Preventing and treating tooth sensitivity Published Jan. 21, 2014 By Commentary by Lt Col Leo Shockley 22nd Aerospace Medicine Squadron Dental Flight MCCONNELL AIR FORCE BASE, Kan. -- Tooth sensitivity can have a number of causes. Some of the more common causes are caries (tooth decay), cracked or fractured teeth, trauma, tooth grinding or clenching, worn fillings (restorations) or tooth enamel and movement of the gums from the teeth as a result of gum disease or improper brushing. In healthy teeth, enamel protects the crowns (the part above the gums). The roots are coated by a thin protective layer called cementum. Under both the cementum and enamel is a more permeable layer called dentin. The dentin layer contains microscopic canals or tubules, that connect with the pulp of the tooth. The pulp is in the center of the tooth and contains the tooth's nerve and blood supply. When irritants such as hot or cold foods or liquids come in contact with the exposed dentinal tubules, a pain response can be stimulated. This can also occur when biting or chewing on a cracked tooth. How can I prevent tooth sensitivity? Good oral hygiene is your best defense against most oral health problems, including tooth sensitivity. Daily removal of plaque disrupts bacterial colony formation around and in between teeth. If this bacterial plaque is not removed, tartar (calculus) can form. This can then lead to gingival or gum disease. Gum disease, or periodontitis, can irritate the gums and cause bone loss and recession, which can lead to exposure of the roots of the teeth. Recession makes your teeth more susceptible to sensitivity and tooth decay. Chewing tobacco, improper brushing, brushing with a hard or medium tooth brush, or one that is worn out and "mushroomed" can also contribute to recession. Can tooth sensitivity be treated? Yes. A dental professional must first examine your teeth to determine the cause of the sensitivity, and a desensitizing toothpaste may be recommended to help seal dentinal tubules and reduce sensitivity. If decay is present, fillings will be required to restore the teeth. This will also be necessary if the worn or broken fillings are the cause of the sensitivity. In-office treatments are available and include fluoride varnish, liquid desensitizing agents or bonding small fillings to the teeth. Some of these materials can be used to repair areas of the teeth that are damaged or to cover exposed areas of the roots. In some cases grafts can be placed to cover the recession areas. If the tooth sensitivity has irritated the pulp or nerve of the tooth enough, a root canal might be required to prevent the tooth from hurting. Clenching and grinding can also cause sensitivity. A splint, or mouthguard, to protect the teeth may help prevent this. Talk with your dentist about your treatment options and how you can prevent tooth sensitivity. Editor's Note: Information from "For the dental patient," an article prepared by the American Dental Association Division of Science, was used to create this article.