Sensitive teeth

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What are sensitive teeth?

Tooth sensitivity results from irritation of nerves in the tooth, which leads to pain or discomfort when teeth are exposed to hot or cold temperatures or to acidic food and beverages. Sensitivity can also occur during flossing or brushing of the teeth and while eating or chewing.

Above the gums, teeth are protected by a hard coating called enamel. The roots are protected by a similar substance called cementum. The enamel and cementum cover the dentin layer of the tooth. Dentin is also hard, but it is filled with microscopic channels known as tubules. In the centre  of the tooth is the pulp, which is the vital, or living, part of the tooth containing nerves and blood vessels.

Damage to the enamel or cementum can result from tooth decay, tooth trauma, and tooth erosion or wear. A common cause of tooth decay is poor oral hygiene. Regular brushing, flossing, and dental check ups can help prevent tooth decay. Tooth trauma can be caused by injury to the mouth, from biting down too hard, from biting on something hard, or from tooth grinding, which can wear down the teeth.

Repeated exposure to stomach acid, which may occur with bulimia or gastroesophageal reflux disease (GERD), can erode the tooth enamel. Erosion can also be caused by brushing your teeth too hard.

Sensitive teeth rarely represent a medical emergency. However, sensitivity can be associated with tooth decay, which can lead to cavities and their complications. It can also be related to traumatic damage to the tooth, which can become infected if left untreated.

Seek prompt medical care if you have a broken or cracked tooth, or if you have symptoms that suggest a cavity, cracked tooth, or infection. These symptoms include sensitivity to heat, significant overall sensitivity, pain when biting or chewing, fever, toothache, and swelling or redness of the gums. If your tooth sensitivity is persistent or causes you concern, contact a medical professional.

What other symptoms might occur with sensitive teeth?

Sensitive teeth may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the teeth may also involve other body systems.

Oral symptoms that may occur along with sensitive teeth

Sensitive teeth may accompany other symptoms affecting the mouth including:

Bad breath (halitosis)

  • Changes in taste
  • Pus or discharge
  • Receding gums
  • Redness and swelling of the gums

 

Other symptoms that may occur along with sensitive teeth

Sensitive teeth may accompany symptoms related to other body systems including:

  • Clicking or popping noises when opening or closing the mouth
  • Heartburn
  • Indigestion
  • Jaw pain
  • Pain in muscles of the face
  • Sinus pain
  • Trismus (inability to fully open mouth)
  • Weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, sensitive teeth may occur with other symptoms that might indicate a serious, or even life-threatening, condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

  • Bloody stool (the blood may be red, black, or tarry in texture)
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Difficulty breathing
  • High fever (higher than 101 degrees Fahrenheit)
  • Reduced jaw mobility, such as difficulty opening or closing the mouth
  • Severe pain
  • Swelling of the jaw
  • Vomiting blood or black material (resembling coffee grounds)

What causes sensitive teeth?

Sensitive teeth can result from damage to tooth enamel or the cementum (protective covering of the root). A common cause of damage is tooth decay and cavity formation. Trauma can break or crack the teeth, grinding can wear them down, and even overly vigorous brushing can cause damage. Chronic exposure to acid due to gastroesophageal reflux disease (GERD) or repeated vomiting, as in bulimia, can erode the teeth.

Everyday causes of sensitive teeth

Sensitive teeth may be caused by various habits that contribute to tooth decay including:

  • Between-meal snacking
  • Consuming food or beverages that are high in sugar or starch
  • Eating sticky foods
  • Lack of dental care
  • Poor dental hygiene, such as failing to brush or floss frequently

Traumatic causes of sensitive teeth

Sensitive teeth can also be caused by trauma including:

  • Biting a hard object
  • Breaking or cracking the teeth
  • Bruxism (tooth grinding) or jaw clenching
  • Damage to previous fillings or other dental work
  • Injury to the mouth or jaw
  • Poorly fitting dental appliances

Other causes of sensitive teeth

Sensitive teeth can result from conditions or actions that erode the tooth enamel including:

  • Brushing vigorously
  • Bulimia
  • Gastroesophageal reflux disease (GERD)
  • Professional whitening procedures

 

Serious or life-threatening causes of sensitive teeth

In some cases, sensitive teeth may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Facial trauma
  • Jaw trauma

Questions for diagnosing the cause of sensitive teeth

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your sensitive teeth including:

  • When did you first notice the sensitivity?
  • Have you experienced an injury to your mouth or teeth?
  • Have you ever caught yourself clenching or grinding your teeth?
  • Where do you feel the pain or discomfort?
  • What triggers the sensitivity?
  • Is there anything that makes it better?
  • Are you experiencing any other symptoms such as bad breath, bleeding gums, jaw pain, or indigestion?
  • When did you have your last dental checkup?
  • What medications are you taking?

 

What are the potential complications of sensitive teeth?

Tooth sensitivity can diminish quality of life, with loss of weight and poor hygiene habits. Sensitive teeth usually indicate damage to tooth enamel or the cementum. Because these layers protect the crown and root of the tooth, if severe enough, the damage must be repaired to help reduce the risk of infection. Ongoing damage resulting from decay and grinding can be lessened with good oral hygiene and a mouthguard to protect the teeth at night. Good oral hygiene includes frequent flossing and brushing, using a soft toothbrush, and regular dental examinations. Relaxation techniques and stress reduction can help with tooth grinding. A balanced diet that avoids acidic foods can be helpful.

Management of bulimia and gastroesophageal reflux disease (GERD) can help prevent ongoing erosion of tooth enamel. Furthermore, each of these conditions can result in serious or life-threatening complications if left untreated.

Because sensitive teeth can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Cavities
  • Electrolyte imbalance
  • Malocclusion (improper alignment of the teeth and jaw)
  • Pain in the temporomandibular joint (TMJ) and the muscles around it
  • Spread of infection
  • Tooth abscess
  • Tooth loss

 

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