Sensitive Teeth Explained

Ordinary Sensitivity or Something Else?

The pattern of the pain tells us a lot. Typical sensitivity is quick and provoked: a sharp twinge from cold water, a breath of winter air or a sweet, gone within seconds once the trigger's removed. It often affects several teeth, usually near the gumline.

The first row is the common, harmless kind. The others mean something needs looking at.

Why Dentine Reacts

Enamel, the outer shell of the crown, has no nerves at all. Below it sits dentine, which is softer and riddled with microscopic tubes leading inwards to the pulp. When dentine is exposed, cold or sugar makes the fluid in those tubes move, and the nerve fibres at the inner end fire. The roots below the gumline are covered only by a thin layer called cementum, which wears away easily, so roots exposed by gum recession are especially reactive.

The things that uncover dentine tend to stack up:

• Brushing too hard, especially with a firm brush and a sawing action, which scrubs away gum and enamel near the gumline
• Acid from fizzy drinks, including diet and sparkling water with flavouring, fruit juice, wine, sports drinks, citrus fruit and pickles, plus stomach acid from reflux or frequent vomiting
• Grinding and clenching, which wear down the biting edges and can flex enamel away from the gumline
• Gum recession, from gum disease or simply over time
• Recent dental work, such as a new filling or a deep clean, which can leave a tooth reactive for a while
• Whitening, which makes teeth temporarily more permeable

Someone who sips sparkling flavoured water all day, brushes straight after breakfast juice and grinds at night is wearing enamel three ways at once, and the sensitivity usually shows it.

What You Can Do Yourself

1. Switch to a toothpaste made for sensitive teeth and use it twice a day. After brushing, spit the foam out and leave it, so the active ingredients stay put. Give it at least two weeks, and up to four
2. For a particularly sore spot, smear a little of the same toothpaste on with a clean fingertip at bedtime and leave it overnight
3. Use a soft brush, or an electric one with a pressure warning, and brush in small circles angled at the gumline rather than scrubbing back and forth
4. Have acidic drinks with food, not between meals. Use a straw for fizzy drinks and follow them with a mouthful of plain water
5. Wait about an hour after anything acidic before brushing, because enamel is softer for a while afterwards
6. Add a fluoride mouthwash at a separate time of day, such as after lunch, rather than straight after brushing

If one brand hasn't helped after a month, try another. They work in different ways, some by plugging the tubes in the dentine and others by calming the nerve, and people respond differently.

When to Book an Appointment

• A single tooth is far more sensitive than its neighbours
• The ache carries on well after the cold drink, or arrives with no trigger at all
• It hurts to chew on one particular tooth
• You can see a hole, a dark patch, a chipped tooth or a broken filling
• Your gums bleed when you brush, or have visibly shrunk back
• A month of sensitive toothpaste has made no difference

These can point to a crack, decay, a failing filling or an irritated nerve, and they're easier and cheaper to sort out early. A routine examination is £70, or £70 for new patients including X-rays, and both are covered by our dental plans. ¹ If a tooth is waking you at night, phone 01698 767220 for a same-day appointment.

Treatment at the Practice

We work out the cause first, by testing individual teeth with cold and with biting, and taking X-rays where needed. Then the treatment matches the cause:

• Exposed dentine on several teeth: a professional fluoride varnish painted onto the sensitive areas, plus advice on brushing and diet
• An exposed root: a thin layer of tooth-coloured composite bonded over it, from £105
• Decay or a leaking filling: a new white filling, from £118 on a back tooth
• A cracked tooth: an onlay, £750, or a crown, from £675, to hold the cusps together
• Grinding: a custom night guard, £210, to protect the enamel overnight
• An inflamed nerve that won't settle: root canal treatment, from £450
• Gum disease causing recession: gum treatment with Simra Ashraf, our hygienist, to stop it going further

You'll have a written plan with fees before anything is done, and plan members save 10% on most treatment. ¹

After a New Filling or Crown

A tooth that's just been filled or crowned can be touchy with cold for anything from a few days to a few weeks. The nerve has been disturbed by the work and needs time to calm down, and it usually does. Two things are worth reporting, though.

First, if biting on the tooth is sore, the new filling or crown may be sitting a fraction too high. That's a few minutes to adjust, and the soreness then fades. Second, if the sensitivity is getting steadily worse rather than better after two weeks, or starts to ache on its own, let us know. Occasionally a deep filling close to the nerve tips it over, and it's better caught early.

Stopping It Coming Back

• Stay on a sensitive or high-fluoride toothpaste even once the twinges stop. They tend to return if you stop
• Keep your brush soft and replace it, or the head, every three months
• Wear your night guard every night if you've been given one
• Keep fizzy and acidic drinks to mealtimes
• Keep up your hygiene visits, so gum disease and recession are caught early. Our gum care guide has more
• If you have acid reflux, tell us. We can protect your enamel and you may want to speak to your GP too

If whitening is behind it, our guide to whitening sensitivity explains how to adjust your routine.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.