Why Does My Tooth Feel sensitive?

• Sensitivity to cold is the most common 
  
  • This is mostly due to improper brushing technique. As patients brush aggressively with coarse tooth brush, it traumatizes thin issues. Gingival recedes away from the enamel of the tooth and exposes the root surfaces.
  • Unlike enamel, root surfaces are softer and are porous. There are small tubes that go in the inner layer of the tooth.  So then patients use abrasive toothbrushes and toothpastes, it wears down the tooth structure even further.
  • When the tooth is exposed to cold air or water, the cells inside the tubules get irritated and send sharp pain or discomfort to the tooth.  
  • What you can do.:
    
    • Start using soft bristle toothbrush. 
    • Go over proper brushing technique with your dentist.
    • Recession can be corrected by using gum grafting technique to cover up the receded area of the gum.  
    • Use sensodyne toothpaste. Sensodyne is a chemical that plug up those tubules in the root surfaces. You have to brush your teeth periodically with sensodyne to see any changes. Unlikely that sensitivity will go away altogether. 
• After Dental Restroations
  
  • One of the most common post operative issues is sensitive after dental work. This is mostly because of the material that is used in modern dentistry.
    
    • Although the composite restorations, or white fillings, are very esthetic, they are very technique sensitive. There are multiple steps and if the environment is not controlled properly, or if the restorations are big, fillings or crowns can cause post operative sensitivity. 
    • The reason for the pain is because nerve of the tooth is in a narrow tube. Inflammation of the nerve, or pulpitis, will push itself against the walls of the chamber and cause discomfort to patients. 
    • Because white fillings are bonded chemically to the tooth, it requires the tooth to be conditioned with chemicals. As the tooth gets exposed to various chemicals, it can lead to irritation of the nerve. 
    • Most of the times the nerve will recover and the inflammation will go away. If the pain gets worse, it is considered irreversible pulpitis, or irreversible inflammation of pulpal nerve, and the tooth will require root canal treatment.
    • Another reason why your tooth will hurt after getting a white filling is because of shrinkage. As the material hardens, it will shrink slightly, causing stress on the remaining tooth structure. The stress is what causes post operative sensitivity. This will get better over time. Dental material over the years has improved dramatically and shrinkage is less of a problem nowadays but it can happen when the filling is large. 
    • If the sensitivity or discomfort occurs when the patient bites down, it might be because the restoration is hitting earlier than other teeth and can cause inflammation of tissue around the tooth. In that case, go back to your dentist and minor adjustments will be done. 
• Sensitivity when Biting down
  
  • One of the most difficult problems is tooth fracture.
  • Your tooth is surrounded by a ligament called periodontal ligament that acts like a shock absorber. Basic function is to redistribute the force mastication evenly to the surrounding tissue.
  • If you bite down hard on something, the tissue can get irritated and cause discomfort. In this case, you have to let the ligament heal.
  • If the tooth is mobile, it can cause sensitivity to pressure
  • If the tooth has cracked, everytime patient bites down, the crack will cause the tooth to flex and cause discomfort. Treatment will depend on the extent of the crack and where it is
• Gum disease
  
  • Poor oral hygiene can lead to build up of plaque and calculus
  • Body detects foreign substance in your body and releases chemicals to fight off what it perceives as invaders and cause inflammation
  • Chronic inflammation can lead to problems can lead to destruction of soft tissue around the tooth and cause sensitivity. 
• Erosion and wear
• Common in patients who 
  
  • Grind their teeth
  • Have acid reflux problem or bulimia where teeth are constantly exposed to stomach acid
• In both cases, the outer layer of tooth, enamel, is eroded.
• The inner layer of the tooth is much more porous and can lead to sensitivity.