My Achy Breaky Tooth

Is your tooth "talking" to you?  If it ouches to cold water, or zings to pressure it's time to hear what your tooth may be saying.   So, listen my friends and ye shall learn!  The tooth translator is here!

Today's post will go into some of the different possible causes of tooth sensitivity.   This guide is in no way a diagnosis, and for all tooth sensitivity you should go see your dental professional, immediately.  It's time to have a radiograph (x-ray), a photo of the tooth and a diagnosis.

Your Tooth

Teeth are incredible.  We put them through daily stress, pressure, temperature changes, biting forces, chewing, wear and tear year after year.  And they keep on ticking, most of the time.  But, sometimes something sets them off.   When patients come in and tell me they have a sensitive tooth, I put my detective hat on (I wear it a lot) and start asking questions- lots of questions:

Is it sensitive to heat, cold, sweets, or pressure?
When does this occur?
Where on the tooth is it sensitive? The biting surface, in between the teeth or along the gum line?
What does it feel like? Does it "zing" and go away or  have a dull ache? How long does this last?
Does it start all by itself,  or does it occur at specific times, like first thing in the morning?
How long has this been going on?
Did it start after recent dental care?
Have you noticed any type of "taste" coming from the tooth?

What could these signs mean?

  The "Zinger"

You have a tooth or teeth that are sensitive to cold,  It bothers you along the gumline or when you brush.  You like room temperature water, no ice for you.  Hmmm, sounds to me like it could be what we call recession.
The outer layer of tooth structure above the gums is called the enamel.  It's the hardest surface in the body.  The enamel thins out where it meets the root surface along the gums (we call the outer surface covering the root the "cementum").  Often it's this area  that gets sensitive.  The gum tissue that should cover the root is no longer there.  It's "receded".   Now the thinner cementum is subject to cold.  Ouch!  Recession  gives the appearance of being "long in the tooth". 

What causes recession?  

 It could have been abrasive toothpaste,  clenching,  misalignment of teeth,  dental appliances, oral piercings,  gum disease,  thin bone structure, smoking/tobacco use, tongue thrust swallowing, tongue ties, or traumatic occlusion.  

Notching along the gumline, called abfraction, can also cause sensitivity to cold.  Your tooth is like a box of straws- the straws, or more properly, "enamel rods" go straight to the nerve of your tooth.  Cold-temperature foods and beverages cause the fluid in these rods to "zing" right to the nerve, rather like hitting a mallet and ringing the bell.  Metal dental tools also can cause that zinger feeling.

Zingers can also occur while bleaching your teeth whether while in the dental office or using your take home whitening trays or strips.  These zingers can be very uncomfortable.   Discuss this potential problem with your dentist before beginning whitening procedures.  Ozone oil can help reduce this zinging sensation.  See my post on Ozone for more information.

What to do? Lots of products will recover those tooth tubules.  My post  "Got Sensitive Teeth?" has a list of products that'll reduce sensitivity.  See your dentist though, and find out the cause of your recession, or abfraction.  Please always find the cause of your problem, and then address the cause.  Products to stop sensitive teeth may work for a while but the sensitivity is a barometer that something is wrong.

Another cause of the "Zinger" is what we in the profession call "cracked tooth syndrome".  This zinger starts because of  clenching pressure on the biting surface of the tooth. This zinger is different than the cold zinger.  I've experienced both.  For me, the cracked tooth/pressure zinger zips right up the tooth, and right back down. It started off slowly- happening about once a month, just a quick zip up and down the tooth. Then it occurred about once a week, then once a day.  Just like everyone else, I tried to deny there was a problem, and that I could live with it.  When I finally got myself into my fabulous boss's dental chair and had the tooth properly cared for, I wanted to give myself a big butt kick for procrastinating.  I felt so much better after that!  I don't know why I waited.  The crack in my tooth was like a Ziploc baggie.  Open baggie/close baggie/open baggie/close baggie... But, each time it opened a little deeper into the tooth.  Had I taken care of it right away, my tooth would have been much better off.  Less drilling is always better for the tooth.   Every time you take a drill to a tooth, you stress it.  It takes your tooth longer to recover.  If you have a sensitive tooth, get ye to the dentist, take care of it.  It won't cure itself, and you may make the problem worse by waiting or, rather, trying to wait it out.

The "Sweet" Tooth

So, the chocolate bar you just ate caused a tooth to talk back to you?  Start listening! This could be a signal there's something wrong. It may be a sign there's recession (see above), or maybe it's a sign of tooth decay or a "cavity".   Generally tooth decay does not hurt until the nerve is involved so pay attention to this little warning sign.  Again, don't ignore it!

The "Hot" Tooth

When a cuppa-joe-to-go makes for an uncomfortable morning sip, it's time to make a beeline for your favorite dentist.  Your tooth needs first aid ASAP!  It's not only talking at you but screaming.  Don't wait any longer.  The nerve may be dying, and the tooth's infected.  Only your dentist can diagnose the problem.

The "Dull" Ache

As I did my reading and research on this, I came across the words dull, radiating and throbbing. Cavities can cause the nerve to react this way.  Sinus pressure and tooth abscesses can also be the culprit.  Time to get to the dental office...
This is the reason you have a "dentist of record."  Your dentist is someone you have a professional relationship with, and can call when you have an emergency. This counts as an emergency.  While they don't really want that 2:00 AM phone call, they will answer and call in pain medication for you.  They may even meet you at the office and treat your tooth RIGHT AWAY.   Prevention is the better path, but sometimes this occurs and your dentist can make it all better.

The "Achy Breaky" Tooth

Note the little crack starting 

he waited too long and broke off half the tooth!

Your tooth broke about five months ago but it doesn't hurt.  Hmmm, do you really want to wait until it does? See the dull ache above.
Eventually it will, and trust me, it'll be a doozy.  Plus, it'll be just before that big office proposal, or a big meeting, or during  a big vacation (of course).  While it doesn't hurt, it does have rough edges. Plaque and bacteria are constantly making tooth decay bacteria babies and you can't keep it adequately clean. It will infect the nerve and when it does, it'll be a crisis. A puffed-up cheek and antibiotics, the works.  If you don't have the time or money to fix it, at least get a temporary crown, or filling.  Just know this tooth needs TLC soon.  If your dentist tells you a tooth has cracks in it, this tooth may be getting ready to break.  Note the tiny crack above the silver filling. 

The "Tasty" Tooth 

Bad smells or bad taste coming out of your mouth are worth investigating.   I always know there's a problem when a patient tells me they smell something when they floss.  Is food getting stuck and rotting in there?  I know my garbage smells unlovely after even a day, so when folks don't floss regularly and have food traps (open contacts between teeth), this will smell bad.  It can also then lead to tooth decay and gum infection.  Clean, healthy teeth and gums do not smell.  Period.

The "Sensitive" Tooth

Last week I had a patient in for his dental hygiene appointment who had an onlay cemented about four months ago. The tooth had been sensitive since that appointment.  He was hoping it would get better on its own. It had not.  Why did he wait?  He knew he had this appointment with me and he was busy at work.  The problem was that the onlay bite was very slightly "high".  When your mouth is open for a long time and you've had anesthesia to numb your tooth, the way you bite down is altered.  It takes time to get back to normal.  Sometimes it's hard to get the bite just right on your new filling, crown or onlay.

If the "bite" is off, the teeth will hurt

 Picture walking around on a stiletto heel.  This heel digs into the nice soft wood floor, leaving its mark.  That's what your new dental restoration does.  It stresses the tooth below, specifically the nerve of that tooth.  Five minutes spent adjusting the height of the filling and my patient's tooth was much better.  The nerve gets inflamed and irritated when the bite is even slightly out of whack. You know if you have a hair in your mouth.  That's how finely tuned your teeth are to the biting forces.  I know it's inconvenient to go back to the office, but do it anyway.  Your tooth will thank you. 

Other cause of sensitive teeth: allergies and sinus pressure, clenching, grinding, mouth breathing, tooth decay, and of course, gum disease.  Get in to see your dentist and dental hygienist.  They are your first line of defense against gum disease, tooth decay,  tooth pain and oral cancer.   They want you to be healthy and pain free.  They will investigate and find the cause of your discomfort or pain.  Prevent a crisis and go in right away. Actually, go in regularly and find the tiny spots of tooth decay, the tiny spots of bleeding, the tiny cracks, and find the root of the problem before your tooth starts talking!  

And thank you for listening. 

Keep Smiling!

Barbara

P.S. I always am interested in your feedback! If you don't feel comfortable leaving a comment, you can always send me an email via the box on the right, or email me at TopGums4U@msn.com!