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Dealing with that Thing Called Tooth Sensitivity

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By: Michelle S. Segarra, DMD, MOHDealing with that Thing Called Tooth Sensitivity

You drink cold water and you suddenly feel sharp pain in your teeth. The pain does not last but uncomfortable nonetheless. You go to the dentist and the dentist tells you it’s tooth sensitivity, nothing to be alarmed with. You ask what causes it and what can be done about it.

Tooth sensitivity or “pangingilo” is pain or discomfort caused by changes in temperature, chemical irritants, touch or changes in osmotic pressure. The main cause of hypersensitivity is exposed dentinal tubules.  These tubules are small openings that communicate directly with the dental pulp, which contains nerves as well as blood vessels.  The incidence of tooth sensitivity ranges from 3% to 98%, with a peak age of 30 to 40 years old. Smokers, periodontal patients or people with gum disease and those with gingival recessions show the highest incidence of dentinal hypersensitivity.

Products that seal the exposed dentinal tubules act by decreasing the size of the orifices and forming mineral deposits or, by forming a protective cover on the exposed tubules. Some products are applied professionally and others are active ingredients in some toothpastes.

Fluorides. Fluoride acts by increasing the resistance of dentin to decalcification and by forming precipitations in the dentinal tubules.  There are many forms of fluoride; the most studied is sodium fluoride, which is contained in most professionally applied fluoride gels and fluoride varnishes.

Calcium phosphate products. These products provide a supply of calcium and phosphate in the saliva and thus enhance the formation of mineral deposits in the tubules. Your dentist may prescribe these products for your hypersensitivity.

Glutaraldehye. This chemical clogs the dentinal tubules by precipitating salivary proteins. As glutaraldehyde is a strong tissue fixative, it should be used with caution, avoiding contact with the gingiva.

Resins and adhesives. Application of adhesive resins forms a protective film over the exposed dentinal tubules, thus blocking the inflow and outflow of fluid.

Lasers. Although a little bit on the expensive side and still experimental, Nd:YAG and CO2 lasers, when used in conjunction with sodium fluoride varnish can occlude dentinal tubules.

The best way to manage hypersensitivity is to prevent it from happening or from getting worse.

• Good oral hygiene such as toothbrushing twice a day with fluoridated toothpaste can help prevent hypersensitivity as it prevents plaque accumulation.

• Use soft-bristled toothbrushes and avoid vigorous tooth brushing.

• If you grind your teeth, ask your dentist about a mouthguard.

• Avoid or limit intake of acidic foods and drinks as acidic foods remove small amounts of enamel over time.

• Avoid brushing teeth immediately after eating especially sweets and acidic food and drinks as the enamel is still soft from the acids caused by eating.

• See your dentist regularly. 

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