morning, you may grind your teeth at night and need to consider a nightguard. If it is during the day, it is good to pay attention and see if you clench your teeth in moments of stress.
- A “High” Tooth- A specific tooth may be sensitive to biting if it is raised up. This could be from a recent filling that needs to be buzzed down. An abscessed tooth can also raise up because of infection at the end of the root that is “pushing” or extruding the whole tooth down. If this is the case, the tooth will have to be treated with a root canal.
Spontaneous Pain
- Root Canal- The most likely reason a single tooth begins to hurt on its own without any stimulus from biting, cold, etc. is a dead or dying nerve. A few simple tests at the dentist can usually determine if a tooth needs a root canal.
- TMD- Commonly called “TMJ”, jaw pain that feels like it is radiating from both the top and bottom jaw on one side can be due to pain from “TemperoMandibular Joint Disfunction”. It can also manifest as pain directly in front of the ear. It is important in these cases to identify any clenching or grinding habits that may exacerbate the pain in your jaw muscles or jaw joint. There are a host of treatment options including a mouth guard, medications, physical therapy, trigger point injections, etc. used to treat this condition.
Conclusion
Although there are other possible causes for pain in the mouth (sinusitis, nerve pain or neuralgia, pain related to a tumor or pathology, etc.) the most common reasons are listed above. Although the fix may be as simple as buying desensitizing toothpaste, sensitivity can also be a warning sign of damage that needs to be corrected in your mouth.
