Why Are Some of My Teeth Sensitive?

Teeth can be sensitive for many different reasons and the best solution is to schedule an appointment to get it checked out.  Some of them are:

  1. Cavities:  Patients may notice sweet sensitivity, temperature sensitivity, or even random pain not linked to any action.  If a cavity gets big enough, it may need a root canal.  Main signs of a dying tooth that needs a root canal are prolonged pain to hot or cold for over 20 seconds or spontaneous, unprovoked pain, especially pain that wakes you up at night.
  2. Recession and newly exposed root surface as a result of recession: Best solution if you suspect recession is the cause is brushing with a sensitive toothpaste like Sensodyne and using a soft bristled toothbrush like the Gum brand Summit toothbrush. If there is still sensitivity, I find it very helpful to massage a pea sized amount of Sensodyne toothpaste along the exposed root with my finger and allowing the paste to sit on the tooth overnight.  It will take several nightly applications but eventually the potassium nitrate in the paste will help to clog the exposed pores and help with sensitivity.  Brushing too hard or grinding/clenching will cause these areas to become sensitive again.  If this is something that consistently reoccurs or a notch defect is starting to form on the front of the tooth, the area should be covered with a bonded filling or crown depending on severity.Recession may be caused by a myriad of different factors.  Abrasive tooth brushing, grinding or clenching, acid based diets, gastroesophageal reflux (GERD), periodontal disease, or bone loss are the most common causes.  Recession is more prevalent in fair skin individuals with thinner gum tissue as well.  There can be a single cause but it is usually a combination that causes the gums to pull back and root surface of the tooth to become exposed.  This newly exposed root surface (called cementum) is porous and softer than existing enamel.  It is easier worn or notched during brushing once exposed.Patients commonly experience sensitivity in these areas as a result of temperature fluctuations during eating (ie: ice water during a hot cooked dinner), acidity of the foods being eaten (fruits, citrus, soda, etc), and touching of area.  Once recession happens, it cannot predictably be re-covered with gum tissue.  Measures must be taken to decrease sensitivity with newly exposed tooth surfaces as described above and prevent further tooth wear or gum recession.
  3. Cracked Tooth Syndrome: Due to wear and tear from years of grinding and chewing, teeth will develop craze and crack lines.  Having fillings in the teeth create a wedge effect that can help to further drive these craze lines deeper.  The cracks will start to open up to allow liquids and bacteria to seep into the tooth.  When this progression happens, patients may notice a random biting sensitivity or sweet/temperature sensitivity.  It usually becomes more consistent until the tooth breaks.  During your periodic exams, we will diagnose crack or craze lines for follow-up.  If these areas of concern become sensitive, we recommend a filling or crown to help hold the tooth together and prevent fracture.  Multiple cracked teeth are also a sign of night time grinding or clenching and a night guard is recommended to protect the teeth.
  4. Sinus Infections or Congestion: If the upper molars are sensitive to temperature or biting and you are an allergy sufferer or just plain sick, then this may be caused by close proximity of tooth roots to the floor of the maxillary sinus.  Pressure on the tooth roots from liquid in the sinus can mimic tooth pain.  Taking a course of decongestants or allowing sickness to play its course prior to making a tooth diagnosis is always a wise idea.
  5. Grinding or Clenching: Most patients will notice a generalized tenderness or sensitivity of teeth on both sides, usually molars but not always.  There may be a different randomly sensitive tooth that changes daily or weekly and/or  muscle sensitivity or tightness in the facial, head and neck muscles.  A hard nightguard is recommended in these instances.  If left untreated, grinding and clenching can result in tooth death or fracture and loss of tooth.
  6. Unknown Cause: Sometime teeth are just sore for no cause.  They may be in the process of dying due to a lot of previous dental work or a deep filling where the tooth was not able to heal completely.  There may be past traumatic tooth experience from a sporting accident or even just repetitive bumping of the tooth with a glass during drinking.  Bottom line is if something is bothering you enough that you lose even one minute of sleep, it is better to get it evaluated to see what can be done.  Better to be safe than sorry!

Want to talk more?

Give our office a call at 949-396-3803 and we would be happy to help determine the root cause of your tooth/teeth pain.

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