Easing Sensitive Teeth

Normal Sensitivity or a Warning Sign?

How the pain behaves gives us a strong clue. Everyday sensitivity is brief and triggered: a sharp jolt from cold water, icy winter air or something sugary, fading within seconds once the trigger has gone. It tends to involve more than one tooth, usually close to the gum.

Only the top row is the everyday, harmless type. Every other row means a tooth needs checking.

What Makes Dentine So Reactive

Enamel, the hard outer coat of the tooth, contains no nerves. Underneath lies dentine, a softer layer full of microscopic channels running in towards the pulp. Once dentine is uncovered, cold or sugar shifts the fluid inside those channels and sets off the nerve endings at the far end. Below the gum, the root has only a thin covering called cementum, which wears quickly, so roots left bare by receding gums are particularly reactive.

Several things strip dentine bare, and they often combine:

• Heavy brushing, particularly with a hard brush and a sawing motion, which wears gum and enamel away at the neck of the tooth
• Acid from fizzy drinks (diet versions and flavoured sparkling water included), fruit juice, wine, sports drinks, citrus fruit and pickled food, as well as stomach acid from reflux or repeated vomiting
• Grinding and clenching, which flatten the biting edges and can flex enamel off near the gum
• Receding gums, caused by gum disease or simply age
• Recent treatment such as a new filling or a deep clean, which may leave a tooth touchy for a while
• Whitening, which makes teeth more permeable for a short time

Picture someone who sips flavoured fizzy water all day, brushes immediately after a glass of orange juice and grinds overnight. Their enamel is under attack from three directions at once, and sensitive teeth are the usual result.

Easing It at Home

1. Use a toothpaste for sensitive teeth twice a day. Spit out the foam afterwards without rinsing, so the active ingredient stays on the teeth. Allow at least two weeks, and as many as four, to judge it
2. For one especially sore area, rub a little of that toothpaste onto it with a clean finger before bed and leave it there overnight
3. Choose a soft brush, or a powered brush that warns you when you press too hard, and use small circular movements aimed at the gum line instead of scrubbing
4. Keep acidic drinks to mealtimes rather than sipping between them. Drink fizzy drinks through a straw and rinse with plain water afterwards
5. Leave about an hour after acidic food or drink before you brush, as enamel stays softened for a time
6. Use a fluoride mouthwash at another point in the day, after lunch for example, not immediately after brushing

If one toothpaste hasn't made a difference after a month, switch brands. Some seal the channels in the dentine while others calm the nerve, and different people respond to different types.

Signs You Should Book In

• One tooth is much more sensitive than the teeth either side
• The pain lasts long after the cold drink has gone, or appears with no trigger
• Chewing on a particular tooth hurts
• There's a visible hole, dark area, chip or broken filling
• Your gums bleed on brushing or have clearly pulled back
• Four weeks of sensitive toothpaste hasn't changed anything

Any of these may mean a crack, decay, a failing filling or an irritated nerve, all of which are simpler and less expensive to deal with early. A dental examination is £70, with X-rays included for new patients, and examinations form part of our dental plans. ¹ If a tooth is keeping you awake at night, call 01555 662441 for an appointment the same day.

How We Treat It

First we pin down the cause, testing teeth one at a time with cold and with a bite test, and taking X-rays if they're needed. Treatment then depends on what we find:

• Exposed dentine across several teeth: fluoride varnish applied to the sensitive spots, along with advice on brushing and diet
• A bare root surface: covered with a thin coat of bonded, tooth-coloured composite, from £105
• Decay or a leaking filling: replaced with a white filling, from £118 for a back tooth
• A cracked tooth: braced with an onlay, £750, or a crown, from £675, so the cusps can't split apart
• Grinding: a made-to-measure night guard, £210, to shield the enamel while you sleep
• A nerve that stays inflamed: root canal treatment, from £450
• Recession from gum disease: gum treatment with Fiona Dyer, our hygienist, to halt it

Before any treatment you'll receive a written plan showing the fees, and members of our dental plans get 10% off most treatment. ¹

Sensitivity After New Dental Work

A newly filled or crowned tooth may react to cold for a few days or a few weeks. The work has disturbed the nerve, which needs a little time to settle, and in most cases it does. There are two things to tell us about.

The first is soreness on biting, which suggests the filling or crown is fractionally high. Adjusting it takes a few minutes and the tenderness then eases. The second is sensitivity that's getting worse rather than better after a fortnight, or a tooth that starts aching by itself. Now and then a deep filling near the nerve is enough to tip it over, and spotting that early helps.

Keeping Sensitivity Away

• Keep using a sensitive or high-fluoride toothpaste after the twinges have gone, since they often come back when people stop
• Stick with a soft brush and change it, or the brush head, every three months
• If you've been given a night guard, wear it every night
• Save fizzy and acidic drinks for mealtimes
• Keep your hygiene appointments so gum disease and recession are spotted early. There's more in our gum care guide
• Tell us if you have acid reflux. We can help protect your enamel, and it's worth raising with your GP as well

If whitening is the trigger, our guide to whitening sensitivity covers how to change 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.