5 Invaluable Tips for Combatting Tooth Sensitivity!

Hi, I'm Kyle Hornby and I'm a Kitchener, Ontario Dentist. I operate a Dental Clinic that's been a staple in Downtown Kitchener for over 40 years! Each and every week, I tackle 2-3 dental issues and answer commonly asked patient questions to help raise the bar on info available to the public. This week, I'd like to share some great tips for getting rid to tooth sensitivity and pain.

So, why do our teeth hurt?

Well, there are a bunch of different reasons for tooth pain in the mouth. In fact, sometimes gum pain can present as tooth pain. Generally, most sources of pain and sensitivity have some inflammatory component to them. This is the reason that Advil/Ibuprofen or stronger formulations like Motrin work so well for quelling pain in the mouth. My goal today, though, is to provide some non-medicinal tips that really work!

Now, you may find it interesting that the #1 cause of tooth sensitivity is not from cavities or dental infections and abscesses. When we look at all the patients we see in a given year for tooth sensitivity, most have pain in one or more teeth that are pretty healthy overall. The main reason people experience tooth sensitivity and pain is exposed dentin. Dentin is the layer of yellow tooth structure under your enamel.

But, why does healthy Dentin cause so much pain?

Well, first, a little bit about tooth enamel.

Enamel is a good insulator against cold, sweet and acidic foods (all common causes of tooth pain). Enamel is not supplied by nerves, either. Dentin, in comparison, is made of tubes that contain little nerve fibrils. These fibrils carry signals to the dental pulp or main nerve bundle in the center of your tooth and they're often triggered by hot, cold, sweet, and acidic foods and drinks.

So, how does dentin become exposed?

I'll talk about this now, and it will lead nicely into what you can do at-home to stop sensitivity in its tracks!

Gum Recession, Dentin Exposure and Painful Tooth Sensitivity

Your gums cover your tooth roots right up to where the enamel shell on your tooth begins. This is super convenient given that both gum tissue and enamel act to insulate the very sensitive layer of Dentin underneath. Unfortunately, when gums recede, the dentin on your tooth root becomes exposed. Oftentimes, this leads to patients experiencing spontaneous tooth pain or sensitivity provoked by cold. If we can settle the nerves in your tooth or find ways to limit recession, this can help to eliminate sensitivity. More on how to do those things in a minute...

Tooth Grinding, Dentin Exposure and Painful Tooth Sensitivity

The other main cause of exposed dentin is tooth grinding or bruxism. Grinding and clenching your teeth (during the daytime or at night) can strip away layers of tooth enamel to uncover the dentin underneath. Often patients will notice these sites as yellow areas on the chewing surface of their back teeth.

These areas can trigger sensitivity and pain when you chew on them, when cold foods and drinks touch them, or when you eat something sweet or acidic. Sometimes the pain is dull and other times the pain can be sharp.

So, how can we get rid of these types of tooth sensitivity quickly?

Stopping tooth sensitivity from Dentin Exposure

Here's the deal: we need to either find ways to cover exposed dentin or settle the nerves inside our tooth so they're less responsive when cold, sweet, or acidic hits our dentin.

Here are some ways to limit sensitivity from exposed dentin:

1. Anti-Sensitivity Toothpastes. These toothpastes (Sensodyne is a good example) contain KNO3 or potassium nitrate as a sedative ingredient. How does potassium nitrate help tooth sensitivity? It clogs the little tubes in your Dentin and limits nerve transmission to the main nerve in your dental pulp. This does not compromise the health of your tooth, importantly. It can take 1-2 weeks to notice a decrease in sensitivity after starting to use Sensodyne.
2. Hydroxyapatite Toothpaste. Hydroxyapatite (HA) toothpaste provides teeth with ingredients they need to rebuild outer layers of enamel and dentin. This helps to decrease sensitivity that originates in areas where dentin is exposed.
3. Oil of Cloves/Clove Oil. Clove oil has long been known to act as a sedative and reduce pain. It is no less effective with teeth. Keeping a small amount of clove oil in contact with exposed dentin or a painful cavity can help to provide quick relief!
4. Dental Varnishes. There are dental varnishes that your Kitchener Dentist can paint on your tooth roots to dramatically reduce sensitivity. Luckily, these can be applied simply and non-invasively. You can also locate comparable mouthrinses at your local drugstore. Ask them about a sodium fluoride rinse and they'll make sure you get the correct product. Fluoride can help to augment the outer dentin layers on tooth roots and worn chewing surfaces and this can help to reduce tooth pain.
5. Avoid Acids. I mentioned above that acidic foods can trigger tooth sensitivity. However, acidic foods can do more than just triggering tooth pain. Acids can gradually dissolve outer layers of enamel and dentin. Thus, acidic foods (hot sauces, citrus fruits and juices, etc.,) can bring about long lasting sensitivity to a variety of other triggers (think hot, cold, sweet) as well. Limit acidic foods in your diet and consider diluting citrus juices to reduce their negative impact on your teeth!

Now, what about other sources of tooth pain? Are there at-home remedies for those?

Other sources of tooth pain

I would say that the #2 most common source of dental pain is infection or abscess. These infections can have a more accessible source like in the gum pockets or they can exist in deeper locations like within the jaw around the tooth roots. The location of the infection determines your ability to access it and deliver relief.

For gum infections and related pain, the typical cause is food and bacteria deep down in gum pockets. Popcorn hulls/shells, for instance, are a very common culprit. Using a waterpik at home can flush out gum pockets and help to bring immediate relief.

For cases where the source of infection is inside root tips deep in the jawbone, relief is much harder to come by. These sites are hard to access and typically, only antibiotics will reduce pain. If the infection has formed a pathway out to the gums, you will notice a pus pimple along your gums. Popping this (in the same way you would pop a pimple) will allow outflow of pus and this reduces pressure and pain.

Seeking the help of your Kitchener Family Dentist is highly recommended if you suspect an infection or abscess as the source of your pain.

A helpful note about Orajel

In 2018, Orajel was the leading dental pain relief brand to the tune of 76.5 million in sales in the USA. When dental pain arises, people reach for Orajel.

Is their a problem with this?

Well, Orajel is essentially the same product as the 18% benzocaine gel your dentist swabs on your gums before the dental freezing or anesthetic injection. If you want rapid pain control on a fairly superficial area, then Orajel will work wonders.

Where does Orajel come up short (or why doesn't Orajel work in some cases)?

When you need pain relief in deeper layers of the jawbone or inside a tooth itself, Orajel's activity becomes very limited. It simply can't diffuse through gums, connective tissue, and then dense bone to reach the site where you need it. So, feel free to give Orajel a try but, if it's not working, don't just add more and more. It's probably not able to reach what is a deeper source of pain.

Can Orajel be dangerous?

Yes. Orajel can alter your hemoglobin, reducing it's capacity to carry oxygen through your bloodstream. This is called methemoglobinemia and it can be fatal, especially in children and infants. In fact, concerns about the safety of Orajel use are significant and led the FDA to recommend against its use in children and infants.

For this reason, I recommend against Orajel use in children and infants for teething and dental pain. Additionally, adults should use this product very judiciously, if at all.

Dental Treatment for Tooth Pain

What I wanted to share today is information about how you can quell or settle down tooth pain and sensitivity at home. In some cases, though, even pain that you can relieve with at-home methods may indicate that a cavity or tooth infection is present.

When tooth sensitivity and pain is coming from a cavity, your Family Dentist will need to remove the causative tooth decay and place a dental filling.

I also touched on deep space infections above and, commonly, root canal treatment is required to remedy these. In some cases, infection can arise because bacteria gained access to the jaws through a large cavity or crack that can't be repaired. In these instances, your tooth may be unsalvageable and require dental extraction.

I hope you've found useful information about combatting tooth sensitivity in today's post. Please do check in for more helpful content next week!

By Dr. Kyle Hornby, Kitchener Dentist

Our Dentist Office in Kitchener is conveniently located Downtown. We are a short drive away for families in Waterloo, Breslau & St. Jacobs. Our central location means we truly offer family dentistry near you!

This article is not intended to be a substitute for professional advice, diagnosis, or treatment. Accordingly, always seek the advice of your Dentist or other healthcare providers regarding a dental condition or treatment.