Tooth Sensitivity
WHEN TO SEE YOUR DOCTOR
* Pain lingers after eating or drinking any cold food.
* Your teeth feel any pain at all in response to heat.
* The sensitivity is concentrated in one tooth.
* Toothpaste for sensitive teeth doesn't help.
What Your Symptom Is Telling You
No matter what flavor ice cream you choose, it always ends up tasting bittersweet—so luscious on your tongue, so painful to your teeth.
Everyone occasionally experiences fleeting pain in their teeth when they bite into something cold. That's usually because teeth have lost some of their enamel protection. And beneath the enamel lies a honeycomb of tiny, fluid-filled tunnels called dentinal tubules. These tubules lead directly to the tooth's inner core, which contains pulp—and the tooth's sensitive nerve.
Normally, saliva helps deposit calcium on the enamel to cover and protect the tubules' openings. But excessively hard brushing (especially with abrasive tooth polishes), receding gums, acidic foods and tooth grinding can all erode that protective covering, baring the ends of the tubules. Cracks in the teeth and loose fillings also expose the tubules or even the pulp itself.
Whatever the cause, once the tubules are exposed, extreme changes in temperature cause fluids inside them to flow back and forth quickly, explains J. Frank Collins, D.D.S., a dentist in private practice in Jacksonville, Florida. That movement causes the twinge in your teeth.
Eroded enamel can cause painful reactions to hot and cold food or drinks, says Lisa P. Germain, D.D.S., M.Sc.D., an endodontist in private practice in New Orleans. If you're sensitive to anything hot or if the reaction to cold either builds up slowly or lingers for more than a moment, you could have an irreversible inflammation, which can lead to an abscess—a pus-filled inflammation.
Symptom Relief
If you've recently had dental work and are experiencing sensitivity to hot and cold, however, you shouldn't be immediately concerned, says Dr. Germain. This kind of irritation is normal and should go away within a few weeks. It means the pulp inside the tooth became slightly inflamed and needs time to return to normal. If the pain does not go away for several weeks, see your dentist, or an endodontist (root canal specialist), because the nerve in the tooth may be dying.
Otherwise, curing your teeth's sensitivity to cold can be as easy as squeezing a tube of the right toothpaste and avoiding certain foods and drinks.
Plug up touchy teeth. Toothpastes for sensitive teeth work by plugging up the tubules with strontium chloride, which, like sodium fluoride, helps draw calcium from saliva into the tubules and the enamel. To be effective, says Dr. Collins, "you have to use it frequently, and you must brush meticulously."
Do the fluoride swish. Fluoride mouthwashes also help block the tubules, Dr. Collins says.
Try ibuprofen. If you're feeling sensitivity to hot or cold after a trip to the dentist, try ibuprofen to relieve the discomfort, says Dr. Germain.
Try a gentler brushing technique. Always use a soft-bristle toothbrush, wet the brush before you apply toothpaste and never scrub very hard, recommends Van B. Haywood, D.M.D., an asso-ciate professor in the Department of Operative Dentistry at the University of North Carolina School of Dentistry in Chapel Hill. "Probably the most common cause of sensitivity is that people brush too hard with a hard-bristle brush. They wear off the enamel," he says. "They saw back and forth like they're sawing down a tree, and that's what they'll do. They'll saw a tooth right in half. You can literally saw a notch in the tooth."
Change your brushing technique. If you're like most people, you put the most effort and pressure into the beginning of your brushing and slack off by the time you've covered all your teeth. Typically, too, you start your brushing in the same spot every time. "The place you start is usually the place that's sensitive," Dr. Haywood says. "You can almost pick out the right-handers who come in complaining of sensitivity in their top left-side teeth, because that's where they start brushing."
Begin with the backs of the lower front teeth, Dr. Haywood recommends. "That's the most inaccessible spot in the mouth and where most of the tartar builds up, so you'll be putting most of your effort onto the most difficult area."
Proper brushing will also help prevent receding gums, which can contribute to tooth sensitivity.
Save the acid for chemistry class. Acidic foods and drinks—tomatoes, lemons, colas and other carbonated soft drinks—will very quickly eat the enamel off your teeth and make them much more vulnerable to sharp temperature changes, Dr. Haywood says. "Some people get a seasonal tooth sensitivity in the summer because they eat a lot of tomatoes or suck on lemons," he says. "Carbonated beverages do a lot of damage over the long haul to your teeth—but because they're so acidic they're great for bug stains on your windshield."
Stop that grinding. If your dentist says tooth grinding is causing your problem, ask him to fit you with a protective device that you can use while sleeping.
Get a spark of insensitivity. If nothing works to stop the sensitivity, your dentist might suggest a procedure called iontophoresis, in which an electrical current is used to apply protective fluoride deep within the tubules, says Dr. Haywood. The procedure can be done in the dentist's office.
See also Tooth Grinding