All About Tooth Sensitivity

By Dr. Boris Zusin · Published June 16, 2021

If you find yourself avoiding hot drinks and cold foods, then your teeth may be sensitive. Tooth sensitivity is common, and in optimistic terms, will be temporary. But when it’s chronic, it can affect the way you enjoy life. Your dentist can get to the bottom of this painful condition, but it’s essential to know why tooth sensitivity occurs and how you can relieve it.

What Causes Sensitive Teeth?

Tooth sensitivity involves the wearing down of the protective layers of your teeth. In healthy teeth, the enamel layer protects the crown from bacteria and food particles. Underneath the enamel, the dentin holds the tooth’s nerves and pulp. When enamel wears down, dentin becomes exposed to temperature changes through microscopic tubules that carry sensation to the nerve, causing dentin hypersensitivity. Common causes include:

• Tooth Erosion: Consistent exposure to intrinsic (stomach) or extrinsic (food and drink) acids can soften enamel over time.
• Tooth Decay: Plaque build-up wears down enamel, especially with poor oral hygiene, and can form cavities that also cause sensitivity.
• Gum Recession: Periodontal disease can expose the tooth root, leading to temperature sensitivity.
• Bruxism: Grinding your teeth at night wears down enamel and exposes dentin.
• Post-Dental Treatment: A tooth can become sensitive for a period after a crown or inlay is placed.

How Do Dentists Treat Tooth Sensitivity?

Because tooth sensitivity has many possible causes — age, gender, diet, and medical history all play a role — it’s essential to see a dentist who can provide immediate relief and, if needed, a long-term treatment plan. Your dentist may prescribe sensitive toothpaste and a soft toothbrush, along with mouth guards or restorative treatments for longer-lasting relief. For more questions regarding tooth sensitivity, contact our office and schedule an appointment.

One important distinction worth knowing: a quick, sharp twinge to hot or cold that fades within seconds is usually simple sensitivity, but pain that lingers well after the trigger is removed points to a different, more urgent problem with the nerve itself. See our dedicated guides on cold water tooth pain and hot water tooth pain for how that timing distinction is made.

Which Sensitivity Toothpaste Works Best?

The best-supported choices are toothpastes containing stannous fluoride or arginine, and current reviews recommend either as a first step; which one you use can come down to taste, how it feels, and what is available. Others, such as those with bioactive glass or potassium, are reasonable alternatives. Examples of the types studied: an arginine plus calcium carbonate toothpaste (the Colgate Sensitive Pro-Relief line) and a calcium sodium phosphosilicate bioactive-glass toothpaste (Sensodyne Repair & Protect). Toothpastes made with nano-hydroxyapatite, a fluoride-free form of the mineral teeth are made of, are another reasonable option and appear to work about as well in the studies so far, though there are fewer and shorter studies. Look for the active ingredient on the label rather than the brand, and ask us if you are unsure which to choose. Pastes that pair potassium, which calms the nerve over a few weeks, with stannous fluoride, which plugs the tiny channels in the tooth, have some of the strongest results, because they work two ways at once. Use it twice a day and give it time: relief builds over about 2 to 8 weeks rather than overnight. Some improvement also happens with plain fluoride toothpaste, simply from brushing more carefully and the tooth recovering on its own, so if it is not clearly better after a couple of months, let us take a look instead of switching brands again.

In-Office Options When Toothpaste Isn’t Enough

When a desensitizing toothpaste has had a few weeks and the sensitivity is still there, or the exposed root surface is the problem, there are professional treatments. Honestly, no single one has been proven clearly better than the rest; in studies they all beat a placebo, and the differences between them are small and uneven. A few patterns do show up. Resin-based sealing — a bonding agent or a fluoride-releasing varnish painted over the exposed dentin — tends to work fastest and last longest, because the sealed layer resists brushing and acid. Bioactive-glass products block the tiny dentin channels with a mineral layer and work best in the first weeks. Fluoride varnish is inexpensive and effective but the shortest-lived, so it needs repeating. Dental lasers can add some longer-term relief for sensitivity to a blast of air, though they cost more and have not been shown to beat a well-applied sealant. We pick based on how many teeth are involved, what triggers the sensitivity, and your budget, and we always check first that the problem is not a high bite, a crack, or a nerve problem that sensitivity treatment would only mask.