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The story of sensitivity part II, the solution

Finger-in-dyke

In yesterday’s entry I neglected to mention that dentinal sensitivity isn’t the only cause of tooth sensitivity. There can be many other causes of tooth pain including having a cavity, injury to the nerve of the tooth from trauma or tooth decay, or a fractured tooth to mention a few.  The sensitivity that I’m talking about here is due to exposure of the dentin layer from tooth erosion or gum recession.

So you’ve got these microscopic tubes (called “dentinal tubules“)in your teeth that cause pain when the liquid in them moves around. This liquid moves back and forth because the outer cover of the tooth has worn off.  So what’s the solution? Simply put, you put a cover back on the tubes.  There are several ways to go about it.

One very common way is to use a “sensitive tooth” toothpaste.  Just about every company that makes toothpaste makes one and they all have potassium nitrate as an ingredient.  Potassium nitrate acts to plug the opening of the tubules from the outside.  Plugging these tubes will reduce or eliminate the movement of the liquid in the tubes which should eliminate this sensitivity.  Generally you need to use the toothpaste over a period of time (often up to 2 months) before you notice a significant decrease in sensitivity. Further, you need to continue using sensitive toothpaste to continue the results.  Using this toothpaste is a noninvasive and conservative treatment using a chemical in the toothpaste.  If this doesn’t solve the problem I will often try another “chemical” solution.

Most people think of fluoride for it’s anti-cavity properties but it also treats sensitivity.  It works in a similar way to potassium nitrate to occlude the dentinal tubules.  The concentration of fluoride in tap water or toothpaste is generally too low to treat dentinal hypersensitivity, so we’ll often prescribe a higher concentration.  There are many types of higher concentration fluoride products including rinses, pastes and gels which are used at home for a period of time like the over-the-counter sensitive toothpastes.

Fluoride varnishes are my preferred chemical treatment for sensitivity.  These varnishes are placed at the dental office by a hygienist or dentist.  They are highly concentrated fluoride in a sticky matrix. Usually they have mild and pleasant flavorings and when applied feel like a little bit of fuzz on your teeth for a few hours or so.  What’s nice about them is they can be placed directly where the sensitivity is taking place.

If we can’t control sensitivity using these chemical means we sometimes try to seal the sensitive tooth surfaces.  When we place fillings and crowns we use a special kind of glue called a bonding agent.  This glue is very thin and clear.  It completely seals the surface of the tooth to close over the dentin tubes. In severe sensitivity cases we sometimes have to anesthetize the teeth in order to seal the sensitive surfaces.

Finally, there is a “surgical solution.”  In cases where there’s been a lot of gum recession you can actually have a gum graft.  This is a procedure where a dentist actually covers the exposed root surface with a piece of gingiva (or “gum”) taken from another part of the mouth (usually the palate).  This actually closes the tubules by covering them up with what was originally there in the first place.

If you have trouble with tooth sensitivity I would recommend that you have a dentist take a look.  In many cases these conservative treatments can be helpful but it’s important to rule out other tooth problems before you try them.  If you’d like to have me take I look I would encourage you to make an appointment with us!  You can call the office at (989) 799-9133 or you can email me at alan@meadfamilydental.com.  I would be happy to answer questions or help you treat your sensitive teeth!