Dental sensitivity "Sensitive teeth"
Dentinal Hypersensitivity (DH), or Dental Sensitivity, is defined as an intense and transitory dental pain caused by the exposure of the dentin, internal part of the tooth, to the oral environment and which appears after contact with external stimuli: cold, hot, acidic or sweet food or drink.
Dental sensitivity occurs when the dentin, which is protected by the gum, root cement and tooth enamel, loses its natural protection and is uncovered.
The dentin contains thousands of microscopic tubes, known as dentinal tubules, which connect the outside of the tooth with the nerve endings. When the tooth loses its protection due to retraction of the gum and/or wear of the tooth enamel, these tubules are left open to the outside, allowing external stimuli to reach the nerve endings and cause the sensation of pain.
Numerous situations cause the exposure of dentinal tubules, potentially causing Tooth Sensitivity. These are usually related to lifestyle and daily oral hygiene habits:
- Toothbrushing that is not adequate in strength and/or frequency and a very abrasive toothpaste can cause abrasion of the enamel and/or cementum, exposing the dentin.
- Acidic food and beverages (citric juices, carbonated soft drinks, etc.) cause decalcification or erosion of the tooth, especially at the tooth neck.
- Excessive chewing force (occlusal trauma, bruxism) or poor patient habits may cause wear (attrition and/or abfraction) and dentinal exposure.
- Periodontal treatment, particularly surgery, can eliminate part of the gingiva, causing gingival recession.
- General diseases or certain situations can cause the oral medium to be acidic, including ailments that are stomach-related (ulcers, hiatal hernia, etc.), psychological (bulimia, anorexia nervosa) or work-related (wine tasters, bakers, etc.).
- It may also appear as a consequence of gingival recessions caused by dental treatments, including professional cleaning, basic periodontal treatment or orthodontic treatment.
Pain from dental sensitivity is easily identifiable, as it always appears in the presence of diverse but clearly recognisable stimuli:
- Very cold or very hot food or beverages
- Consumption of sweet or acidic substances
- Toothbrushing
- When breathing cold air
- Tactile pressure
If the pain that occurs is not related to a certain stimulus and/or it persists after the stimulus ceases or cannot not be easily located, the cause is likely to not be dental sensitivity and could be due to the existence of underlying conditions, such as, for example, tooth decay.
To properly treat tooth sensitivity, it is very important to establish preventive measures and carry out adequate therapy (in-office or home treatment).
- Recommend dietary habits: avoiding acidic foods and beverages.
- Correction of bad habits: avoid the use of wooden picks, bruxism, etc.
- Instructions for proper oral hygiene: adequate brushing technique and use of non-abrasive toothpaste.
- Use of desensitising agents to treat tooth sensitivity.
