Also called sensitive dentin, dentin sensitivity, dentin hypersensitivity, cervical sensitivity, cervical hypersensitivity.
Sensitive teeth, also called dentin hypersensitivity is a very common dental condition where a sharp but short duration pain occurs in the dental region inside the teeth and gums in response to certain stimuli but not caused due to any other disease. The stimuli can be thermal, mechanical or tactile, electrical, osmotic, or due to chemicals or evaporation.
The root cause of dental hypersensitivity is exposure of the dentine layer of the teeth that lies just underneath the outer enamel coating. The dentine layer may be exposed due to receding gums, or due to the erosion of the enamel. Dentine contains millions of microscopic tubules fanning outward from the pulp. These dentinal tubules are filled with a fluid. Once exposed, the external stimuli cause changes in the flow of this fluid, and this triggers the sudden sharp pain response from the mechanoreceptors from the nerves in the pulp. Some level of sensitivity is noted even in healthy teeth, but the response is much sharper and more intense in case of hypersensitivity.
A great number of treatment options are available to treat and manage dental hypersensitivity. Even without treatment hypersensitivity response is slowly managed and muted by the body by laying down tertiary drains and thickening the dentine, but these processes take a very long time, and the condition might turn more severe if the pulp becomes involved and inflamed.
A multitude of treatment options are available for dental hypersensitivity. The most easily available are desensitizing toothpastes that are available over the counter at any pharmacy. These toothpastes help to block pain by forming a layer over the exposed ends of the dentinal microtubules. Fluoride is also used to strengthen the enamel so that it resists decay. The exposed dentin surface may also be sealed in a process similar to dental filling for cavities. Lost gum tissues may need to be replaced by taking up tissues from elsewhere in the mouth. In case other treatments are ineffective, a root canal procedure is performed, which involves a surgical removal of pulp with all its nerve endings. The procedure is usually applied to treat severe hypersensitivity problems arising from other more severe causes like inflammation of the dental pulp. Treatments may need to be combined with teeth crowns to protect them from further damage.
Dental hypersensitivity is characterized by sharp sudden pains in the teeth in response to various stimuli. Commonest of these stimuli is temperature, where the pain is triggered by cold or hot liquids coming in contact with the affected teeth. Even cold air can cause a dental hypersensitivity in some of the more severe cases. Brushing teeth may cause the pain. Sugar solutions like fruit juices, soft drinks, etc. can cause the pain to occur. Solid or liquid edibles with acidic pH coming in contact with the affected teeth can cause pain. Dental hypersensitivity may occur due to some other dental diseases, in which case the underlying cause needs to be addressed. If no other diseases are seen to be the cause of hypersensitivity, the patient is eligible for hypersensitivity treatment.
Some dental diseases like pulp inflammation may be the cause of hypersensitivity. In this case, treatments like sealing of dentine is not advised as the pulp may turn necrotic and the damage may spread to other parts of the mouth and gums.
Some side effects are associated with treatments for sensitive teeth. For example, fluoride treatment can cause fluoride poisoning if used non-judiciously. Dental crowns placed to protect the enamel from decay may further aggravate the problem of increasing dentinal hypersensitivity.
Post treatment guidelines for teeth hypersensitivity include simple habits to keep the teeth and gums clean and healthy to prevent their further decay. These include regular brushing and flossing at least twice a day, rinsing out the mouth properly after every meal, having some water after having some acidic food, wearing mouth guards if grinding teeth is a regular problem, etc.
Some of the treatment options manage the condition by preventing further enamel decay and reducing dental sensitivity, and these treatments are regular treatments. Root canal surgery is performed in severe cases, and it takes about three to four weeks to recover.
Treatment costs for dental hypersensitivity vary widely from Rs. 50 going up to Rs. 10,000 or higher for surgical procedures and follow ups.
Some treatments are regular and ongoing. Results of most treatments are long lasting if proper care is taken and further decay does not occur. Results of root canal surgery are permanent since the entire pulp with nerves is removed.