Causes and Treatments of Extremely Sensitive Teeth

• What Is Tooth Sensitivity?

• What Causes It?

• In-Office Treatment

• At-Home Treatment

• If tooth sensitivity to hot and cold foods is accompanied by other symptoms like loose teeth, swollen gums, or pain while chewing, it may be due to a more complex dental issue requiring professional attention.

• Tooth sensitivity occurs when the protective layers of enamel and cementum wear away, exposing the underlying dentin and its microscopic tubules, which allows heat and cold to trigger nerves inside the tooth.

• Common causes for enamel erosion include consuming acidic foods, aggressive brushing, and overusing whitening products. However, extreme sensitivity is more likely caused by issues like tooth decay, worn fillings, or fractured teeth.

• Professional, in-office treatments for extremely sensitive teeth may involve a crown, inlay, bonding, a surgical gum graft to cover exposed roots, or a root canal if sensitivity is severe and persistent.

• At-home relief can be found by using desensitising toothpastes. A dentist might also recommend a fluoride gel treatment to strengthen tooth enamel and reduce sensitivity.

The crowns, or the part of the teeth above your gum line, are covered with a layer of protective enamel, while the roots below your gum line are protected with a material called cementum. Underneath the enamel and cementum is dentin, which is less dense than the protective coverings. The dentin contains microscopic canals called dentin tubules, and when enamel or cementum wears away or becomes damaged, it exposes the dentin. When your gums recede and expose the dentin, the tubules allow fluid to flow in them and are affected by heat and cold causing the nerves in the tooth to have sensitivity and pain.

Why would the enamel or cementum wear away? You may be consuming too many acidic foods and beverages, brushing your teeth too aggressively, or overusing certain tooth-whitening products. However, with extremely sensitive teeth, or hypersensitivity, the more likely causes are those that expose more dentin, such as tooth decay, worn fillings or fractured teeth.

Because extremely sensitive teeth are frequently caused by a more complex dental problem, it's important to see a dentist and have the issue treated directly. This may involve a crown, inlay or bonding, depending on the problem. If you have gum disease that has progressed to a chronic or advanced stage, you'll need to treat this as well.

If you have lost gum tissue from the root, your dentist may recommend a surgical gum graft to cover the roots, so they're protected again. If you have persistent and severe sensitivity, an x-ray should be taken to determine if a root canal could be the issue, which removes the nerve so it's no longer there to cause you pain.

You can also find some relief from a desensitising toothpaste. There are various products that contain ingredients that help protect the tooth surface. Your dental professional might also recommend a fluoride gel treatment, which strengthens your current tooth enamel, decreasing the sensations sent to the nerve.