Sensitive Teeth, Explained
Why certain teeth flinch at cold, heat and sugar, what you can do about it at home, and when sensitivity points to something that needs treating.
Why Are My Teeth Sensitive, and What Can I Do About It?
That sudden jolt from a cold drink or an ice cream nearly always means dentine, the layer beneath the enamel, has been uncovered by worn enamel, gums that have receded, grinding, or drinks high in acid. A sensitive toothpaste, used twice a day and not rinsed away, calms most cases within two to four weeks. If a single tooth is noticeably worse than the others, the pain hangs around, or chewing on it is painful, book a check: a routine examination at Ferry Smile Studios is £70.
Everyday Sensitivity, or a Sign of Trouble?
How the pain behaves tells us a great deal. Ordinary sensitivity is sharp and brief, set off by something specific: a cold drink, a gulp of cold air on a walk along the Esplanade, or a sweet, and gone within seconds once the trigger has passed. It tends to affect several teeth at once, generally close to the gumline.
| What you notice | Likely explanation |
|---|---|
| A brief twinge in several teeth when something cold or sweet touches them | Dentine exposed by enamel wear or gum recession |
| A lone tooth that stabs as you bite down or as the pressure comes off | A fracture line in the tooth |
| A lone tooth that sugar sets off, perhaps with a dark area visible | Decay, or a filling that no longer seals |
| An ache that outlasts a hot or cold drink by a minute or longer | An inflamed nerve |
| Throbbing that begins by itself or disturbs your sleep | An inflamed or infected nerve that needs seeing promptly |
| Sensitivity across the mouth while using whitening gel | A temporary side effect of whitening |
The top row is the common, harmless variety. Everything below it deserves a proper look.
What Makes Dentine So Touchy
Enamel, the hard outer coat of the crown, contains no nerves whatsoever. Underneath lies dentine, which is softer and shot through with microscopic tubules running inwards to the pulp. When that dentine is exposed, cold or sugar moves the fluid in the tubules, and the nerve endings at their inner end respond. Below the gumline the root is protected only by a thin coating called cementum, which wears off easily, so roots laid bare by gum recession are particularly reactive.
The causes of exposed dentine often pile up together:
- Heavy-handed brushing, especially with a hard brush and a back-and-forth sawing motion, which strips gum and enamel away where tooth meets gum
- Acid from fizzy drinks, including diet versions and flavoured sparkling water, as well as fruit juice, wine, sports drinks, pickles and citrus fruit, together with stomach acid from reflux or repeated vomiting
- Clenching and grinding, which grind away the biting edges and can lever enamel off at the gumline
- Receding gums, whether from gum disease or simply the passing years
- Recent treatment, such as a fresh filling or a deep clean, after which a tooth can stay reactive for a spell
- Whitening, which temporarily makes the teeth more porous
Picture someone who nurses flavoured sparkling water all day, brushes immediately after their morning orange juice and grinds in their sleep: that is enamel being worn three different ways at once, and the sensitivity usually reflects it.
Is One Tooth Worse Than the Others?
Book an examination and we will find out what is behind it.
Things to Try at Home
- Change to a toothpaste designed for sensitive teeth and use it morning and night. Once you have brushed, spit out the foam but do not rinse, so the active ingredients stay on the teeth. Allow a minimum of two weeks, and up to four
- For one especially tender spot, rub a little of the same toothpaste onto it with a clean finger at bedtime and let it sit overnight
- Pick a soft brush, or an electric one that warns you about pressure, and work in small circles angled towards the gumline instead of scrubbing side to side
- Have acidic drinks with meals instead of sipping them through the day. Drink fizzy drinks through a straw and chase them with a swig of plain water
- Leave roughly an hour between anything acidic and brushing, since enamel is temporarily softened
- Use a fluoride mouthwash at a different time from brushing, for example after lunch, rather than immediately afterwards
If a brand has done nothing after a month, switch to another. They act in different ways, some by sealing the tubules in the dentine and others by soothing the nerve, and what works varies from person to person.
When It Is Time to Book
- One tooth is considerably more sensitive than the ones around it
- The ache goes on long after the cold drink, or appears without any trigger
- Chewing on one specific tooth is painful
- You can see a cavity, a dark patch, a chip or a filling that has broken
- Bleeding gums at brushing time, or gums that have visibly pulled back
- Four weeks of sensitive toothpaste has changed nothing
Any of these may indicate a crack, decay, a filling on its way out or an irritated nerve, and each is far easier and less costly to put right at an early stage. A routine examination costs £70, or £70 with X-rays for new patients, and both come as part of our dental plans. 1 Should a tooth be keeping you up at night, call 01382 477350 and we will see you the same day.
How We Treat It
Diagnosis comes first: we test each tooth with cold and with biting pressure, and take X-rays where they are needed. The treatment then follows the cause:
- Dentine exposed on several teeth: a professional fluoride varnish applied to the sensitive patches, with advice on brushing technique and diet
- An exposed root surface: a fine layer of tooth-coloured composite bonded across it, from £105
- A leaking filling, or decay: a fresh white filling, priced from £118 for back teeth
- A crack in the tooth: an onlay at £750, or a crown from £675, to bind the cusps together
- Grinding: a custom-made night guard, £210, so the enamel is protected overnight
- A nerve that refuses to settle: root canal treatment, from £450
- Recession caused by gum disease: gum treatment with our hygienist to halt its progress
Fees are confirmed in a written plan before any treatment, and dental plan members receive 10% off most of it. 1
Sensitivity After a Filling or Crown
A freshly filled or crowned tooth can be sensitive to cold for anywhere between a few days and a few weeks. The treatment has disturbed the nerve, which needs time to recover, which it almost always does. There are two things we would want to hear about, however.
The first is soreness on biting, which can mean the new filling or crown is sitting a fraction too high. A quick adjustment takes only minutes, and the discomfort then eases off. The second is sensitivity that two weeks on is still climbing instead of fading, or a tooth that starts aching unprompted. Now and again a deep filling near the nerve pushes it over the edge, and that is far better picked up early.
Keeping It Away for Good
- Once the twinges have gone, stay on a sensitive or high-fluoride paste; stop, and they tend to creep back
- Use a soft brush only, and replace it, or its head, every three months
- If a night guard has been made for you, wear it every single night
- Limit fizzy and acidic drinks to mealtimes
- Do not skip hygiene visits, so that gum disease and recession are spotted early. There is more in our gum care guide
- Let us know if you suffer from acid reflux. We can help protect the enamel, and it may be worth a word with your GP as well
Where whitening is the culprit, our guide to whitening sensitivity shows how to adapt 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.