Why teeth are sensitive and how to effectively tackle tooth sensitivity

Tooth sensitivity (sometimes called tooth tingling) is a common phenomenon in modern society. Almost every third person has sensitive teeth. However, the common occurrence does not diminish the seriousness of an almost incurable disease.

Causes of tooth sensitivity

Whether you suffer from sensitive front teeth, back teeth, or just one tooth, you likely have dentin hypersensitivity. Dentin hypersensitivity is the technical term for tooth sensitivity. This condition is caused by the weakening of the tooth enamel and the subsequent exposure of the dentin (the tooth's inner layer).

What causes sensitive teeth:

• Insufficient oral hygiene
• A diet rich in sugars and acids
• Unprofessional and frequent teeth whitening
• Poor tooth brushing technique
• Grinding teeth under stress
• Natural aging
• Poorly performed dental procedure

Influences of insufficient hygiene on tooth sensitivity

The most likely reason for the weakening of tooth enamel and the formation of dental caries is insufficient oral hygiene or the choice of toothpaste with high abrasiveness.

Be careful with teeth that are sensitive after cleaning. Approximately 10-15 minutes after consuming very acidic drinks and foods, do not brush your teeth, because at that moment they are much more sensitive.

Influences of the diet on tooth sensitivity

Generally, the contact of aggressive stimuli (cold, hot, sweet, sour) with sensitive teeth is signaled by a sharp, short pain. The most common sensitivity is to cold.

You can reduce tooth sensitivity by limiting consumption of:

• Cold (e.g., water with ice)
• Hot (e.g., immediately drinking tea after pouring)
• Sweet (e.g., sugared pastries)
• Sour (e.g., cola drinks)

Why then does a tooth hurt because of cold water? It has already been mentioned that sensitivity is caused by exposed dentin. The dental nerves are hidden under the dentin, but it is not as hard as dental enamel. The nerves signal a lack of protection to the brain with a stabbing pain at the point of contact. The same logic also applies to hot, sour, and sweet stimuli.

Some people have teeth sensitive to sweets. However, the biggest problem is not sweet as a stimulus, but sweet as a cause of the problem. Pathogenic bacteria that produce acids, which gradually erode the enamel, feed on sugars.

The effects of whitening on tooth sensitivity

Often, people themselves cause tooth tingling through improper or frequent whitening. Home whitening with peroxide significantly damages tooth enamel. However, even whitening by a professional should not be undertaken frequently if you want to avoid dentin hypersensitivity.

Types of teeth whitening to avoid:

• Home teeth whitening kits
• Constant use of whitening toothpaste
• Excessive whitening by a dental hygienist

Teeth whitening requires a specialist. The safest option is to consult with a dentist and have the whitening done by a dental hygienist. The procedure will cause tooth sensitivity after whitening, as the teeth will be very dehydrated. This pain will subside within approximately 24 hours.

Permanent use of whitening toothpastes is also harmful. These are very abrasive, meaning they aggressively wear down tooth enamel. Such pastes help maintain the natural color of teeth but will not whiten teeth by several shades. Essentially, the effect of whitening pastes is not too different from normal pastes.

Sometimes, sudden tooth sensitivity is caused precisely by the constant use of highly abrasive toothpastes.

The impact of cleaning techniques on tooth sensitivity

The problem can also be caused by aggressive tooth brushing and using a brush with hard bristles. Such a technique leaves microscopic grooves in the enamel, in which bacteria that weaken the enamel settle.

For thorough cleaning of the tooth surface, mechanical removal of food residue is necessary, but for such removal, it is sufficient to gently brush the teeth. Dental hygienists are happy to help with cleaning techniques during regular dental hygiene. The key is to clean the teeth thoroughly and, most importantly, gently.

The impact of stress on tooth sensitivity

Stress can be an invisible culprit. Stressed people often grind their teeth without realising it, especially in their sleep. Frequent grinding increases sensitivity.

A dental hygienist or dentist can identify stress as the cause based on the biting surfaces of the teeth. The effect of subconscious teeth grinding can be mitigated with a special night guard for teeth.

The effects of aging on tooth sensitivity

As we age, natural erosion of the tooth enamel (weakening of the enamel layer) occurs. Erosion can be slowed down with diligent oral care, but it cannot be completely avoided.

Receding gums are another reason for sensitive teeth. In case of low dental care in youth, teeth in old age will turn against you in the form of receding gums. In extreme cases, this problem can develop into periodontitis, which can lead to total tooth loss. On the other hand, without teeth, you will no longer suffer from tingling.

Tooth sensitivity after improper dental procedure

Teeth sensitive to cold air is not normal and can be a sign of a poorly performed dental procedure. Dentists rarely make mistakes. However, if a mistake occurs, it often involves a poorly done tooth filling. In such cases, even mild stimuli can significantly irritate the tooth.

You can recognise tooth sensitivity after a filling by an increased intensity of sensitivity. If you suspect that the filling was done improperly, schedule an appointment with your dentist to check the tooth.

Symptoms of tooth sensitivity

People often describe tooth tingling as sensitive gums, sometimes even painful gums. Gums as such should not be sensitive. If they are, it could be inflammation. In such a case, immediately visit a dentist.

A symptom of tooth sensitivity is a sharp pain in the tooth or the same pain in the area of exposed tooth necks. However, a dentist cannot resolve pain caused by weakened enamel. It will not regenerate.

Symptoms of tooth sensitivity:

• Sensitivity to cold (e.g., ice cream)
• Sensitivity to hot (e.g., coffee or soups)
• Sensitivity to sweet (e.g., chocolate and other sweets)
• Sensitivity to acidic (e.g., Coca-Cola or citrus fruits)
• Sharp, short pain when biting

Tooth sensitivity during a cold

Symptoms of tooth sensitivity during a cold or the flu rarely indicate a worsening condition or the onset of tooth sensitivity. Tooth pain is a sign of inflammation, and more sensitive teeth are caused by a temporary increase in the effects of irritating stimuli on already sensitive teeth.

Consuming hot beverages (tea, hot drinks with paracetamol) and acidic foods (citrus fruits) is common during a cold. Drinking tea increases tooth sensitivity to heat. Teeth also tingle more often due to a higher consumption of acidic foods. This symptom is only temporary and will diminish once a normal routine is resumed.

During a cold, inflammation of the sinuses (sinusitis) can occur. Sinusitis also includes toothache. However, this is not about normally sensitive teeth. The pain comes without the irritation of the teeth by external stimuli.

Tooth sensitivity during pregnancy

Pregnancy can show signs of developing sensitivity. Even in this case, the symptoms are mostly caused by other issues.

Teeth that were sensitive before pregnancy can be problematic during pregnancy. Frequent vomiting is not good for the teeth. Stomach acids are an aggressive stimulus to which sensitive teeth react with tingling.

A pregnant woman cannot avoid vomiting, but she can minimise enamel damage. Immediately after vomiting, teeth are extremely prone to damage. It is good to avoid mechanical cleaning with a brush for 10-15 minutes and just rinse with a fluoride-free mouthwash to reduce the odor. Use the brush only after waiting for this period.

How not to irritate teeth after vomiting:

• Do not mechanically clean with a brush immediately (wait 10-15 minutes)
• First, just rinse with mouthwash to reduce the odor
• Use fluoride-free mouthwash if vomiting frequently (to reduce the risk of fluoride overdose)

Pregnant women have a particularly hard time for 9 months. Among other things, they are also more prone to developing dental caries. It is the caries that subsequently make the tooth more sensitive. For healthy teeth during pregnancy, it is good to increase the intake of minerals and vitamins that keep the enamel resistant.

Tooth sensitivity after dental cleaning

Tingling in the teeth after a dental cleaning doesn't necessarily indicate the onset of sensitivity. Teeth are generally more prone to signal pain following external interventions such as grinding or whitening. In particular, whitening treatments can cause teeth to be sensitive when eating for a few hours. If tooth pain after a dental cleaning persists for more than 24 hours, it is advisable to visit the dentist.

Prevention against tooth sensitivity

What helps with sensitive teeth? Mainly prevention before the problem itself arises. Dental enamel does not regenerate; the later you damage it, the longer you will live without tooth tingling.

How to not have sensitive teeth:

• Proper oral hygiene and regular dental visits
• Reduced consumption of foods high in acids and sugars
• Choose the right products for tooth sensitivity

Proper oral hygiene

Thorough oral hygiene is the best means of relieving pain from sensitive teeth because it protects the teeth from developing sensitivity.

Suitable oral hygiene for sensitive teeth includes:

• A toothbrush with very soft bristles
• Interdental cleaning and tongue cleaning
• Toothpaste with low abrasiveness
• Low-acid mouthwash
• Cleaning teeth twice a day

Reduced consumption of foods high in acids and sugars

The first sign of a problem is a tooth sensitive to heat and cold. Subsequently, it becomes sensitive to sweet and sour as well. It is advisable to preventively avoid excessive consumption of acid-forming foods that weaken the tooth enamel.

Foods to avoid include:

• Sweet pastries and sugar in general
• Spicy cheeses
• Flavoured mineral waters
• Coffee and alcohol

The right products for tooth sensitivity

What is best for sensitive teeth? People with sensitive teeth must limit their dietary habits more and slightly adjust the composition of their dental care products. In particular, the abrasiveness (measured by the RDA index) of toothpaste is a very important factor in choosing a paste. The lower the RDA, the gentler the toothpaste.

What to use for sensitive teeth:

• Toothpaste with a remineralizing component (often sodium fluoride or hydroxyapatite)
• Toothpaste with low abrasiveness
• Mouthwash with a low acid content (pH neutral)
• And of course, classic interdental cleaning and a soft brush

Remineralizing toothpaste for healthy enamel

Toothpaste not only for people with sensitive teeth should contain ingredients that remineralize dental enamel. For those with sensitivity, it's even more important.

Tabsta® toothpaste tablets are the perfect option, using natural remineralization with hydroxyapatite. The good thing is that they're not just good for your sensitive teeth but also for the planet because of the plastic-free packaging.

Toothpaste with low abrasiveness

Abrasiveness is expressed by the RDA index (Relative Dentin Abrasion index). This index indicates how strongly the toothpaste wears down dental enamel. The lower it is, the more suitable it is for sensitive teeth. Note that the index does not take into account the wear caused by the toothbrush.

RDA Levels:

• 0-70 = Low abrasiveness (gentle wear)
• 71-100 = Medium abrasiveness value (moderate wear)
• 101-150 = High abrasiveness (intense wear)
• Over 150 = Very high abrasiveness (may be damaging)

Non-irritating mouthwash

When choosing a mouthwash, it's good to opt for a variant with a low acid content (pH neutral, slightly alkaline) and alcohol-free. Unfortunately, the market still has the bad practice of using alcohol in mouthwashes. Alcohol might belong in beer, not in mouthwash.

We recommend the eco-friendly mouthwash tablets from Georganics, which help restore a healthy pH level of 7 and do not contain alcohol. Another suitable option is the natural mouthwash from the brand Ben&Anna, although it has a rather strange taste.

Avoid hard toothbrushes

Toothbrushes are available in stores in four levels of bristle hardness. Hard brushes are suitable at most for cleaning dental prostheses. Forget about those straight away. Only buy toothbrushes with soft or ideally extra soft bristles.

Levels of bristle hardness for toothbrushes:

• Extra soft - suitable for sensitive and healthy teeth
• Soft - suitable for healthy teeth
• Medium hard - unnecessary, manufacturers could stop producing them
• Hard - more suitable for dental prostheses

The most used toothbrushes are those from Curaprox. In their portfolio, you will surely find a toothbrush of your chosen hardness level. Despite these toothbrushes being popular, we recommend the eco-friendly option of a bamboo toothbrush without plastic and with soft bristles.

Treatment and management of tooth sensitivity

There are several methods to address sensitive teeth. The most commonly used treatments are still dental fillings or crowns. However, dental medicine is advancing rapidly. Today, it is even possible to use a gum implant in areas with exposed tooth necks.

How to soothe sensitive teeth:

• Dental Fillings
• Crowns
• Removal of nerves in the tooth or the entire tooth
• Gum Implant

Dental filling

If just one tooth is sensitive to cold and hot, it might be due to tooth decay. To eliminate the pain caused by the decay, the dentist will opt for treatment in the form of a dental filling.

After the filling, overly sensitive teeth should be nothing but a bad memory. If the pain continues, a crown may be necessary.

Crowns

When a tooth is severely infected with decay, the only option is to proceed with an artificial replacement in the form of a dental crown. The crown is usually a ceramic dental prosthesis that goes around the ground-down stump of the tooth.

Crowns are a reliable protection for sensitive teeth, but they do not unconditionally protect the rest of the natural tooth against decay. It's still necessary to watch out for potential accumulation of dental plaque in the spaces between the teeth at the gum line and the crown.

Nerve removal or tooth extraction

A tooth very sensitive to hot and cold? Unfortunately, the most drastic "treatment" is the complete removal of the tooth or the extraction of the dental nerves from the root canals. With quality root canal treatment, the extreme sensitivity of the tooth ceases because the tooth will essentially be dead.

The tooth can still hurt in the case of an infection. However, this should not occur with careful dental surgery.

Gum Implant

Sensitive gums and teeth are slowly becoming a solvable problem with the advancement of science. A gum implant is exactly the kind of treatment that many people might not even think is possible.

A gum implant is the solution for sensitive tooth necks. Unfortunately, as we age (and with poor oral hygiene even when young), we increasingly encounter this issue. The gums recede, revealing the necks, which are more sensitive than the rest of the tooth, and unpleasant pain begins to bother.

How does the transplantation work? First, it should be noted that the procedure is painless, performed under local anesthesia. During the surgery, a graft of tissue from the roof of the mouth is harvested and then stitched onto the exposed tooth neck (the part of the tooth that meets the gum). Complete healing usually occurs within 3 months.

However, a gum implant is one of the most complex procedures to alleviate sensitive gums and teeth. This procedure is still not common within the realm of plastic microsurgery. We can only hope that it will become a standard like dental fillings in the future. 

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Always discuss tooth sensitivity with your dentist.

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