From the Guidelines
Tooth sensitivity is primarily caused by exposed dentin, which contains tiny tubules leading to the nerve, and this exposure typically occurs when enamel wears down or gum recession reveals the tooth root. The main triggers for tooth sensitivity include consuming hot, cold, sweet, or acidic foods and beverages. According to 1, when dentin is exposed, there may be tooth sensitivity, and the patient should be referred to a dentist within a few days.
Causes of Tooth Sensitivity
- Exposed dentin due to enamel wear down or gum recession
- Temperature changes
- Consumption of certain substances like sweet or acidic foods and beverages
- Rough edges from tooth fractures causing irritation to the tongue or lips, as mentioned in 1
Management of Tooth Sensitivity
- Use a desensitizing toothpaste containing potassium nitrate or stannous fluoride twice daily for at least two weeks
- Apply a pea-sized amount and avoid rinsing after brushing for better effectiveness
- Utilize a soft-bristled toothbrush and gentle brushing technique to prevent further enamel wear
- For immediate relief, consider over-the-counter products like Sensodyne Rapid Relief, which can provide results within three days, as seen in the example answer
- If sensitivity persists, dental professionals can apply in-office treatments such as fluoride varnish or recommend prescription-strength desensitizing agents, as noted in the example answer
Importance of Dental Care
It is essential to monitor the tooth for signs of pulpal necrosis, as mentioned in 1, and to refer the patient to a dentist if the sensitivity persists or worsens over time. By covering the exposed dentin, the risk of pulpal bacterial contamination is reduced, as stated in 1.
From the Research
Causes of Tooth Sensitivity
Tooth sensitivity, also known as dentine hypersensitivity, is a common oral health problem that can be caused by various factors. Some of the main causes of tooth sensitivity include:
- Exposure of the dentine to the external environment of the mouth, which can result from loss of enamel by processes including abrasion and erosion, or by denudation of the root surface as a result of gingival recession or periodontal treatments 2
- Gingival recession, toothwear lesions, and periodontal disease, which can increase dentine permeability and lead to symptoms of sensitivity 3, 4
- Restorative procedures, which can rapidly change the architecture of the protective enamel and dentine layers, leading to pulpal inflammation and increased thermal sensitivity of the tooth 4
- Erosion, particularly from dietary acids, which can play a dominant role in both the exposure of dentine and the opening of tubules, thus permitting increased fluid flow in tubules on stimulation 5
Factors Contributing to Tooth Sensitivity
Several factors can contribute to tooth sensitivity, including:
- Age, as enamel loss and gingival recession may be more severe with advancing age 2
- Oral hygiene, as individuals with less than adequate plaque control may experience more root hypersensitivity to air stimuli than others with better oral hygiene 2
- Diet, as consumption of acidic foods and drinks can contribute to erosion and increase the risk of tooth sensitivity 5
- Occupation, as certain occupations may involve exposure to acidic substances or other factors that can contribute to tooth sensitivity 4
Mechanism of Tooth Sensitivity
The hydrodynamic mechanism theory suggests that tooth sensitivity occurs when dentine becomes exposed and tubules are opened, permitting increased fluid flow in tubules on stimulation 2, 5. This can lead to stimulation of the pulpal Aδ fibres, resulting in pain. Sealing the outside of the tubules with an impermeable substance, such as a desensitizing toothpaste or a professional desensitizer, can effectively treat hypersensitivity by reducing dentin permeability and occluding the dentinal tubules with a layer of calcium phosphate 6