It's normal to occasionally wince when eating ice cream or a hot soup, but the less-fleeting pain of sensitive teeth is hard to ignore. Discomfort due to an extreme temperature is a common complaint of almost 40 million people, according to the Academy of General Dentistry (AGD), and often affects more than one tooth. However, if you are suffering from just one sensitive tooth, it may be a sign of a more advanced problem.
Causes of Sensitivity
Sensitive teeth, sometimes called dentin hypersensitivity as described by AGD, is often the result of overzealous tooth brushing, a stiff-bristled brush or use of an overly-abrasive toothpaste, which can wear away tooth enamel over time to reveal the tooth's inner layer of dentin. Tooth enamel can also erode due to acid reflux, bulimia or a similar condition that causes stomach acid to enter the mouth. It may come from excessive amounts of acidic foods and beverages, as well.
Why Just One Spot?
Keep in mind that grinding or clenching your teeth can cause nerve irritation – in localized areas if you have an imperfect bite – as can recent editions of tooth whitening treatment. And if periodontal disease has caused your gums to recede due to an abscess in one particular area (more on that below), the exposed root can be just as sensitive to hot and cold.
Treatment Options for Dentin Hypersensitivity
Having ruled out other causes for your sensitivity, your dentist may recommend desensitizing toothpaste, which helps to seal off the dentin tubules (connected nerves) that cause the discomfort. It usually takes at least a month of regular use before you notice results.
In the meantime, be willing to accept an in-office desensitizing treatment or prescription fluoride gel, which you can apply to the sensitive areas after brushing. And of course, your dentist will work with you to correct any bad habits that may have contributed to the problem.
If one tooth in particular bothers you, your dentist will examine the tooth in question and ask you to describe your symptoms. Most likely, he or she will take an X-ray to determine if a few common conditions could be the problem – one of which is tooth decay.
In this case, acids produced by the bacteria built up against the tooth can eventually dissolve its enamel, exposing the dentin layer. And because dentin is filled with tiny nerve endings, you may experience temperature sensitivity and pain when biting down. Once your dentist removes the decay and fills the tooth with either an amalgam or tooth-colored filling, you should be pain free. A full-coverage crown might be needed for more stability and longevity.
Loose or Broken Filling
Unfortunately fillings don't last forever, and when they break or become loose, you may experience sensitivity due to bacteria getting underneath, causing the tooth to decay further. Luckily, this problem is easily remedied with a new filling or crown.
A cracked tooth may not be visible to the naked eye. It may not even show on X-rays, making a diagnosis difficult. However, the American Association of Endodontists (AAE)says a common sign of a cracked tooth is a sharp pain when biting down, but one that disappears after releasing that bite. Cracks involving a break around a filling can be repaired with a new filling or crown, but when a crack extends into the pulp of the tooth, you may need root canal treatment before a crown can be placed. Ultimately, a crack that extends below the gumline and into the root of the tooth will need to be removed.
An abscessed tooth occurs when the pulp of your tooth – which is made up of nerve and blood vessels – becomes infected. The American Dental Association (ADA) explains that symptoms can include fever, persistent pain and facial swelling. Usually, there's pus-filled swelling at the root tip, which drains periodically and gives you a bad taste in your mouth. You will need root canal treatment to save any tooth that has abscessed.
Dental procedures, like removing deep decay or preparing a tooth prepared for a crown, can inflame the nerves within the pulp tissue. This can cause a temporary sensitivity to hot and cold, but it usually dissipates after a week or two.
Whether you have one sensitive tooth or several, it's wise to see your dentist right away. Early diagnosis and treatment can ensure that small problems won't progress into more serious dental complications or the loss of a tooth.