Tooth sensitivity is such a huge part of my job and I would say it is my ultimate nemesis, the Joker to my Batman, the Vadar to my Skywalker, the Regina George to my Cady Heron.

“If you experience tooth sensitivity at your dental appointment we can use desensitising gels, local anesthetic or even gas & air to help you feel happy and confident with your treatment.”

Now you would think, as a Dental Hygienist, that my biggest beef would be with Gum Disease, and yes Gum Disease is a big problem but after all is said and done, and Gum Disease is treated, and the patients work really hard they’re STILL left with tooth sensitivity. It can make life difficult, especially during a teeth cleaning.

Tooth sensitivity is usually an intense, sharp, on the ceiling kind of pain which then resolves quickly. It can usually be triggered by these 5 things.

cold - probably the most common trigger
hot
sweet
chemical interactions - like teeth whitening
instrumentation - usually when using a hand scaler

The usual sort of patient who will suffer from sensitivity is someone who:

has had treatment for Gum Disease and has had a large reduction of gum inflammation (that’s good) which has now exposed dentine and caused tooth sensitivity (less of a problem in the grand scheme of things but still not great)
has a tendency to overbrush which has exposed dentine
has a lot of acid erosion which has exposed dentine
has attrition which has reduced the height of the patients teeth exposing dentine on top of the teeth just feeling a bit achy after a big teeth grinding session
has gum recession which has exposed dentine
has a lot of fillings which at one point has exposed dentine
has a cavitiy which has worked its was through the enamel of your teeth and has exposed dentine.
has broken a tooth and exposed dentine.

So I think we’re starting to see a bit of a pattern here, having exposed dentine causes tooth sensitivity. Your tooth is like a cute little Russian doll, with one layer of dental tissue covering another and then another. Enamel is on the outside, it is rock hard, the hardest substance in your body. It forms the same way a diamond does and it can take a fair beating, but it will soften or wear away over time due to tooth wear or if left for long enough bacteria in plaque will eat through it exposing the dentine. Dentine is the next layer, its softer and made up of loads of little tubes or tubules, all of which contain liquid and this my friends is exactly which exposed dentine causes sensitivity.

See all these little tubes in this super magnified dentine?

All of the stimulus we talked about above, the cold, the heat, the sweet, the mechanical pressure, the chemical interaction will cause the liquid in these tubes to move allowing the outside world to contact with the pulp of your tooth kind of like when you make one of those phones with 2 plastic cups and a piece of string. Heeelllloooooo - just me?? Now your pulp is alive and your body will protect it at all costs, so anytime any of these things get a bit too close to the pulp of your tooth your body sends up the alarm in the form of pain. Usually this is a pretty good system but when you have exposed dentine, having the mayday alarms going off all the time is not ideal.

One of the best ways to deal with tooth sensitivity is prevention rather than cure with good toothbrushing techniques and good lifestyle habits and you can read more about how you can do this on my series of tooth wear blogs which are all featured here.

The easiest, cheapest and fastest way of dealing with tooth sensitivity once you have it is to use a sensitive toothpaste. Why? Because it will either deal with the exposed dentine and block up the entrance to the tubules protecting them from the outside world, or they calm down the pulp to stop it overacting to the outside world. My favourite toothpaste for treating sensitivity is Colgate Sensitive Pro Relief * it works for me personally and it works really well for my patients, it even works if I put it on a few seconds before I clean their teeth! Its amazing. I also have patients who have really great results with Sensodyne Repair and Protect * for recession based sensitivity. For my patients who have gum issues and sensitivity which happens ALL the time you could try Sensodyne Sensitivity & Gum *.

The golden rule with sensitive toothpastes is that you need to keep using it all the time because as soon as you stop the tubules become exposed again, or the pulp isn’t being treated anymore and the sensitivity will come back. Actually there are two golden rules you shouldn’t rinse your mouth with water or mouth rinse after brushing, just spit the foamy bit out and let the rest kind of marinade into your teeth.

If you only have a certain tooth or area that is sensitive you can use the sensitive toothpaste topically like a cream on that one tooth or area. Rub it on and don’t rinse it off afterwards, it’ll probably work the best if you do it just before you go to bed, but you can keep some sensitive toothpaste with you and do it throughout the day as you need to. This should help quieten down tooth sensitivity pretty quickly, anything from the first application to up to 2 weeks of use. If you’re not noticing tooth sensitivity resolving in 2 weeks it might be good to speak to your dental practice as your Dentist might want to examine the tooth or area further.

Fluoride is generally a great desensitiser and sometimes the Dentist might prescribe a fluoride toothpaste for you to use for a limited time or apply or ask your Dental Hygienist to apply some fluoride varnish to your teeth for you. If you are using a fluoride free toothpaste you might experience an increase in tooth sensitivity.

In some really extreme tooth sensitivity cases, where there has been over brushing or a lot of recession, there are other ways we can help with tooth sensitivity such as gum grafts which I’ve discussed here or using tooth coloured filling material to build the tooth back up again which I’ve touched on here.

Hopefully this has helped trouble shoot any of your tooth sensitivity issues, remember for any tooth sensitivity that doesn’t clear up in about 2 weeks, or if you have sensitivity to hot, if you have a dull ache that takes a while to go away or gets worse when you tilt your head back you should contact your dental practice.

Thankyou so much for reading <3.