Why Are My Teeth Sensitive?


           Your teeth are termed sensitive when only certain actions make them uncomfortable, such as eating or drinking. The different types of sensitivity you might experience include; temperature sensitivity, sensitivity to sweets, sensitivity on biting and mechanical sensitivity. Transient sensitivity may occur when you have your teeth lightened (bleached).  Pain that occurs either intermittently or constantly without provocation, such as to wake you from sleep, is more properly called a toothache. Discomfort that lasts well after the provocation is past (such as a cold drink) is also more than sensitivity. Since the nerves in your teeth are most comfortable at body temperature, and most people do not consume things much above this temperature, significant or lingering soreness to hot is likewise serious. This is especially so if the distress caused by heat is relieved by cold. These are different matters altogether and should be brought to Dr. McArdle's attention immediately as should any difficulty from a root canalled tooth. There are many reasons for your teeth to become sensitive. The following describes different sources of tooth sensitivity that can occur unrelated to recent dental treatment and what can be done about them.

           Some times restorations (fillings, inlays, crowns or bridgework) can be the cause of sensitivity. An entirely or partially lost restoration exposing your inner tooth to the outside world will generally cause sensitivity. Replacing the lost restoration should bring things back to normal. Older restorations with leaky margins can allow fluids inside your tooth producing sensitivity on biting or more commonly to cold. Replacing these older restorations with new ones can solve this problem. Very deep or extensive fillings can create sensitivity by conducting cold temperatures in towards your tooth's nerve that may never completely resolve. Depending on how intolerable you find this situation, the only solution may be to crown the tooth. A root canal would be the last resort in a case like this.


A very extensive filling, like this one, can cause temperature sensitivity.

           Any time a tooth fractures it may become sensitive. If it breaks cleanly with some loss of tooth structure, it will probably be sensitive mechanically and to cold. If there is a crack left in your tooth after the break or if your tooth cracks without loss of tooth structure, it may also be sensitive on chewing or biting. The latter instance is known as cracked tooth syndrome (CTS). Cracks in the outer surface of the tooth can be eliminated when the tooth is prepared to accept a crown. If the crack breaches your tooth's nerve chamber, it will be more painful than sensitive and will need to be root canalled. Cracks that extend too far down your tooth's root(s) will require its extraction.

           Gum recession that exposes the roots of your teeth can generate sensitivity. Root surface is called cementum. Cementum is perforated with microscopic channels that connect directly with your tooth's nerve. Exposed cementum can be cold sensitive, mechanically sensitive (such as brushing with even warm water) and sensitive on eating sweets. The latter happens when bacteria in the plaque on your teeth digest the sweets you have eaten and produce acid. This is also the mechanism for tooth decay. Certain tooth pastes (Crest Sensitive/Sensodyne) and fluoride rinses available on the market can lower this type of sensitivity. Desensitizing agents, such as a fluoride gel, can be applied to your exposed roots here in our office that block cemental channels reducing sensitivity. If this strategy fails, bonded filling material can be placed to cover your exposed roots. In complex cases gum grafts can be used for this purpose.


Recession (arrow) due to toothbrush abrasion can cause sensitivity.

           Grinding your teeth (bruxism) or clenching them are known as parafunctional habits. These habits can induce sensitivity by putting pressure on your teeth in their sockets. They can also wear away the outer enamel covering of your teeth revealing an inner layer called dentin that has channels in it much as cementum does with the same kind of sensitivity on exposure. In cases like these a hard on the outside/soft on the inside appliance called a nightguard can be fitted to protect your teeth from grinding in your sleep when it normally occurs or a bite adjustment can be done if a malocclusion (misalignment of your teeth) is the cause of your grinding. If wear from parafunction is already excessive, crowns will be needed to rebuild your teeth. Parafunction can also cause problems with your jaw joint, also known as your TMJ.




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Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

Questions or Request an Appointment: Contact Us     Phone: 603-430-1010     Email: drmcardle@mcardledmd.com     Website: http://mcardledmd.com