The Academy of General Dentistry (AGD) in the USA has released the results of a survey conducted among their members,  with 33% indicating that the No. 1 cause of sensitive teeth for their patients was aggressive toothbrushing. The next most common cause of teeth sensitivity were consumption of acidic food and drinks.  To read more details, click here. Specialist Dental Group also wrote a blog posting about sensitive teeth last month.

Possible causes of teeth sensitivity

1. gum disease
2. wear and tear of teeth
3. overbrushing /type of toothbrush used
4. decayed teeth
5. consumption of carbonated drinks
6. hormonal changes
7. teeth whitening
8. broken or cracked teeth
9. bulimia
10. acid reflux

The AGD survey is consistent with our clinical experience. Dr Helena Lee, Specialist in Periodontics at our clinic was recently quoted in a My Paper story on sensitive teeth stating that our clinic had seen a 10% increase in patients with sensitive teeth compared with five years ago.  In the AGD survey, nearly 60% of the 700 dentists reported an increase in the frequency of tooth erosion in the same time frame of comparison.

To read more about tooth erosion and consumption of sports drinks, click here.

Tips for Sensitive Teeth Problems:

1. Brush with a soft-bristled brush with gentle strokes. 
2. Floss between teeth;
3. Don’t use a toothpick.
4. Visit your dentist at least once in 6 months for thorough check-up and scaling
5. Rinse after consuming soft drinks or eating acidic food
6. Use a de-sensitizing toothpaste – there are several in the market

If you are experiencing sensitivity in your teeth or have experienced it in the past, you are not alone. Globally, about 33% of the population experience tooth sensitivity. In Singapore, two studies conducted by GlaxoSmithKline in 2009 indicated that between 23-25% of Singaporeans suffered from sensitive teeth.

People may report sensitivity to a variety of stimuli including cold drinks, hot soups, sweet or sour food and tooth brushing. This sensitivity may be transient or lingering. Transient sensitivity may not bother the person much, but lingering, high intensity sensitivity is more debilitating.

Causes of Sensitivity

Normal, healthy teeth have an outer layer of enamel protecting the sensitive underlying layer of dentine. The roots of normal teeth are also covered by bone and gums. No dentine is exposed, so there is no sensitivity to normal stimuli during eating and drinking.

Possible causes of the increased incidence of sensitive teeth include:

• Gum disease – As people are keeping their teeth for a longer time due to a reduction in dental caries, more of these teeth may be exposed to periodontal disease. Gum disease is often a silent, slowly progressing, inflammatory process that causes loss of the bone and gums around roots of teeth. When the roots are exposed, sensitivity will be felt. 
• Wear and tear of teeth – Whether through function or through excessive grinding of teeth (bruxism), the enamel on the biting surfaces is worn down and underlying dentine is exposed. Over time, fillings may be worn or teeth cracked. This can also result in sensitivity.
•  Overbrushing or Type of Toothbrush used – People who brushing their teeth too frequently and who use a hard-bristled toothbrush or brush aggressively will end up scrubbing away the thin gum covering the root surfaces. The exposed roots can also be subsequently abraded by aggressive brushing and lead to sensitivity.
• Decayed teeth – As the decay progresses, the sensitivity increases in intensity and duration (lingering). If there is a painful reaction to hot stimulus, then the tooth is likely to be irreversibly damaged and will require more extensive treatment.
• Consumption of carbonated drinks - Younger people are also experiencing tooth sensitivity perhaps due to increased consumption of drinks with acidic levels which may cause the erosion of the tooth enamel over time. 
•  Hormonal changes – Women who are pregnant are more predisposed to gum problems due to hormonal changes which may also result in sensitivity of teeth.
•  Teeth whitening – in some cases, teeth whitening procedures may also result in sensitive teeth. Thus, it is important to ensure that consultation with a dentist is done before undergoing this procedure to minimize sensitivity issues. The degree of shades by which the teeth are whitened may also affect sensitivity.  

Treatment Options

Treatment for sensitive teeth depends on the reason for sensitivity and the extent. Thus, treatment can range from using a desensitizing toothpaste, to professional application of certain gels and varnishes, or even fillings to cover the exposed surfaces.

Several companies have toothpastes and other oral care products targeted at sensitive teeth sufferers – these include Systema, Sensodyne and more recently, Colgate.

One little-known treatment possibility is the use of gum grafting to cover the exposed roots and bring the gum level back to the original position. This is a specialized surgical procedure that may benefit a small percentage of people with receding gums and exposed roots. You can find out more about this procedure by speaking with a periodontist (gum specialist).

Practical Tips

Some practical preventive tips include the following:

• Brush with a soft-bristled brush with gentle strokes. (Ask a dentist to teach you correct techniques).
• Floss between teeth;
• Don’t use a toothpick.
• Visit your dentist at least once in 6 months for thorough check-up and scaling (professional cleaning to remove hardened deposits of calculus).
• Rinse after consuming soft drinks or eating acidic food

 The key for treating sensitive teeth is to determine what the source of sensitivity is – during the consultation, our dentists will try to determine the type of sensitivity the person experiences and from the responses, address the situation and find a resolution to the problem.