Tooth sensitivity to touch, cold or sweets may be a sign of a cavity or infection, but it may also be caused by tooth root sensitivity. Teeth are covered by enamel which is a very hard substance, which insulates the nerve inside the tooth from the stimuli your teeth experience, such as cold, hot, sweets, and chewing. The enamel surface covers the tooth down to the level on the gums and then the root surface starts. The roots are covered by a substance called cementum. This cementum as shown in the picture to the left, is not as strong as enamel, but is normally protected by the overlying gums. Root sensitivity occurs when something happens to cause the gums to recede, leaving the cementum exposed. The cementum is not a very good insulator, so that is why we get sensitivity.
What causes gum recession?
Your toothbrush could be one of the biggest culprits. Root recession can occur by brushing too hard or by using a hard bristled toothbrush. The use of a soft toothbrush with proper technique, which our wonderful Camarillo Smiles hygienists can help you with, is paramount to preventing recession.
Clenching and grinding of your teeth can cause the recession of the gum tissue. As the teeth come together hard, the teeth flex causing enamel to chip out at the gum line which usually presents itself as a small, or sometimes very large, indentation or shelf at the gum line. These are called abfraction lesions and are very common in people with clenching or grinding habits. These biting forces can also cause the bone that holds the teeth in to recede down away from the tooth exposing the root surface.
Root sensitivity can also be caused by chemical erosion. This can occur in people who drink a lot of carbonated beverages like Pepsi and Coke, or highly acidic drinks like Gatorade and lemonade or suck on highly acidic foods, such as lemons or limes. The strong acids in these products eat away at the protective enamel coating of the teeth right along the gum line, leading to sensitivity. And if you add this to using a hard bristle toothbrush or clenching or grinding your teeth you will get even more recession.
Tooth root sensitivity can also occur after dental treatments. This is especially true if the dental treatment affects the position of the gum tissue on the tooth. Some examples would be gum surgeries that expose more tooth structure or the extraction of teeth, which may cause shrinkage of the gum tissue in the area adjacent to other teeth or even a dental cleaning if there was quite a bit of build up on the teeth.
What Can Be Done For Root Sensitivity
The most critical aspect in treating tooth root sensitivity is accurately diagnosing the cause. If the cause is not known and corrected, the problem will continue to recur in spite of treatment. Since the root surface does not have the benefits of insulation that of enamel affords, the treatment goal is to coat or seal the surface of the exposed root to prevent the stimulus (cold, sweets, etc.) from transmitting to the nerve of the tooth, causing sensitivity.
There are desensitizing toothpastes available at most stores that are made specifically for sensitive teeth. It can take a few weeks, but these toothpastes decrease the tooth root sensitivity over time. Because often times the cause of the sensitivity is not addressed, the sensitivity returns once the toothpaste is stopped. Another option that just came out are the Crest Sensi Stop sensitivity strips. They are a small clear patch that goes over the root surface. You wear them for 10 minutes and it is supposed to give you a month of relief. We will keep you informed about how this and other new products are working. You can see, sensitivity is a widespread issue which is why every major manufacturer of dental products make something for it.
Another option is to have us apply a highly concentrated fluoride varnish to the sensitive areas in our office. We can also seal the area with a thin coating of resin, which is like a thin coat of a clear liquid that helps to seal your tooth. We also offer the most current technologies available that can also desensitize the root surfaces using a laser.
Putting a filling over the exposed area can also seal them. We will do that if the root area has a divot that needs to be filled in, but of course, the cause of the divot needs to be identified and corrected, otherwise the gum may continue to recede past where the filling was placed, causing a new area of root sensitivity. If the recession is more extreme, or it is an esthetic concern, a gum graft may be done. A lot of progress has been made with these procedures and they are better than ever. The results are wonderful.