You have just taken a bite out of your favorite chocolate bar, gooey gummy worm or that savory pie and you feel pain in your mouth… well, in your tooth or multiple teeth.
You instantly start to worry… you think it must be a cavity because that’s what you were told growing up. You wonder if you broke a tooth and didn’t feel it or if you have an abscess or anything else that can go wrong with the teeth.
There is a long list of reasons why you’re feeling this tooth pain when trying to enjoy your favorite foods.
Most often it’s related to the sensitive part of the tooth being exposed somehow. Once the enamel is damaged there is closer contact to the nerve center which allows irritants to get in, which causes you pain. It can also occur with cold or heat.
Tooth sensitivity has multiple causes:
- Gum recession. This occurs when the gum line wears away or pulls back. This exposes the tooth’s root which is not protected by enamel so nerves are more accessible. The recession of the gums also creates a gap which allows bacteria to get stuck in there and start to build up. Receding gums can be caused by genetics, vigorous tooth brushing, poor oral hygiene, and age. If you don’t brush or floss regularly the gums can become inflamed due to sugars and food particles below the gum’s surface.
- Tooth attrition. Possibly a term you have heard on a TV crime show, this is the regular wear and tear from the teeth making contact with each other, commonly from eating and talking. This is just the natural breakdown of the teeth as we age.
- Moderate-to-severe wear. This is similar to attrition in that wear is what happens to teeth over time but dentists actually have developed a “rate of wear” and if a person’s annual rate is increased, there is likely an additional reason such as brushing too aggressively.
- Tooth grinding. Most people grind their teeth once in a while. Most commonly it is a temporary excess of stress or anxiety for a short time. However, excessive grinding, also called bruxism, can damage teeth and cause other complications. It often occurs during sleep due to stress, anxiety, an abnormal bite or teeth that are crooked or missing. Some sleep disorders, like apnea, can also cause a person to grind their teeth excessively. Bruxism can lead to teeth breaking, becoming loose or even tooth loss. It can lead to TMJ—temporomandibular joint—disorder or syndrome which causes pain, clicking and locking in the jaw. Most importantly, the grinding removes the enamel which is the hard substance that covers the part of the tooth that we see. Once damaged, it’s difficult to repair and the enamel loss allows the irritants to cause the pain you feel.
- Clenching. Though commonly included with grinding, it can also be a cause of sensitivity on its own. Clenching doesn’t necessarily damage the enamel—though it can—but the force of clenching can cause microscopic fractures or can break small pieces off the teeth. Either of these issues allows access to the nerve root.
- Acid erosion. Do you remember when we were kids and we were always being told to avoid sugar because it would rot our teeth? Sugar isn’t the only cause of tooth decay. Many of the regular foods and beverages we ingest every day contain higher-than-normal acid levels. Even foods you wouldn’t think of like fruit juices have high levels of acid. Excessive soft drinks, dry mouth or a lack of saliva production and a high sugar diet also contribute to the erosion of the enamel.
- Tooth trauma. Trauma to a tooth, from an accident, sports injury or fall even if not visible to the eye can cause tiny cracks in the surface that creates openings where irritants can access the nerve pathways.
- Aggressive brushing. Brushing your teeth too hard or using a toothbrush that is not soft or extra soft can brush away the enamel layer over time.
- Tooth whitening. This is temporary sensitivity but if you’ve just had a whitening treatment you could experience sensitivity for several hours afterward. The main ingredient in the whitening products is peroxide which has been shown to irritate the nerves of the tooth.
First, you need to visit your dentist. If it’s the first time you have experienced the discomfort you need to have your teeth checked for cavities and other potential physical causes of the sensitivity.
Your dentist will check your teeth, probably take x-rays and, once you get the all-clear, discuss alternatives with you to reduce or eliminate the sensitivity and allow you to get back to enjoying that ice water and a favorite chocolate bar.
Because the majority of the causes of sensitive teeth are related to enamel damage, stopping or reversing that is going to be key.
I’m sure you have noticed the pattern forming from the list of causes above. From that list, some prevention tips are obvious while others might not immediately jump out at you.
There are many different brands of toothpaste that are meant to help decrease or eliminate tooth sensitivity. It’s best to ask your dentist for their suggestion for the best one as some are designed to just help numb the pain where others help to fill in the holes.
Develop your plan for oral hygiene and stick to it. Brush and floss at least once a day, preferably twice, and find a mouthwash to use once a day to help reduce bacteria where your brush and floss can’t reach. Good oral hygiene will go a long way to reducing the bacteria in your mouth and consequent enamel breakdown. Oral hygiene also reduces gum inflammation which also helps to reduce sensitivity because healthy gums cover and protect the roots of the tooth eliminating sensitivity at that point.
You should replace your toothbrush every three months with a soft toothbrush. Even if you use a soft brush using a soft hand when brushing. You don’t have to use the same force as you do to clean your tiles. For a professional-like brushing, we recommend the Philips Sonicare Platinum.
Deal with grinding and clenching
Most people who grind their teeth regularly do so in their sleep and it’s commonly their spouse who notices the condition because they hear it. Your dentist can also identify this on examination as he can see the damage being done. If you wake up in the mornings with a sore jaw, toothache or possibly a headache you should seek medical attention. Talk to your dentist and take their advice and recommendations. The most common recommendation is a nighttime mouth guard to protect the teeth. The mouthguard wears down instead of your teeth but it does not resolve the underlying issues that cause you to grind your teeth. For that, it might be beneficial to seek stress management therapy or try to use muscle relaxants.
As previously mentioned, clenching and grinding often occur together. However, people can clench their jaws and teeth without grinding. Stress and anxiety are the most common causes for this as well so seeking therapy to is an option as is fitting in some bedtime yoga and meditation. Muscle relaxants would also assist with clenching as would a mouthguard.
Prevent trauma when you can
If you’re big into playing sports, get a sports mouthguard designed made and wear it whenever you play. This includes team practices. It has become mandatory for some sports but you can get one if you feel you need one.
There are a number of tips to reduce acid erosion which we are all prone to.
- Save acidic foods for mealtimes whenever possible as this will decrease the acidity because it mixes with other foods.
- Drink lots of water including with your meals. Not only does water aid in digestion but when you drink water with acidic food or beverage it helps to rinse it out of your mouth and off your teeth.
- Use a straw to keep most of the acidic beverage from touching your teeth.
- Look for low or sugarless drinks because the dentist was half right when we were kids… sugar still does cause tooth decay.
- Wait about half an hour before you brush your teeth. This will help reduce the damage. Acid softens the enamel so brushing right after can do more harm. Waiting and rinsing your mouth with water helps to reduce this.
Whether you whiten on your own or have it professionally done there are several suggestions to help decrease the pain after.
- Always follow the instructions you receive from the dentist or manufacturer and never whiten longer than recommended.
- Check the peroxide level first. If you’ve done whitening and it was a problem then get a product with 6-10% peroxide.
- If you already have sensitive teeth limit the irritants that cause your sensitivity before, during and after going through the whitening process.
- Use fluoride rinses and these are often recommended before, during or after treatment. Often this is done at the time of a professional treatment.
- Ask your dentist about products that can be applied in the office.
If you have been passing on hot or cold drinks or your favorite sweets because you know it will be painful it’s time to stop.
It’s unpleasant to suffer pain when we don’t have to but there are so many ways to prevent tooth pain.
In conclusion, take the extra time, see your dentist and use what’s available and go back to enjoying those sweets!