Understanding Tooth Sensitivity: Causes and Solutions

Tooth sensitivity can turn an everyday activity into an uncomfortable experience. Drinking cold water, eating something hot or sweet, or even breathing in cool air may cause a sudden, sharp sensation.

For some people, the discomfort is occasional and settles quickly. For others, it keeps returning or begins to affect what they feel able to eat and drink.

Sensitive teeth are common, but persistent or severe symptoms should not simply be accepted as normal. Sensitivity can sometimes be caused by exposed dentine, but it may also be linked to tooth decay, gum recession, a damaged filling, a cracked tooth or another problem that needs professional assessment.

What Is Tooth Sensitivity?

The visible part of each tooth is covered by enamel, which protects the softer layers beneath it. The roots are normally protected by gum tissue and a thinner surface called cementum.

Beneath these protective layers is dentine. Dentine contains microscopic channels that lead towards the living centre of the tooth, where the nerves and blood vessels are located.

If dentine becomes exposed, temperature changes, sweet or acidic foods and physical contact can trigger a short, sharp sensation. This is often referred to as dentine hypersensitivity.

However, not every sensitive tooth is caused by exposed dentine. A dental examination may be needed to rule out decay, infection, cracks and problems with existing dental work.

What Can Cause Sensitive Teeth?

There are several possible causes, and more than one may be present at the same time. Identifying the cause is important because a toothpaste designed for sensitivity will not repair a cracked tooth or treat decay.

Worn or Eroded Enamel

Enamel can gradually become thinner through a combination of chemical and physical wear.

Frequent exposure to acidic food and drink is one possible cause. Fizzy drinks, fruit juice, wine, citrus fruits and some sports or energy drinks can all contribute to erosive tooth wear, particularly when consumed repeatedly between meals.

Other contributing factors may include:

• Brushing aggressively or using an abrasive toothpaste
• Grinding or clenching the teeth
• Acid reflux
• Frequent vomiting
• Using teeth to open or hold objects

Enamel that has been physically lost cannot grow back. However, early mineral loss may sometimes be strengthened through fluoride, saliva and changes to the factors causing the damage.

Your dentist can help identify signs of wear and recommend suitable ways to protect the remaining tooth surface.

Receding Gums

When gum tissue recedes, part of the tooth root may become exposed. Roots do not have the same protective enamel covering as the crown, so they can be particularly sensitive to cold temperatures and touch.

Gum recession may be associated with gum disease, tooth position, natural changes over time or an unsuitable brushing technique. It can also affect one isolated area or several teeth.

Arrange dental advice if your teeth appear longer than they used to, you can see a notch near the gum line or sensitivity is developing around an exposed root.

Tooth Decay

Decay can cause sensitivity when it progresses through the enamel into the deeper layers of a tooth. The discomfort may be triggered by hot, cold or sweet food and drink.

Sensitivity caused by decay may become more frequent as the problem progresses. The tooth might also begin to ache without an obvious trigger.

Treatment will depend on the location and extent of the decay. It may involve preventative advice, monitoring, a filling or more extensive treatment if the centre of the tooth has become affected.

A Cracked or Damaged Tooth

Cracks can allow pressure or temperature changes to irritate the inside of a tooth. Some cracks are easy to see, while others are extremely fine or hidden beneath an existing filling.

Possible signs include:

• Sharp pain when biting
• Pain as you release your bite
• Sensitivity that repeatedly affects one tooth
• Discomfort that comes and goes unpredictably
• A rough or sharp edge on the tooth

A cracked tooth should be assessed because the damage may worsen over time. The appropriate treatment will depend on where the crack is located and how deeply it extends.

Worn, Loose or Damaged Fillings

Fillings can wear, loosen or develop small gaps around their edges. This may expose the underlying tooth to temperature changes, pressure and bacteria.

A recently placed filling may also feel mildly sensitive for a short period. Contact the practice if the discomfort is severe, becomes worse, affects your bite or does not begin to settle.

Grinding or Clenching

Grinding and clenching place repeated pressure on the teeth. Over time, this can wear enamel, damage fillings and contribute to cracks, jaw discomfort or sensitivity.

Many people grind their teeth while asleep and may not be aware of it. Possible signs include flattened tooth edges, morning jaw discomfort, facial muscle tension or headaches on waking.

A dentist can check for signs of wear and discuss whether a custom-made protective appliance may be suitable.

Recent Dental Treatment

Temporary sensitivity can occur after certain treatments, including fillings, crowns, professional cleaning and some gum treatments.

This often improves as the tooth and surrounding tissues settle. The expected duration will depend on the procedure and the condition of the tooth before treatment.

Contact your dentist if sensitivity after treatment becomes increasingly painful, lasts longer than expected or is accompanied by swelling or pain when biting.

Teeth Whitening

Some people experience temporary sensitivity while whitening their teeth or shortly after treatment. This may be triggered by cold food, drinks or air.

A dentist should check that your teeth and gums are healthy before whitening begins. They can also adjust the treatment schedule or recommend ways to manage sensitivity if it develops.

Whitening products obtained from unqualified providers may not be suitable for your mouth and can cause damage when used incorrectly. More information is available on the practice’s teeth whitening page.

How Are Sensitive Teeth Treated?

The most appropriate treatment depends on why the sensitivity is occurring. A dentist will usually ask about the symptoms, examine your teeth and gums, and may carry out additional tests or take an X-ray where clinically necessary.

Desensitising Toothpaste

Toothpaste formulated for sensitive teeth can help reduce discomfort caused by exposed dentine. Different products work in different ways, such as blocking the microscopic channels in dentine or reducing the nerve response.

These toothpastes usually need to be used consistently rather than on a single occasion. Follow the instructions on the packaging and ask your dentist or hygienist which type may suit your needs.

Avoid frequently switching between products before they have had an opportunity to work.

Fluoride Treatment

Fluoride helps strengthen tooth surfaces and protect them against decay. Your dentist may recommend an appropriate fluoride toothpaste or apply fluoride varnish where clinically suitable.

Some patients at higher risk of decay may be prescribed toothpaste containing a higher fluoride concentration. This should only be used as directed by a dental professional.

Changes to Your Brushing Technique

Scrubbing harder does not clean teeth more effectively. Heavy pressure can damage toothbrush bristles, irritate the gums and contribute to wear around the gum line.

Use a soft or medium toothbrush and clean each surface with gentle, controlled movements. An electric toothbrush with a pressure sensor may help if you regularly press too firmly.

Brush twice a day for around two minutes with fluoride toothpaste, including last thing before bed. Spit out the excess toothpaste afterwards rather than rinsing immediately with water.

Further practical advice is available through the practice’s preventative dentistry services.

Treating Decay or Damaged Dental Work

Sensitivity caused by decay, a damaged filling or a cracked tooth is unlikely to be resolved by toothpaste alone.

Depending on the diagnosis, treatment might involve:

• Repairing or replacing a filling
• Bonding material to an exposed or damaged area
• Protecting a weakened tooth with a crown
• Treating decay within the tooth
• Root canal treatment if the dental pulp is irreversibly damaged or infected

Your dentist should explain the available options, expected benefits and costs before treatment begins.

Managing Gum Problems

When sensitivity is linked to gum disease or recession, treatment will focus on controlling the cause and protecting the exposed area.

This may involve changes to your brushing and interdental cleaning routine, professional hygiene care or further gum treatment. In selected cases, restorative or gum procedures may be considered.

Managing Grinding and Clenching

If tooth wear or sensitivity is associated with grinding, your dentist may discuss a custom-made bite guard. This is designed to protect the teeth from direct contact while you sleep.

A guard does not necessarily stop the grinding habit itself, so other contributing factors may also need to be considered.

What Can You Do at Home?

Home care may help manage mild sensitivity, but it should not replace a dental assessment when symptoms are persistent, severe or isolated to one tooth.

Useful steps include:

• Use a fluoride toothpaste twice a day
• Try a toothpaste specifically formulated for sensitive teeth
• Brush gently with a soft or medium toothbrush
• Avoid highly abrasive whitening or smoker’s toothpastes
• Reduce how frequently you consume acidic food and drink
• Keep acidic drinks to mealtimes where possible
• Avoid swishing acidic drinks around your mouth
• Drink still water regularly
• Do not use your teeth to open packaging or bite hard objects

If you have just consumed something acidic, rinse your mouth with water rather than brushing aggressively. Reducing the frequency and duration of acid exposure is particularly important.

When Should You See a Dentist?

Arrange a dental examination if the sensitivity:

• Appears suddenly without an obvious reason
• Repeatedly affects one particular tooth
• Is becoming more frequent or severe
• Does not improve with appropriate home care
• Causes pain when biting or releasing your bite
• Begins after a tooth has chipped or broken
• Develops around a filling, crown or other restoration
• Is accompanied by bleeding or receding gums

Seek more urgent dental advice if you have significant toothache, facial swelling, a high temperature, a bad taste in your mouth or difficulty opening your mouth.

These symptoms can be associated with infection or another condition that requires prompt assessment.

Arrange an Assessment for Sensitive Teeth

Tooth sensitivity can have several different causes. Although desensitising toothpaste may help in some cases, the correct treatment depends on understanding why the tooth has become sensitive.

Park Street Dental Practice can examine your teeth and gums, discuss when the symptoms occur and explain the appropriate next steps. You can learn more about routine examinations and restorative care on the general dentistry page.

To arrange an appointment at the practice in Selby, visit the contact page.