Dentin Hypersensitivity

Dentin is exposed when enamel or cementum no longer covers it, and gum recession can expose it at the root. Tooth decay, fractured teeth, worn fillings, gum disease, worn enamel and an exposed root are listed causes of sensitive teeth.

Enamel covers the crown above the gum line, cementum covers the root below it, and dentin lies beneath both. Dentin is less dense and contains microscopic hollow tubules, so loss of either covering can create sensitivity.

Sensitivity can accompany a cavity, a fractured tooth, a worn filling, gum disease, worn enamel or an exposed root. Those causes matter because treatment aims at the reason dentin has become exposed.

Clinical management begins by identifying the cause of the sensitivity and following a consistent strategy from diagnosis to prognosis. The assessment distinguishes exposed dentin from other reasons a tooth may be painful.

Desensitising toothpaste can block transmission of sensation from the tooth surface to the nerve, though it usually needs several applications. Fluoride gel can strengthen enamel and reduce sensation transmission; bonding, an inlay, a crown, gum grafting or root canal treatment may be used for particular underlying problems.

Care can be as simple as repeated use of desensitising toothpaste or fluoride gel, but a flaw, decay, lost gum tissue or severe persistent sensitivity can require bonding, a restoration, gum grafting or root canal treatment.

Sensitivity can signal decay, a fracture, gum disease, worn enamel, a worn filling or an exposed root. Persistent discomfort may therefore continue until the cause of exposed dentin is addressed.

Proper oral hygiene helps prevent sensitive-tooth pain. Protecting enamel and cementum, and addressing gum recession or other causes of exposed dentin, reduces the pathway through which triggers reach the nerve.