Teeth sensitive to pain

Hanna Rutkowski is a freelance writer for the medical team.

More about the experts All content is checked by medical journalists.

Teeth that are sensitive to pain (dentine hypersensitivity) are not uncommon. More than half of German adults suffer from sensitive teeth. Hot or cold, sweet and sour triggers the unpleasant flash of pain, which is usually caused by exposed tooth necks. Dental diseases are rarely the cause of sensitive teeth, usually the wrong toothbrushing technique is to blame. We'll tell you what helps against pain-sensitive teeth.

Sensitive teeth: description

Many people have sensitive teeth. Dentists refer to this as dentine hypersensitivity. Teeth that are sensitive to pain are caused by exposed tooth necks caused by receding gums. Cold or hot food and drinks, sweet, sour, salty and even a cold draft can then trigger the unpleasant, lightning-like pain in the tooth area.

The most important building substance of the tooth is the dentin, the tooth bone. It gives the tooth its shape, color and stability and extends from the tip of the root to the crown. Inside there is a cavity (pulp) in which the smallest nerves and vessels run and supply the tooth. From here, the dentin is traversed by the finest canals (dentinal tubules), which strive from the inside out and supply the tooth with nerve cells and cell extensions.

The tooth neck - i.e. the transition area between the tooth crown and the tooth root - is usually covered by the gums. However, if this recedes, the tooth neck is exposed. It is not or hardly covered by protective tooth enamel, so that a direct connection between the tooth nerve and the outside world is created via the tubules in the dentine. The tooth then reacts to stimuli of all kinds (hot, cold, etc.) with pain.

Sensitive teeth: causes and possible diseases

The recession of the gums ensures that the sensitive dentin becomes on the tooth necks, which with its canals form the “gateway to the nerve”. Temperature fluctuations as well as chemical or mechanical stimuli are now transmitted directly to the tooth nerve without a protective intermediate layer and registered as pain. But what contributes to receding gums and thus to teeth that are sensitive to pain?

Inflammation of the teeth supporting structures: In most cases, exposed tooth necks can be traced back to periodontitis - an inflammation of the teeth supporting structures caused by bacteria and poor oral hygiene. It shows up as reddening and swelling of the gums. The inflamed tissue gradually withdraws from the tooth necks, which can lead to tooth necks that are sensitive to pain.

Periodontal recession: This is a non-inflammatory gum recession. From severity 3, it is also accompanied by a shrinkage of the jawbone in the affected area. The causes of the recession are diverse and range from natural aging processes to the wrong toothbrushing technique.

Incorrect toothbrushing technique: Most people brush their teeth incorrectly - they scrub in horizontal movements over the front surface of the teeth (instead of brushing from "red to white"). Especially in the area of the neck of the tooth, the gums can be injured and subsequently retreat. The more the tooth necks are exposed, the more sensitive they can be to hot, cold, etc.

Wedge-shaped defects: A triangular undercut in the area of the tooth neck is called a wedge-shaped defect. Dentists suspect that the cause is grinding of teeth. The enamel in this area is blown off by strong shear forces. Incorrect toothbrushing can also contribute to wedge-shaped defects in the dentin.

Dental interventions: With certain interventions, the dentist can also contribute to receding gums. This includes, for example, the treatment of periodontal disease and the provision of crowns and bridges.

Sensitive Teeth: When Should You Go to the Dentist?

Teeth that are sensitive to pain can become quite uncomfortable. Even so, many patients prefer to endure the pain instead of going to the dentist. However, it is advisable to go to the dentist's chair immediately if:

Bleeding gums: If you have recently observed an increase in bleeding gums, you should definitely have this checked out by your dentist.
Recession of the gums: it only develops over time and gradually becomes visible. If you discover such changes in yourself, it could be a sign of periodontal disease.
Loose teeth: Teeth that suddenly become loose are always a warning sign.
Tooth fractures: Bumps against teeth can cause cracks and breaks in the tooth, which are often only noticeable in the fact that the affected teeth have recently become sensitive to pain.

Sensitive teeth: what does the dentist do?

There are various options for treating the necks of the teeth that can contain the pain stimulus:

Sealing: In the case of exposed tooth necks, the surface can be sealed with medication or low-viscosity plastics; they form poorly soluble deposits in the dentinal tubules. Even a single application closes the tubules and prevents the occurrence of further pain stimuli.
Tooth neck fillings: A hollowed out tooth neck area or wedge-shaped defect can be closed with a small, invisible plastic filling. This not only keeps unpleasant stimuli away from the dentin, but the tooth also regains its original shape.
Surgery: Severe gum recession, especially in combination with bone recession, is common in patients with periodontal disease.Teeth that are sensitive to pain, but also aesthetic losses are the consequences: the exposed tooth necks are darker in color and the teeth appear elongated. The gums can be returned to their original position by means of surgical measures. The aesthetics are improved and sensitive tooth necks are covered again.

These measures only relieve the symptom - the sensitivity of the teeth to pain. In addition, the cause should be treated if possible. This includes, for example, learning the correct toothbrushing technique, wearing an occlusal splint when grinding your teeth at night or treating deformities or periodontitis.

Sensitive teeth: you can do it yourself

Correct tooth brushing: Let the dentist show you how to brush your teeth gently. Particularly important to avoid exposing the tooth necks and pain-sensitive teeth: Avoid pressing too hard with a hard toothbrush! With a gentle massage and soft brush bristles, plaque can also be removed without damaging the gums and the necks of the teeth.

Special toothpastes and mouthwash solutions: There are various oral care products specially designed for teeth that are sensitive to pain. They are often identified with the epithet "sensitive". Depending on the product, these toothpastes or mouthwashes contain strontium, calcium, arginine or amine fluoride. These form compounds that are deposited on the tooth and thereby close the dentinal tubules. This can help against sensitive teeth.

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