Symptoms
Pain-sensitive teeth manifest as short-lasting, sharp, acute pain that occurs in response to specific triggers. These include thermal, mechanical, chemical, evaporative, and osmotic stimuli:
- Cold, e.g., cold drinks, ice cream, inhalation of cold air, rinsing with water
- Heat, e.g. warm drinks
- Touch, e.g. when eating, during dental care.
- Sweet or sour
If the dental pulp is not inflamed, the pain lasts only as long as the stimulus is present. Sensitive teeth are uncomfortable, make it difficult to eat and lead to avoidance of triggers.
Causes
The cause of pain-sensitive teeth lies in exposed dentin, that substance of the tooth which lies beneath the enamel. In this context, one also speaks of dentin hypersensitivity or tooth neck hypersensitivity. Risk factors include:
- Gum recession
- Dental caries and other dental lesions, dental treatments.
- Nocturnal teeth grinding (bruxism).
- Incorrect dental care with too much pressure (“scrubbing”).
- Acid exposure: food (e.g. fruit), beverages (e.g. soft drinks, fruit juices, smoothies), gastric acid.
- Dry mouth
- Chewing tobacco
Dentin is usually covered by either tooth enamel or root cementum. It contains dentinal tubules (dentinal tubules), which are filled with a fluid. If the tubules are exposed, the movement of the fluid changes in response to stimuli, which stimulates the nerves in the dental pulp, leading to pain.
Diagnosis
The diagnosis is made in dental treatment based on the patient’s history and clinical symptoms as a diagnosis of exclusion. For example, an ice-cold stimulus or an air-water syringe may be used for provocation. Other possible causes must be considered.
Nonpharmacologic treatment and prevention.
- Avoid the triggering stimuli, e.g., keep drinks at the right temperature.
- Use a soft toothbrush and do not apply too much pressure when brushing teeth (do not “scrub”).
- Use a toothpaste with a low abrasion.
- Be careful with acidic drinks and foods. Brush teeth in some circumstances before and not after eating. Do not clean teeth for up to one hour after contact with acid.
- Clean the spaces between the teeth.
- Treat an acid reflux, dry mouth or bulimia.
Drug treatment
Special toothpastes are available that superficially close the dentinal tubules or reduce pain sensitivity. Depending on the product, they can be applied as needed or twice daily as a replacement for regular toothpaste. Ingredients include potassium salts (e.g., potassium nitrate), arginine, calcium salts (calcium carbonate), fluorides (e.g., stannous fluoride) and strontium salts. At the dentist’s office, the sensitive areas can be treated and sealed with various substances, including.
