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Tooth sensitivity is a common dental problem that causes discomfort or pain in the teeth when exposed to certain substances and temperatures.
It is aggravated by the fact that the pain is often sharp and sudden. And although it is temporary, it can “shoot” at the nerve endings of the tooth, and, as you know, there is nothing pleasant in this. Fortunately, sensitive teeth can be treated and quite effectively.
People often say that they are lucky with their teeth, and they do not bother at all. But it also happens that a sharp pain in a tooth takes you by surprise during their cleaning, a lunch break or at a dinner party. No one is immune from this kind of problems – neither children nor adults, since there are a lot of factors that can cause discomfort.
Development of dentine hypersensitivity to temperature changes
When exposed to certain external factors, the enamel becomes thinner. It performs an important protective function for the sensitive part of the teeth.
The fragile and thinned surface increases the degree of influence of external factors on the nerve endings. And if mechanical damage is observed, then pain of an acute or aching type can appear not only as a reaction to cold or hot, but also to spicy, sweet, salty and sour.
Hyperesthesia develops according to the following algorithm. At first, there is slight discomfort during the period of taking hot or cold food (all symptoms disappear within a few minutes).
If you do not pay attention to mild symptoms in a timely manner, there is an increase in irritation, which spreads to other types of foods (salty, sweet, spicy, etc.). The pain is strong, sharp, turning into aching (with such symptoms, you should contact your dentist immediately). And, as a result, the teeth react painfully to any irritant: the temperature of water, air, any food, conversation, etc. At the same time, acute and prolonged pain is noted, which does not go away without the action of painkillers.
The dentist should be visited at the first stage for a faster, less expensive and easier prevention of the decay process.
Classification of hypersensitivity
At the moment, two types of hyperesthesia are distinguished: systemic (pain captures several teeth at the same time) and limited (the reaction is observed in only one tooth).
Regarding the clinical manifestations, pains of the 1st degree differ – uncomfortable sensations in cold or heat. Grade 2 – increased sensitivity to thermal factors, as well as to spicy, salty, sour and sweet foods. Grade 3 – teeth react painfully to any contact with external factors.
Causes of tooth sensitivity
There are no risk groups for tooth sensitivity. According to dentists, no one is immune from such a condition, it is only important to notice discomfort in a timely manner and contact a specialist to solve this problem. The most common symptom of sensitive teeth is a sudden, sharp flare-up of pain when the teeth are exposed to air, cold, sweet, sour, or hot foods. Some people may experience tooth sensitivity during the rinsing or brushing period.
In healthy teeth, enamel protects the lower layer of dentin, which is softer and made up of nerve endings. The roots of the teeth are protected by the gums. But if the enamel is worn or the gum line has receded, then the dentin loses its protection. Cavities, cracks, gingival recession, erosion of enamel and roots – all these reasons make the dentin more sensitive. It consists of nerve endings, which stimulate pain and discomfort.
Dentin contains thousands of microscopic tubules leading to the dental pulp. When exposed, these tubules allow heat, cold, acid, or even sticky substances to enter the nerves inside the tooth, causing pain.
Some factors that contribute to increased tooth sensitivity may include:
- Intensive cleaning of teeth with hard brushes. Over time, brushing too hard or using a hard bristled toothbrush can wear down the enamel and irritate the dentin, which causes gingival recession (gum tissue pulls away from the teeth).
- Gum recession. When the gums move away from the tooth due to conditions such as periodontal disease, the root surface becomes exposed.
- Gum disease (gingivitis). Inflamed gum tissue can cause tenderness due to loss of supporting ligaments that expose the root surface and lead directly to the nerve of the tooth.
- Mechanical damage to the tooth (chips, cracks) opens access to the nerve endings, provoking the appearance of hypersensitivity.
- Tooth grinding. Grinding or squeezing teeth can wear down the enamel and expose the dentin.
- Teeth whitening products or toothpaste with baking soda and peroxide. These products are the main factors in the appearance of hypersensitivity.
- Age. Tooth sensitivity is at its peak between the ages of 25 and 30.
- Plaque. The presence of plaque on root surfaces can cause sensitivity.
- Caries – destruction of enamel is observed, nerves are exposed. This condition, in addition to dentin hypersensitivity, can provoke the development of serious inflammatory processes and even tooth loss.
- Long-term use of certain mouthwashes, which can aggravate tooth sensitivity. Acids further damage the dentin layer.
- acid foods. Regular consumption of high acid foods such as citrus fruits, tomatoes, pickles and tea can lead to enamel erosion.
- Recent dental procedures. Sensitivity can occur after mechanical cleaning of the teeth, grinding of the roots, restoration of teeth, etc. The discomfort caused by dental procedures is temporary, usually disappearing after four to six weeks.
In addition to the above, other reasons can also affect the hypersensitivity of teeth to hot, in particular, disruptions in the functioning of the body itself. This may be a violation of the functionality of the endocrine system – hormonal instability can provoke an active production of acid in the oral cavity, as a result, a destructive effect on the enamel is observed. Diseases of a viral or infectious type – even a minimal disease not associated with the oral cavity provokes the appearance of hyperesthesia. In this case, the doctor selects therapy, primarily affecting the focus of the disease.
Distress leads to hypersensitivity – frequent stressful situations can affect the increased sensitivity of teeth to hot or cold. In this case, it is worth noting that the cause of what is happening is the overexcitation of the nervous system and the exacerbation of its reaction to external factors affecting the body.
Exposure to chemicals adversely affects the teeth – the presence of aggressive substances in water, air, food, can provoke a gradual destruction of enamel, therefore, increasing the sensitivity of dentin, a lack of minerals and vitamins. An excess of calcium, magnesium and phosphorus leads to the destruction of the tooth, exposing its nerve endings. Toxicosis during pregnancy increases the level of sensitivity in the oral cavity, the reaction of not only receptors, but also nerve endings is aggravated.
Diagnostics
Diagnosis of “increased tooth sensitivity” involves a complex and lengthy stage. This is an exclusion-type diagnosis that is reached when all other possible explanations for the pain are excluded. This requires a thorough study of the patient’s history and clinical examination. Diagnosis includes a pain provocation test by exposing a dental instrument to airflow over a sensitive area or uneven scratch. If a negative pain provocation test result is present, treatment for dentinal hypersensitivity is not indicated and another cause should be sought.
Inflammation of the dental pulp “pulpitis” causes a real hypersensitivity of the nerves.
The disease is classified as irreversible – inflammation of the pulp irreversibly progressing to necrosis due to compression of the venous microcirculation and tissue ischemia, and reversible – the pulp is still able to return to a healthy and non-inflamed state, although this usually requires dental treatment. Irreversible pulpitis is easy to distinguish from hypersensitivity. There is mildly localized, severe pain that is exacerbated by thermal stimuli and that continues after the cause has been removed. Also, spontaneous pain usually occurs without any stimuli. Reversible pulpitis can be easily confused with dentinal hypersensitivity, however, some obvious signs such as cavity, fissure, etc. are highlighted that indicate the presence of pulpitis. The pain of the dentin is short and sharp.
Possible complications
One of the pronounced complications for the patient is the need to limit oneself in certain things in order to minimize the amount of discomfort. In modern medicine, other complications are also distinguished, including the formation of single and multiple cysts or granulomas, by going beyond the root canal of the infection. Due to prolonged cystosis, there is a melting of the bone jaw tissues, while increasing the deformation and increased traumatization of the jaw. A complication such as periostitis is rare – it occurs through the spread of infection from the root canals to the periosteum.
Most often, complications are observed in patients who neglect going to the dentist and self-medicate (suppression of pain symptoms with antispasmodics and other drugs). It is important to understand that non-steroidal anti-inflammatory and analgesic drugs are not intended for regular and long-term use, and can provoke serious side effects for the whole body. Cases have been recorded when patients who abuse this kind of drugs come to the clinic with inflammatory processes in the gastrointestinal tract, with liver and kidney damage, with bleeding and other pathological conditions. Painkillers should be prescribed by the attending physician, there can be no question of any self-medication.
It is important to consult a dentist in a timely manner, regularly carry out preventive procedures so as not to accidentally attribute the symptoms of such serious diseases as hypersensitivity, such as periodontal disease, periodontitis, infectious diseases, hormonal disruptions and disruptions in the endocrine system. Remember, treating hypersensitivity in the initial stages is much easier and less expensive than restoring teeth after more radical destruction.