We have encountered in many instances where a person complaints of toothache or shooting pain as they take something cold or hot to drink. Or else, they may complaint that they can’t breathe cold air as it will give rise to a toothache or more accurately a sharp twitching pain in one or more teeth in the mouth. This phenomenon might not last for many days or even hours. It has the potential to recede within few minutes as and when the causative element disappears. This is the nature of a condition known as ‘teeth sensitivity’.
Many people at one time or the other will feel a slight sensitivity due to various reasons. But, for some, the problem might be persisting and would require interventions by a dentist to resolve the issue. Heap of causes have been identified as elements which can lead to such sensitive teeth and most of these causes are things which can be prevented.
How does ‘sensitivity’ occur?
When considering the underlying pathophysiology of development of sensitive teeth. It’s understood that each tooth is covered by a protective hard layer known as the ‘enamel’. The layer provides strength as well as impermeability to certain elements into the nerve endings which are present beneath the tooth substance. Even though the ‘crown’ or the biting area of a tooth is covered by the enamel, the area below the gum line or at the junction where the tooth surface and the gums meet, would be deficient in ‘enamel’ and instead a less dense layer known as the ‘cementum’ will provide protection. This layer has the potential to be eroded rather quickly than the area of the tooth covered by the ‘enamel’.
Underneath both the ‘enamel’ and the ‘cementum’ is a layer known as ‘dentin’. The structure contains tiny network of tubules which leads to the nerve endings that are present within. If the two protective layers are damaged, the external insults such as hot or cols liquids and air or else the acids, can reach the nerve endings and thus give rise to a hypersensitivity towards these elements. The perception of such hypersensitivity will give rise to a pain or else a sharp twig which is known as ‘sensitivity of the tooth’.
Therefore, what makes the ‘enamel’ and the ‘cementum’ to be damages and expose the dentin? Let us take a look at these causes one by one.
1. Improper brushing techniques
When you brush in a horizontal direction, brush too vigorously or hard, and apply too abrasive toothpaste, it might damage the ‘enamel’ in the long run and thus giverise to dentin being exposed and later-on sensitive teeth.
2. Gum disease
In gum diseases, there will be a gap forming between the tooth and the gums and will allow bacteria and food particles to settle and lead to further damage of the less protective ‘cementum’ area as well as the ‘root’ of the tooth. The ultimate result would be the exposure of the nerve endings and thus the increased sensitivity.
3. Acidic effect
Acids such as in citrus fruits and certain soft drinks can erode the surface enamel and can expose the underlying dentin after a brief period of such exposure. The conditions can be augmented through poor oral practices as it will promote formation of plaques which further lead to erosiveness.
4. Damaged tooth
At times, the underlying cause for increased tooth sensitivity can be a fracture which run from the edge of the teeth towards the root. The result can make a sudden change in the feelings as it directly exposes the dentin layer to outside chemicals.
5. Receding gums
Naturally, the gums can recede and expose the ‘root’ area of the tooth which are less protective than the ‘crown’ of the tooth. Therefore, the elderly and people who practice poor oral hygienic practices will experience sensitive teeth due to this effect.