TOOTH (dentine) HYPERSENSITIVITY and EROSION (worn teeth)
What is hypersensitivity?
It is a short sharp pain arising from exposed dentine (part of the tooth which is in communication with the nerve inside the tooth) in response to stimuli. These could be thermal such as hot or cold drinks, chemical such as sweet or acidic food and drink or tactile (touch) which cannot be ascribed to any other form of dental defect or disease (pathology).
How common is it?
The prevalence of dentine hypersensitivity ranges from 8% to 57% in the general population.
What causes it?
Dentine hypersensitivity occurs when dentine is exposed. This is usually through either loss of enamel (the hard protective outer part of the tooth), gum recession (the shrinkage of gums away from the tooth-root surface which is not normally protected by enamel), toothbrush abrasion (brushing too hard and incorrectly), tooth grinding (often at night) or bleaching.
Tooth enamel is eroded in presence of acids in the mouth. Given the chance teeth will repair themselves using minerals from saliva. But if acid is in the mouth too often teeth cannot repair themselves and the enamel becomes thinner. This is called erosion.
What will my dentist do?
They will first eliminate any other dental disease which could be causing or contributing to your symptoms. If there are no other reasons found, you should start to use a toothpaste for sensitive teeth (such as sensodyne or other products suggested by your dentist or hygienist) and try to avoid any of the causes described above. Sensitivity will normally go away by itself but it might take many months.
What is dental erosion?
Erosion is the loss of tooth enamel. Enamel is the coating of the tooth, which protects the sensitive dentine underneath. When the enamel is worn away the dentine is exposed and it may lead to pain and sensitivity to hot, cold food and drinks.
What causes dental erosion?
- Every time you eat or drink anything acidic the enamel becomes softer for a short while loosing some of its mineral content. Your saliva has the ability to neutralise this acidity in your mouth and to restore it to its natural balance. However if this acid attack happens too often your mouth won’t have a chance to repair itself and small parts of the enamel can be brushed away. Over time, you will start to lose the surface of your teeth.
- The tooth enamel can be damaged by the high level of acid found in stomach fluid.
- Incorrect tooth brushing technique can also wear off the enamel.
How can I prevent dental erosion?
All fizzy drinks (including diet brands and fizzy mineral water), sports drinks, squashes and fruit juices are acidic to varying degrees. Avoid having these too often during the day. Try to have them at meal times. Drink acidic drinks quickly. Don’t sip them and don’t swish them around your mouth. Between meals you should only have “safe” drinks which are not sugary or acidic: milk, water, tea and coffee. You can use non-sugar sweeteners if necessary.
Pickles and citrus fruits are examples of acidic types of food.
Some medicines are acidic. Check with your doctor.
People with some illnesses, such as eating disorders may suffer from erosion because of frequent vomiting (gastric reflux) as stomach acids erode teeth.
Brushing of teeth should be before or one hour after eating or drinking acidic food or drinks as teeth exposed to acidic environments can be abraded easily.
Excessive or hard brushing can cause gum recession. Your dentist and/or hygienist can instruct you on correct brushing techniques. Chew sugar-free gum after eating to help produce more saliva to help cancel out the acids which form in your mouth after eating
How can it be treated?
Dental erosion does not always need to be treated. Above, all it is important to protect the tooth and the dentine underneath to prevent sensitivity. In these cases, simply bonding a filling on to the tooth will be enough to repair it. These bonded fillings might need to be redone regularly because they may de-bond.