Sensitive teeth can be annoying and cause discomfort. There are numerous dental conditions that can result in sensitive teeth. Pulpal inflammation, gum recession, dentin hypersensitivity, cracked tooth syndrome, and excessive occlusal wear can all cause your teeth to be more sensitive to hot and or cold.
There are two kinds of pulpal inflammation: reversible and irreversible. Reversible pulpal inflammation can arise after a recent restorative procedure has been completed. For example, you had a cavity filled. The decay may have been extensive. The mechanical trauma of working on the tooth can inflame the pulp or nerve initially, resulting in an increase in temperature sensitivity. This sensitivity may last for several weeks, but it usually will subside over time.
Sensitive teeth may also result when a patient experiences intense or prolonged sensitivity to hot and cold food or drink. This may be an indication that the pulpal tissues are irreversibly inflamed. There can be multiple conditions that lead to an irreversible pulpitis. An irreversible pulpitis can be treated successfully with root canal therapy. Root canal therapy is a process where the nerve and vascular tissues that reside within the root of the tooth are removed. The root canal system is cleaned, shaped, and filled with a material that seals the space. Once root canal therapy has been completed, the tooth often needs to be crowned to protect it from fracturing.
Cracked tooth syndrome may also cause sensitive teeth. Cracked tooth syndrome is a condition where there is a hairline craze or fracture in a tooth. A fracture is usually the result of normal wear and tear or parafunctional habits like clenching, grinding, or bruxing. A craze line can be small initially, but if left untreated, it can progress deep into the tooth and effect the nerve. A craze line can act as a channel to allow bacteria that naturally occur in your mouth to reach the pulp and eventually inflame it. The common symptoms associated with cracked tooth syndrome are periodic biting pain, an increase in temperature sensitivity, or an increase in sensitivity to “sweets.” A crown can successfully treat a tooth that has been diagnosed with cracked tooth syndrome.
An increase in hot and cold sensitivity can also be the result of a series of conditions that are tied together. Sensitive teeth may result from gum recession and excess occlusal wear that can lead to dentin hypersensitivity, and both are related to parafunctional habits. Gum recession is a condition where the gum tissue has migrated down the root surface, exposing the dentin, or cementum, of the tooth, which can be more sensitive to external stimuli than the rest of the tooth.
As we age, it is normal to have some wear and tear on the enamel that covers the biting surfaces of our teeth. Excessive occlusal wear is an increase in the rate of this wear. With this condition, the enamel that protects the biting surface of the tooth is being rapidly damaged, which is usually the result of parafunctional habits like clenching, grinding, and bruxing of the teeth. Clenching and grinding your teeth not only cause damage and accelerate the rate of enamel wear, but it can even lead to gum recession.
It is important to not only treat the symptoms of sensitive teeth that coincide with gum recession, dentin hypersensitivity, and excessive wear of enamel, but to treat the cause of these problems. This can often be accomplished by having a patient wear a protective mouthguard to bed.