Dr. Roshan Appanna

Is the taste of ice cream or a sip of hot coffee sometimes a painful experience for you? Does brushing or flossing make you wince occasionally? If so, you may have sensitive teeth.

Possible causes include:

• Tooth decay (cavities)
• Fractured teeth
• Worn fillings
• Gum disease
• Worn tooth enamel
• Exposed tooth root

In healthy teeth, a layer of enamel protects the crowns of your teeth—the part above the gum line. Under the gum line a layer called cementum protects the tooth root. Underneath both the enamel and the cementum is dentin. 
Dentin is less dense than enamel and cementum and contains microscopic tubules (small hollow tubes or canals). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold or acidic or sticky foods to reach the nerves and cells inside the tooth. Dentin may also be exposed when gums recede. The result can be hypersensitivity.

Sensitive teeth can be treated. The type of treatment will depend on what is causing the sensitivity. Your dentist may suggest one of a variety of treatments:

• Desensitizing toothpaste. This contains compounds that help block transmission of sensation from the tooth surface to the nerve, and usually requires several applications before the sensitivity is reduced.
• Fluoride gel. An in-office technique which strengthens tooth enamel and reduces the transmission of sensations.
• A crown, inlay or bonding. These may be used to correct a flaw or decay that results in sensitivity.
• Surgical gum graft. If gum tissue has been lost from the root, this will protect the root and reduce sensitivity.
• Root canal. If sensitivity is severe and persistent and cannot be treated by other means, your dentist may recommend this treatment to eliminate the problem.

Proper oral hygiene is the key to preventing sensitive-tooth pain. Ask your dentist if you have any questions about your daily oral hygiene routine or concerns about tooth sensitivity.

There is always the constant attempt to look better and more appealing. To this effect, smile designing is one particular specialty of cosmetic dentistry with the sole aim of improving a person's smile.
Photographs of various angles, jaw tracing analysis, and simulation of images on the computer are all used to arrive at an optimal size, shape, contour of the jaw and the teeth that can produce the best smile for a given patient. These changes are then replicated on paper and tooth models if required and detailed discussion happen with the patient. Thorough patient counseling is done before initiating work at smile designing.

Some parameters that are manipulated to produce a good smile designing are as follows - first the tooth per se followed by the soft tissues:

1. Tooth color: In most cases, the tooth color is changed using tooth whitening material or laser. Trust the dentist to achieve a balance between whiteness of the tooth and natural look. In some cases, silver amalgam fillings may be replaced with composite restorations to improve the appearance. Bridges with metal backup may be replaced with complete ceramic crowns too.
2. Tooth alignment: Crooked or misshaped teeth can be corrected using veneers in minor cases and by orthodontic braces in severe cases. Again, if the patient is very conscious, aesthetic ceramic braces (read more about braces) can be used.
3. Tooth length: If too much or too less of a tooth is showing during a smile, that needs to be corrected too. Longer teeth are considered to produce a younger appearance than short teeth, which usually is associated with old age and wear and tear. The gums can be reshaped as a part of crown lengthening.
4. Missing teeth: Teeth that are missing produce a very bad smile and need to be replaced at the earliest for a better smile. Depending on various factors including age and bone health, the choice could be a crown or a bridge or an implant.
5. Tooth ratio: When a person smiles, the front tooth are the most obvious and should have a ratio of length to width as 4 to 5. This produces a balanced smile.
6. Tooth texture: Mottling or rough edges on the tooth surface can be corrected by veneers or small composite restorations. As regards the soft tissues.
7. Gum line: The smile is reproduced on tracing and corrections are made to produce a better smile, even if it requires gum corrections.
8. Fuller lips and cheeks: Surgical procedures or chemicals may be used to produce fuller lips and cheeks that improve a person's smile.

The next time you are not happy with your smile, visit a dentist. With so many parameters that affect your smile, a little correction could produce a better smile! If you wish to discuss about any specific dental problem, you can consult a specilized dentist and ask a free question.