What causes sensitive teeth?
Sensitive teeth are often caused by exposed dentine – the inner substance of the tooth, which is normally covered by enamel. This can result in a short sharp pain to cold drinks, food, air, hot, sweet, sour, and touch (i.e. by your toothbrush).
Dentine contains little tunnels (dentinal tubules) that link to the nerves on the inside of the tooth, and when dentine is exposed, these nerves are stimulated, resulting in pain.
How do you stop sensitive teeth pain?
Use a toothpaste for sensitive teeth!
There are a number of different substances that can help, so if one type of toothpaste for sensitive teeth doesn’t work for you, try another. They are listed in approximate order of effectiveness 1 2 3:
1. Stannous fluoride
Stannous fluoride works by forming a barrier on the dentine surface, which acts like a protective shield. Examples (in the UK and Ireland) include Oral-B Pro-Expert Professional Protection and Sensodyne Rapid Relief toothpaste. There is good evidence that stannous fluoride works well as a desensitising agent.
2. Arginine / Pro-Argin
Arginine (e.g. Colgate Sensitive Pro-Relief toothpaste) can also help with sensitive teeth, although the evidence is not quite as good as it is for stannous fluoride.
3. Calcium sodium phosphosilicate (aka NOVAMIN)
Again, there’s moderate evidence that this works. It is sold as Sensodyne Repair & Protect with Novamin in the UK.
4. Potassium Nitrate
This is the most commonly used desensitising agent, even though there’s no clear evidence that it works. Examples include Sensodyne Deep Clean and Oral-B Pro Expert Sensitive toothpaste.
How do I use toothpaste for sensitive teeth?
Use instead of your normal toothpaste. Make sure that you work the paste right into the bristles of the brush so that it doesn’t all fall off in a big lump when you first put it into your mouth. Brush twice a day. When finished, spit out and don’t rinse!
For quick relief, rub it onto the affected areas with your finger for one minute.
It may take some days for the desensitising effect to kick in, so don’t give up if it doesn’t work straight away.
Desensitising toothpastes can be used indefinitely. The warning on some packaging not to use desensitising toothpaste for more than a month is a legal requirement, designed so that people won’t put off seeing a dentist when something might be seriously wrong. There are no health reasons for not using them long-term.
What can dentists do about sensitive teeth?
- Your dentist or hygienist may be able to paint special fluoride gels, rinses or varnishes onto the affected teeth.
- Seal & Protect is a light cured resin material that has been developed to “seal” off the dentinal tubules from the external environment. It can reduce sensitivity for up to twelve months. However, it’s fairly expensive and it will need to be reapplied once it has worn off.
- If you grind your teeth in your sleep, ask your dentist about having a mouthguard made to wear at night.
Illustration of exposed dentinal tubules: reprinted from Journal of Oral Biosciences Volume 59, Issue 4, Ji won Kim and Joo-Cheol Park, “Dentin hypersensitivity and emerging concepts for treatments”, Pages 211-217, November 2017, with permission from Elsevier.
- West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of professionally and self‐administered agents. Journal of Clinical Periodontology, Vol. 42, Issue S16.
- Poulsen S, Errboe M, Lescay Mevil Y, and Glenny A-M. Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database of Systematic Reviews 2006, Issue 3. DOI: 10.1002/14651858.CD001476.pub2.
- Karim BFA, Gillam DG. The efficacy of strontium and potassium toothpastes in treating dentine hypersensitivity: a systematic review. Int J Dent. 2013; 2013: 573258. DOI: 10.1155/2013/573258