1 Sensitive teeth

Sensitive Teeth
What about it:
Sensitive teeth or simply Tooth sensitivity is tooth discomfort in one or more teeth that’s
triggered by hot, cold, sweet, or sour foods and drinks, or even by breathing cold air. The pain
can be sharp and sudden and can shoot deep into the nerve endings of your teeth. The most
common trigger is cold, with 75% of people with sensitivity reporting pain upon application of a
cold stimulus.

Types of stimuli may also trigger pain in Teeth sensitivity, including:

 Thermal – hot and cold drinks and foods, cold air, coolant water jet from a dental
instrument.
 Electrical – electric pulp testers.
 Mechanical–tactile – dental probe during dental examination, periodontal scaling and
root planning, tooth brushing.
 Osmotic – hypertonic solutions such as sugars.
 Evaporation – air blast from a dental instrument.
 Chemical – acids, e.g. dietary, gastric, acid etch during dental treatments.

The frequency and severity with which the pain occurs are variable

There are two types of tooth sensitivity:
Dentinal sensitivity: normally this occurs when the dentin (middle layer) of a tooth is exposed.
Normally, the dentin is covered by enamel above the gumline and by cementum below the
gumline. Dentine has tiny tubes ('tubules') that lead to the nerve and are filled with fluid. Eating
or drinking foods and drinks that are hot, cold or sweet can cause a change in fluid movement.
This fluid movement causes the nerve endings to react in response, triggering a short, sharp pain.
This causes sensitivity. Dentin becomes exposed when the outer protective layers of enamel or
cementum wear away. Images below
are Cross sections of teeth.

Salum Mkata |

the root surface becomes exposed. It’s easy for bacteria to accumulate in these tiny crevices. Salum Mkata | . which causes acid build-up and enamel breakdown. Over time.  Grinding. which exposes the root surface that leads directly to the nerve of the tooth.  There is decay around the edges of fillings. Hydrogen peroxide. fillings can weaken and fracture or leak around the edges. gingivitis can lead to periodontitis.  Tooth whitening products.  Your age. The bacteria can enter the pulp. Chipped or broken teeth may fill with bacteria from plaque. If you grind your teeth when you sleep or during the day. is a tooth whitening ingredient which is known to cause sensitivity. in the form of carbamide peroxide. See your dentist if you notice this type of tooth sensitivity between visits. As gums move away from a tooth due to conditions such as periodontal disease or brushing too hard. in most cases. It can also cause the gums to recede (the gum tissue pulls away from the teeth). fillings can be easily replaced. Tooth sensitivity is highest between ages 25 and 30. causing inflammation.  Cracked teeth. as during this time the enamel is softened and more vulnerable. If left untreated. Inflamed and sore gum tissue may cause the loss of supporting ligaments. Periodontitis is when gum disease gets worse and damages the tissues and bone that support the teeth. 2 Sensitive teeth Pulpal sensitivity: is a reaction of the tooth's pulp.  Tooth decay near the gum line. As you get older.  Gum disease (gingivitis). One sign of periodontitis is sensitive teeth. Pulpal sensitivity tends to affect only a single tooth What Causes Sensitive Teeth?  Brushing too hard. you may be wearing down enamel and exposing the underlying dentine layer of your tooth. Speak to your dentist about sensitivity if you are considering having teeth whitening treatment.  Recession of the gums. The pulp is a mass of blood vessels and nerves in the center of each tooth. Also Brushing shortly after acid challenge can cause the enamel to be more easily worn away. or if you clench your teeth. as the receding gums leave dentine exposed. brushing too hard or using a hard-bristled toothbrush can wear down enamel and expose the dentin. These products may be major contributors to sensitive teeth.

usually disappearing in 4 to 6 weeks. Sensitivity can occur following teeth cleaning. can cause enamel erosion. root canal treatment is necessary.  The gums around a sensitive tooth change color. ask your dentist about the use of a neutral fluoride solution. If you have dentin sensitivity. In this case. pickles. The acids further damage the dentin layer.  Long-term use of some mouthwashes. When to See a Doctor about Tooth Sensitivity While you can often self-treat generalized tooth sensitivity. 3 Sensitive teeth  Plaque buildup. Again. If a single tooth becomes sensitive to heat. see your dentist if:  Your teeth are persistently sensitive to pressure. The purpose of flossing and brushing is to remove plaque that forms after you eat.  A single tooth is persistently sensitive.g.  Sensitivity doesn't decrease after two weeks of using desensitizing toothpaste. An excessive build-up of plaque can cause your enamel to wear away.  You have dental pain that lasts more than an hour.  Acid erosion e. the tooth's nerve is dying.  You have any obvious decay. Sensitivity caused by dental procedures is temporary. bulimia or excessive consumption of acidic foods and drinks such as citrus fruits. Sensitivity to cold drinks or foods is the most common symptom. Symptoms Both dentinal and pulpal sensitivity usually involve reactions to temperature or pressure. which could indicate that its pulp is infected or dying. Salum Mkata | . the teeth are sensitive to hot temperatures. root planning. tomatoes. and tea. Some over-the-counter mouthwashes contain acids that can worsen tooth sensitivity if you have exposed dentin (the middle layer of the tooth). crown placement. Less often.  Recent routine dental procedures. related to gastro esophageal reflux disease. and tooth restoration. your teeth can become more sensitive as they lose their enamel protection.

However. You also will need X- rays to show if there is decay or a problem with the nerve. especially in areas of periodontal attachment loss. The metals in amalgam (mercury) conduct the cold very well. Your dentist also will look for decay. from tooth brushing) and dentin sclerosis. thereby increasing the thickness between the pulp and the exposed dentin surface and lessening the symptoms of sensitivity. but they take time. advances in bonding now make it less likely to cause tooth sensitivity.g. Females are slightly more likely to develop tooth sensitivity compared to males. In some cases. These physiologic repair mechanisms are likely to occur with or without any form of treatment. it is estimated to affect about 15% of the general population to some degree. The dentist will ask about your oral habits. He or she may use an explorer — a metal instrument with a sharp point— to test teeth for sensitivity. Bonded (tooth-colored) fillings require etching the tooth with acid before the filling is placed. The condition is most commonly associated with the maxillary and mandibular canine and bicuspid teeth on the facial (buccal) aspect. It can affect people of any age. the dentin-pulp complex may adapt to the decreased insulation by laying down tertiary dentin. Overall. Similar process such as formation of a smear layer (e. this etching removes enough enamel to make the tooth sensitive. When questionnaires are used. although those aged 20–50 years are more likely to be affected. 4 Sensitive teeth Diagnosis Your dentist will look at your dental history and will examine your mouth. deep fillings and exposed root surfaces. Salum Mkata | .Dentists may under-report tooth sensitivity due to difficulty in diagnosing and managing the condition. transmitting it to the pulp. A tooth may be sensitive to cold for several weeks after you get a filling. Your dentist or endodontist can do tests to see if you need root canal treatment. Due to differences in populations studied and methods of detection. the reported incidence is usually higher than when clinical examination is used. Prognosis Tooth sensitivity may affect individuals' quality of life. Grinding or clenching your teeth can contribute to sensitivity. Epidemiology Tooth sensitivity is a relatively common condition. the reported incidence ranges from 4-74%. Over time.

Excessive use of acidic conditions around the teeth should be avoided by limiting consumption of acidic foods and drinks such as wine. strontium acetate. and consequently many treatments have been suggested which varying degrees of efficacy when scientifically have studied. arginine. How to Manage Sensitive Teeth Treatment There is no universally accepted. potassium citrate. mild to moderate tooth sensitivity associated with several teeth. vinegar salad dressings and soft drinks. dental care recommendations and advice for your sensitive teeth.e. and in-office treatments for localized. 5 Sensitive teeth Prevention Gingival recession and cervical tooth wear can be avoided by healthy dietary and oral hygiene practices. toothpastes) or desensitization of nerve fibres/blocking the neural transmission (e. calcium carbonate. available over-the-counter or by prescription. gold-standard treatment which reliably relieves the pain of tooth sensitivity in the long term. Home treatment At-home treatments include desensitizing toothpastes or dentifrices. hydroxyapatite and calcium sodium phosphosilicate. The purported mechanism of action of these treatments is either occlusion of dentin tubules (e. and brushing should be carried out no more than twice per day for two minutes on each occasion. severe tooth sensitivity associated with one or two teeth. Desensitizing chewing gums and mouthwashes are also marketed. potassium chloride. the teeth should not be brushed immediately after acidic foods or drinks. mouthwashes and chewing gums. and seeking medical treatment for any cause of regurgitation/reflux of stomach acid. A variety of toothpastes are marketed for teeth sensitivity. Flossing each day also helps to prevent gum recession caused by gum disease. varnishes. potassium nitrate). a recommended technique such as the modified Bass technique rather than indiscriminately brushing the teeth and gums in a rough scrubbing motion) will help prevent receding gums and tooth wear around the cervical margin of teeth. intended to be applied by a dentist or dental therapist). By using a non-traumatic tooth brushing technique (i. or treatments which can be carried out at home. See your dentist for regular check-ups. simple treatments which can be carried out at home should be attempted before in-office procedures are carried out.Non-invasive. including compounds such as strontium chloride. Non-abrasive toothpaste should be used. resins.OTC products are more suited for generalized. potassium salts. A non-abrasive diet will also help to prevent tooth wear.g.e. they can be divided into in-office (i. Avoid grinding your teeth or clenching during the day by asks your dentist about a mouth guard for night time use. Generally. Importantly. Salum Mkata | .g.

Within a few weeks. Studies have found that mouthwashes containing potassium salts and fluorides can reduce teeth sensitivity. although it has been reported as significantly reducing teeth sensitivity. In individuals with teeth sensitivity associated with exposed root surfaces. people with sensitive teeth need a stronger fluoride rinse or gel than the ones available over the counter. Try a fluoride rinse. this has not been confirmed in intact human teeth and the desensitizing mechanism of potassium-containing toothpastes remains uncertain. For example. your teeth should begin to feel less sensitive. Since 2000. such as root planning (which reduces plaque). In such situations. although rarely to any significant degree. However. Swish it around in your mouth. transient and small increase in potassium ions in saliva that brushing with potassium-containing toothpaste creates. although rinsing the mouth after brushing may reduce their efficacy. as of 2000. Meta analysis reported that these individuals' subjective report of sensitivity did not significantly change after six to eight weeks of using the potassium nitrate toothpaste. Fluoride rinses. Spit. As of 2006. However. Desensitizing toothpastes containing potassium nitrate have been used since the 1980s while toothpastes with potassium chloride or potassium citrate have been available since at least 2000. Try putting some of the toothpaste on your finger or on cotton swab and spreading it over the sensitive spots before you go to bed. Animal research has demonstrated that potassium ions placed in deep dentin cavities cause nerve depolarization and prevent re-polarization. and then spit it out. but don't rinse. available without a prescription at your local pharmacy or in the dental section of grocery stores. some treatments for gum disease. can leave sensitive teeth even more sensitive than usual. brushing twice daily with toothpaste containing 5% potassium nitrate for six to eight weeks reduces reported sensitivity to tactile. especially for people plagued with decay problems. 6 Sensitive teeth Potassium-containing toothpastes are common. can help decrease sensitivity.It is believed that potassium ions diffuse along the dentinal tubules to inactivate intradental nerves. however. no controlled study of the effects of chewing gum containing potassium chloride has been made. How to use: Use it once a day. It is not known if this effect would occur with the twice-daily. the mechanism by which they may reduce teeth sensitivity is unclear. thermal and air blast stimuli. several trials have shown that potassium-containing toothpastes can be effective in reducing teeth sensitivity. Sometimes. How to use: Brushing at least twice a day with desensitizing toothpaste by soft-bristled brush. dentists can apply a fluoride gel that helps relieve the problem. In-office treatment In-office treatments may be much more complex and they may include the application of dental Salum Mkata | .

Alexander Block. They are thought to act by producing a transient reduction in action potential in C-fibers in the pulp. Salum Mkata | . Strontium Acetate. How Sensodyne Works Sensodyne toothpastes work in one of three ways to relieve the pain of sensitive teeth. In 2006. or a recommendation to wear a specially made night guard or retainer if the problems are a result of teeth grinding. Potassium Nitrate: The potassium ion in Sensodyne is believed to soothe the nerves inside the teeth. The toothpaste was first marketed in 1961 as desensitizing toothpaste based on a strontium chloride formulation.Potassium Nitrate. bonding agents and restorative materials because these materials offer improved desensitization. while some studies have showed that oxalates reduced sensitivity. Low-output lasers are also suggested for teeth sensitivity. a mild local sedative. or NovaMin technology. but Aδ-fibers are not affected. However. a Brooklyn. Sensodyne is owned by GlaxoSmithKline and is marketed under the name Shumitect in Japan. having fillings put over the exposed root that is causing the sensitivity. others reported that their effects did not differ significantly from those of a placebo. History Sensodyne is a brand of toothpaste that was first sold by Block Drug. In 2000 Block Drug was purchased by GlaxoSmithKline. 7 Sensitive teeth sealants. Other possible treatments include fluorides are also used because they decrease permeability of dentin in vitro. New York- based Company established in 1907 by pharmacist. Special Desensitizing Toothpaste I choose to discuss! NOTE: This Desensitizing Toothpaste I selected to discuss is not of matter of advertising BUT it due to long story of this toothpaste! Sensodyne is an oral health brand targeted at people with sensitive teeth. Sensodyne Pronamel was released and is marketed as toothpaste that protects against the effects of dental erosion. Sensodyne products are applied at home by the patient to treat this condition. teeth sensitivity treatments use adhesives. Nowadays. Oxalate products are also used because they reduce dentin permeability and occlude tubules more consistently. Also. In 1980. which include varnishes. potassium nitrate can be applied topically in an aqueous solution or an adhesive gel. Sensodyne launched a new toothpaste containing potassium nitrate. including GaAlAs lasers and Nd: YAG laser. Depending on the product's active ingredient .

ada. 11. doi:10. 12. Do you have a cracked tooth? Journal of the American Dental Association. Bioactive glass: Sensodyne contains calcium sodium phosphosilicate (Brand name NovaMin) which some studies have shown to reduce tooth sensitivity and cause remineralisation. PMC 3010026. Bhoomika (2010). 2000). Parolia A.html 3.full.org/2624. This is because it is formulated to create a physical seal against sensitivity triggers. Vivek. Cleaning your teeth & gums. PMID 21217949. American Dental Association. Journal of Conservative Dentistry 13 (4): 218–24. As long as a toothpaste with potassium like Sensodyne is used twice daily in brushing.com/content/21/1/35. Sensitive teeth. The Guardian. http://www. The strontium in Sensodyne Rapid Relief replaces some of the calcium lost from the dentine and blocks the exposed tubules in the dentinal tissue. Management of dentinal hypersensitivity: A review. http://www. 6. Salum Mkata | . 2013. Sensodyne Rapid Relief: relieves sensitivity pain when directly applied to the sensitive area of a tooth with a fingertip for one minute. 2.aspx?currentTab=1 10. Medical Subject Headings".ada.aspx. Strontium Acetate: Sensodyne Rapid Relief contains strontium acetate. the nerve response will gradually be reduced and sensitivity pain is relieved.com/products/our-consumer-healthcare-products/sensodyne.39:167. Miglani. Clark. Anthony (May 13.gsk. Ramirez. but the Market Is Big. 2011. et al.4103/0972- 0707. Journal of the American Dental Association. Retrieved July 20.134:531. 13. REFERENCES: 1. Ahuja.aspx?currentTab=1 9. National Library of Medicine. This helps prevent the movement of the fluid within the tubules in response to a sensitivity stimulus that could otherwise cause tooth pain. 2010. American Dental Association.org/3058. http://adr. American Dental Association.73385. Canadian Advisory Board on Dentin Hypersensitivity (2003). "SmithKline to swallow Sensodyne".ada. Retrieved 21 December 2013. 1990). 8. Treating dentin hypersensitivity: Therapeutic choices made by dentists of the Northwest Precedent network. Journal of the Canadian Dental Association 69:221-226. Root canal treatment (endodontic treatment). "All About/Toothpaste. The New York Times. 2003. which is similar to calcium. 141:1907.pdf+html 5. 2013. "Dentin hypersensitivity: Recent trends in management". Cunha-Cruz J. Sanjay. Growth Is Glacial. 4. Andrew (October 7.sagepub. and So Is the Gross". http://www.org/5899. 8 Sensitive teeth Clinical studies show potassium nitrate progressively reduces the pain of sensitivity over a period of weeks. Retrieved July 20. Journal of the California Dental Association. Aggarwal. 7. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. et al. http://www.