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Tooth Sensitivity

Updated: Sep 29, 2020

Are your teeth sensitive when you eat ice cream, drink cold drinks or even breathe in cold air?

If this sounds familiar, you’re not alone. It’s estimated that approximately 45 million Americans suffer from sensitive teeth. In the dental profession, this is referred to as dentin hypersensitivity.

Tooth enamel is the hardest substance in the body when it’s supported by dentin (the underlying layer of tooth structure). The enamel protects the crowns of healthy  teeth. A layer called cementum protects the root of the tooth under the gumline. Underneath the enamel and the cementum is dentin, a part of the tooth that is softer than enamel and cementum. The substance underneath the dentin is the nerve or pulp of the tooth.

Our teeth are made up of layers. The outer layer of our teeth is enamel. This is the hardest part of the human body. The outer layer of the tooth root is cementum.

The next layer is known as dentin. This makes up the largest part of the tooth.

Underneath dentin is the third layer known as the pulp. This is where nerve endings and blood vessels of the tooth are located.

The dentin contains many thousands of microscopic canals, or tubules, that communicate with the nerve of the tooth. Dentin is not normally exposed to the oral cavity. Tooth sensitivity occurs primarily when the tubules are open to the oral cavity. The gradual exposure of the softer, second layer of the tooth can cause tooth  is comfort. When the dentin loses its protective covering, the tubules allow heat and cold or acidic or sticky foods to stimulate the nerves and cells inside the tooth. In other words, when the enamel of a tooth is worn down or compromised or, when the gums have receded, the surfaces of these tubules can become exposed resulting in pain from cold or hot temperatures, sweets or changes in oral ph.

Notice the exposed dentinal tubules on the left side of the tooth root.


Symptoms of dentin hypersensitivity include sharp, momentary pain triggered by hot, cold, sour or sweet beverages or foods, forceful brushing or flossing, or cold air.  It appears that the ages of 25 to 50 are most affected.


  • Excessive consumption of acidic beverages such as sports drinks, energy drinks, soda, juices and iced tea, can erode  the enamel of your teeth.

  • Acid reflux and bulimia are also very damaging to tooth enamel.

  • Aggressive tooth brushing can abrade the enamel and root surfaces of your teeth and cause dentin hypersensitivity.

  • Grinding your teeth can also cause a loss of enamel and lead to sensitive teeth.

Prevention and Treatment

  • Using a soft-bristled toothbrush and brushing in a circular motion will minimize enamel abrasion.

  • Avoid grinding or clenching your teeth. Many patients are helped by wearing a mouth guard that’s custom made by our office.

  • Using toothpaste containing a desensitizing agent that protects exposed dentin by blocking the tubules connected to nerves can alleviate pain. Elimination of dentin hypersensitivity with toothpaste will take daily use for two to three weeks plus continued use over time to prevent recurrence.

  • If the desensitizing toothpaste does not ease the discomfort, we give the patient a prescription fluoride toothpaste and often apply a special desensitizing agent.

  • If these measures do not solve the problem, we may recommend a filling or a crown.

  • If the problem is due to gum recession, the necessary periodontal treatment is recommended.

  • In extreme and persistent cases, a root canal might be necessary to alleviate the discomfort.

Don’t let tooth sensitivity interfere with your daily life. There are many ways we can help you alleviate the discomfort so you can enjoy your favorite foods and beverages.

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