One of the most common dental conditions is intermittent tooth sensitivity to temperature or touch. If tasting ice cream, or sipping coffee makes you wince, or if brushing or flossing causes you pain – you likely suffer from dentinal sensitivity.

It is important to make a clear distinction between sensitive teeth and toothaches. If the pain is great, present with or without a stimulus, or is a recent discovery – you might be suffering from a toothache that requires more attention than sensitive teeth. Read our emergency section regarding toothaches, and consult your dentist.

What causes sensitive teeth?

To better understand the cause of sensitivity, it is important to see how a tooth can experience sensation. A healthy tooth has blood vessels and nerves running within it - a region known as the pulp. Since it is innervated, a tooth’s pulp is capable of experiencing all sorts of sensation, including extreme pain. These pulp nerves run through the dentine and cementum layers as well, making them sensitive to temperature and touch.

Fortunately, with a healthy tooth, hard impermeable enamel covers the sensitive dentin layer. Likewise, healthy gums extend up to the enamel, covering the sensitive cementum layer that covers the tooth’s roots. As such, a healthy tooth experiences no sensitivity because all layers that can experience pain are protected from outside stimuli.

Tooth sensitivity arises when the protective enamel layer is lost and dentin is exposed, or similarly, when the gums recede and leave the cementum exposed. Based on that, the following can cause tooth sensitivity:

• gum or gingival recession (your gums recede, exposing tooth roots)

• acidic drinks that dissolve or erode the enamel on your teeth

• excessive teeth grinding or bruxism that wears teeth down

• brushing too hard, or using a brush with hard bristles that wears the enamel

• teeth whitening treatments (though it should be temporary)

• gum disease or anything that exposes a tooth’s roots

• dental decay that has eroded through the enamel and exposed dentin

• new dental filling that is leaking or placed too close to the pulp

• old age – gums naturally recede and expose the roots through time

Treatment options

Sensitive teeth can be treated. There several treatment options available – the best treatment for you depends on what is causing the sensitivity. 

Your dentist may suggest that you try desensitizing toothpaste first, such as Sensodyne. They contain chemical compounds that help block sensation traveling from the tooth surface to the nerve and usually require several applications before sensitivity is reduced. Desensitizing toothpastes are not a cure though – they act like painkillers for your teeth – they treat the symptoms but not the cause.

If the desensitizing toothpaste does not ease your discomfort, your dentist may suggest in-office treatments. A fluoride gel or special desensitizing agents may be applied to the sensitive areas of the affected teeth.

If this fails, your dentist may place a coat of plastic sealant on the expose tooth roots to cover and desensitize them – assuming exposed roots are the cause of your sensitivity.  If tooth decay is the cause, a dental filling will usually resolve the problem. If a new dental filling was the cause of your sensitivity, your dentist will likely replace it. If your sensitivity is from bruxism, your dentist will construct a night guard.

Your dentist may suggest you visit a periodontist to have a grafting procedure performed. Gingival grafting raises receded gums so that they cover any exposed roots that may be the cause of sensitivity. This is a costly procedure that might not solve the problem though.

Finally, if nothing is able to remove the sensitivity, your dentist may suggest root canal treatment be performed. Root canal therapy involves removing the pulp (and therefore, nerves) of the tooth so that the tooth is incapable of feeling any sensation. This should be the last resort.

Visit your dentist

In the end, it is best to see a dentist about sensitive teeth to determine the true nature of the sensitivity. Treatments are plentiful and variable, as you have surely noticed, so the underlying cause is important in selecting the correct therapy.