Conditions

Sensitive Teeth: Causes, Treatments, and FAQs

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Tired of turning down hot or cold beverages because you know it’ll hurt your sensitive teeth? Find out why your teeth are so sensitive—and what to do about it.

by Dr. Burhenne

sensitive teeth
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When you have sensitive teeth, even the most mundane activities can cause excruciating pain.

Whether it’s sipping tea, eating dinner, or walking outside in chilly weather, you might notice a toothache start when your teeth are exposed to heat, cold, or even certain foods and beverages.

The sensitivity of teeth to these stimuli is called dentin hypersensitivity.

In this article, I’ll help you figure out the root cause of your sensitivity, determine the best treatment options, and help you prevent sensitive teeth in the future.

Why are sensitive teeth so painful?

Teeth are covered by an outer layer of enamel that protects the softer, inner layer of dentin. The gums also assist in this protection by covering the dentin of your teeth’s roots.

When enamel is compromised, dentin is exposed and pain is likely to follow.

Cavities, cracked teeth, receding gums, and enamel or root erosion are common causes of sensitive teeth because they degrade enamel.

Dentin is directly connected to the nerve that triggers tooth pain, so when cold air, hot liquids, or other external factors reach the dentin, it can be agonizing.

That’s what tooth sensitivity means.

Before we look at how you can get relief from painful tooth sensitivity, we need to look at why teeth might hurt in the first place.

Causes of Sensitive Teeth

There are many causes of sensitive teeth—some of which can be treated at home, and others that require the care of a dentist.

One easy way to figure out if you need to visit the dentist or try home remedies for tooth nerve pain is this…Is the pain throughout your entire mouth, or is it more local to one tooth (or a few)?

In general, pain or sensitivity that impacts your whole mouth but is not severe is typically caused by factors you can change. Think: generally achy teeth or pain that occurs on both sides of the mouth.

Perhaps you’ve been eating too many acidic foods or grinding your teeth at night, for example.

On the other hand, pain or sensitivity that impacts only one or two teeth, or that is very severe, should be diagnosed by a dental professional. It may require one of several types of procedures to treat.

Before we get to treatment options, let’s take a close look at the different types of teeth sensitivity and what can cause them.

Regional Tooth Pain (One or Two Teeth)

For either severe pain or pain in one or two teeth, your dentist will likely use a process called differential diagnosis to determine the source of your sensitive teeth.

X-rays and visual exams are part of the process, too, but they may not immediately reveal what’s causing your pain when used alone.

Differential diagnosis simply means that your dentist will ask you lots of questions about your pain and dental habits. Then, s/he’ll use the process of elimination to identify the single source—or tooth—that’s causing the pain.

If your dentist uses differential diagnosis to address your sensitive teeth, it’s important that you provide as much information as possible.

What are your symptoms? Have your eating habits changed? Did you recently switch toothbrushes or start using an at-home whitening system like Crest whitestrips?

Sometimes, issues like a deep cavity can “refer” pain. This means the dentin hypersensitivity may not be confined to the tooth with the cavity and could actually present in nearby teeth.

However, even in those cases, the referred pain will be on one side of the mouth. It can even affect the opposing arch on the same side, like the upper arch for a lower tooth cavity.

When tooth sensitivity is localized, it be a result of one of the following:

1. A Cracked Tooth

These can become filled with bacteria from plaque (a microbial biofilm found on the surface of the tooth) that cause inflammation in the pulp of the tooth. In more severe cases, it may lead to abscess and infection.

2. Cavities

Cavities, or dental caries, occur when enamel has become demineralized, exposing dentin. Once the dentin has been exposed, you will probably experience pain in the affected tooth.

It’s also important to note that, at this point, you won’t be able to reverse the cavity at home and will need to have it filled.

3. Tooth Abscess

An infection of the gum or tooth can eat away at enamel, too. Eventually, this can create an abscess that must be removed in order to stop the pain or sensitivity it causes.

Tooth infection symptoms that could point to an abscess also include swollen jaws, swollen lymph nodes, fever, bad breath, and draining sores.

Abscess pain is the kind that puts you on your knees, so if your teeth hurt so much it’s unbearable, this is one major reason to look for.

4. Gingivitis

Gingivitis often causes inflammation near the gum line, close to teeth. This can cause gum pain to be referred through the root of a single tooth or several teeth at once.

Chronic gingivitis might also trigger pain or sensitive teeth because it can cause gum recession.

When gums are recessed, food impaction, like getting a tiny piece of popcorn stuck between your gums and teeth, is more likely to occur. This can cause localized or global pain—your gums hurt and your teeth hurt.

5. Dental Procedures

Due to their invasive nature, dental procedures can cause some short-term pain to the teeth that were worked. Your dentist can help you determine whether you’re experiencing normal pain after a dental visit as you heal, or if there is a problem related to the procedure that needs to be fixed.

sensitive teeth

Global Tooth Pain (Pain Everywhere)

Pain throughout the entire mouth is referred to by many names, like:

  • Non-localized teeth sensitivity
  • Universal pain
  • Bilateral pain
  • Global pain

If you’re experiencing sensitivity in all or lots of your teeth on both sides of your mouth, I have great news for you! Your sensitivity is probably caused by an external issue like diet, illness, or change in lifestyle habits.

That means you can likely fix it without having to go to the dentist.

Here are some of the causes of global teeth sensitivity I’ve seen in my patients:

1. Eating More Acidic Foods

Have you ever discovered a new favorite food and wanted to eat it nearly every day? If that food is high in acid—which can damage enamel—your teeth could become newly sensitive in a matter of days.

2. Teeth Whitening

The ingredients in teeth whitening products like whitestrips are acidic and can break down enamel easily.

Sensitive teeth caused by whitening products should feel better in about 3-5 days after you stop using the product.

3. Sinus Infection

When you have a sinus infection, the inflammation from the infection is located very close to the nerves that cause tooth pain.

This type of pain is intermittent and based on position (meaning it can intensify if you’re sitting, lying down, etc.). It can also move to many different areas of the upper teeth.

4. Poor Brushing Technique

Over-brushing can cause surface enamel to wear down over time, which can lead to sensitivity to sugary, hot, or cold foods. For a tooth sensitive to cold, the first thing to do is be gentler while brushing your teeth.

This could be caused by brushing too hard, brushing too much, or using a brush with bristles that are too hard.

5. Receding Gums

This irreversible condition can expose areas of teeth with very thin enamel. As recession gets worse, even the slightest provocation or tooth decay can cause severe tooth pain.

Causes of gum recession can include these (and more):

  • Gingivitis
  • Over-brushing
  • Eating crusty and firm foods like popcorn or sourdough bread
  • Systemic problems, such as diabetes and heart disease

You’re more likely to see gum recession as you age. That’s why, as you get older, your dentist should measure the length of your exposed teeth at each visit.

Unlike other causes of universal tooth pain, you will need to work with your dentist to slow, stop, and/or treat gum recession.

6. Plaque Buildup

Plaque and calculus can eventually break down the surface of teeth through demineralization. These are the buildups that your hygienist is most skilled at getting rid of.

After calculus is removed, the portion of the tooth now exposed is likely to be more sensitive to sugar, hot, or cold because it’s demineralized. This is one reason some people have toothaches after a full scaling and root planing (also called a deep teeth cleaning).

7. Long-Term Use of Mouthwash

Most over-the-counter mouthwashes are very acidic. If dentin is exposed to acids on a regular basis, the acids can wear away enamel, exposing dentin, and also make existing tooth sensitivity worse.

There are neutral or alkaline pH mouthwashes available that might be a better option, or you can make your own DIY mouthwash.

8. Dental Procedures

As I mentioned above, you may have tooth sensitivity after any kind of dental procedure. Even a cleaning can cause pain for some people, especially if they also have other factors that can contribute to sensitivity.

A high filling or crown can also cause tooth pain in the form of cold sensitivity, which would indicate the need for a follow-up visit.

9. Chronic Inflammation

Diabetics with high blood sugar can experience inflammation in the ligaments that connect teeth in the bone socket, causing pain during chewing. While most often related to diabetes, this condition can also occur with other forms of chronic inflammation.

Sensitive teeth and the associated pain can be a result of some, or all, of the causes above. It’s also important to mention that your sensitivity may be caused by unique factors that I haven’t mentioned.

For example, abruptly changing climates from cold to hot and back to cold can foster a sinus infection. Combine that with a diet filled with more acidic foods than normal, and you may find yourself arriving home from a tropical vacation with tingling, aching teeth.

Grinding and Sensitive Teeth

One of the most common causes of sensitive teeth (as well as mouth and jaw pain) is nighttime grinding, otherwise known as bruxism.

I’ve written about this topic at great length (including in this article explaining why you probably grind your teeth in the first place), but the most important thing to know is this:

Grinding exerts tremendous vertical forces upon the teeth (anywhere from 600 to 750 pounds per square inch, depending on your gender and weight) that can lead to teeth sensitivity, gum recession, fractured teeth, and even eventual tooth loss.

In most cases, grinding is the result of a closed airway.

Basically, grinding and the thrusting of your jaw occurs as a bodily reflex to save you from a collapsing airway.

I used to prescribe night guards for grinding, but I don’t anymore, as it’s more important to address the true causes of grinding instead of just minimizing its consequences.

While many used to think grinding was caused by stress, it turns out that sleep apnea is more often the cause. (1)

So if your dentist discovers that grinding is the cause of your sensitive teeth, determine why you’re grinding and treat the bruxism as you treat the sensitivity.

How to treat sensitive teeth: what can you do?

Due to the number of possible causes that may be causing sensitive teeth, treatment methods don’t always fit into a single category. However, following are some of the possible methods you and your dentist may discuss for treating tooth pain.

1. Damaged Tooth Repair

Particularly for localized, single-tooth sensitivity, there may be damage to a tooth or teeth that requires dental intervention.

A cracked tooth, for example, must be repaired with a crown and/or root canal (in conjunction with a crown) to protect the sensitive dentin.

If you have a cavity that has broken through to the dentin, you’ll need to discuss options for removing the diseased tissue via filling, root canal, or extraction.

2. Abscess Removal

If an abscessed tooth is causing your sensitive teeth, your dentist may need to drain it to relieve the pressure. Other treatments for abscessed teeth and related infections sometimes include root canals, extraction, and antibiotics.

3. Treating Gum Disease

If severe gingivitis or receding gums are causing your pain, you may need to visit your dentist for thorough cleaning and, in some cases, surgery.

Following the procedure, symptoms including inflammation should go away in a matter of a few weeks.

If your gum disease is mild-to-moderate, you may be able to reverse the condition at home by making some key lifestyle changes.

Adopting a paleo-friendly diet that is full of nutrient-dense, inflammation-fighting foods and free of sugars, grains, and processed food is the first step. Focus on grass-fed/pastured meats, healthy fats, and green veggies.

Other home remedies for gingivitis include:

Although food impaction isn’t technically considered gum disease, it will cause gum disease over time. And in the short-term, it can cause a lot of pain.

A small crevice between teeth or between a tooth and a nearby crown or filling can get filled with tiny food particles that cause very acute pain. In these cases, your dentist can clear away the food impaction and that may alleviate pain immediately.

If you think your pain or sensitivity is a result of food impaction, you can first try using knotted floss at home to clear it.

Interestingly, the mid-course of an Invisalign treatment can be a prime time for food impaction as teeth are pulled apart before being realigned.

4. Correction of Failed Dental Procedures

Before any dental procedure, your dentist should let you know about the type of pain you should experience, if any, as a result of the procedure and healing process.

If you experience pain for an extended period of time, or if your pain is more severe than normal recovery pain, your dentist may need to do a follow-up procedure to correct additional issues.

One common example of this, mentioned above, is a crown or filling that’s too high and leads to cold sensitivity. Correction of this issue takes only a few minutes at the dentist.

5. Dietary Changes

Both to prevent and treat tooth sensitivity, you may need to make changes to your diet.

Acidic foods and drinks (citrus fruits, soy sauce, soda, and others) can wear away at enamel and support cavity formation.

To neutralize acidity and prevent sensitivity, try drinking plenty of water, limiting your exposure to these items, and rinsing your mouth after eating or drinking anything acidic.

Sugar sensitivity is one benchmark I use when conducting a differential diagnosis on people with tooth pain.

Sugary foods and simple carbohydrates (white bread, white rice, baked goods, etc.) can encourage tooth decay and, in turn, tooth pain. Very short-lived pain when eating sugary foods is almost always caused by gum recession and decalcification.

Try sticking to a diet filled with nutrient-dense, non-acidic foods. I recommend a Paleo diet, which I follow about 80 percent of the time.

When you choose to have a “flex” meal or snack, keep it short—don’t drink a 20-ounce soda over the course of a few hours, for example. Then, remember to rinse your mouth with water right after and brush at least 30-45 minutes later.

Better diet is my #1 tooth pain remedy for non-localized pain.

6. Proper Dental Hygiene

It’s not uncommon to form bad dental hygiene habits—even I have to remind myself not to brush too hard on occasion!

To develop the best habits, start by using a soft-to-medium bristled toothbrush, replacing it once a month (or replacing heads for electric toothbrushes about once every three months).

Additionally, ditch the over-the-counter fluoride toothpaste, which is abrasive and can also wear down your enamel, and opt for a gentle option or no toothpaste at all.

You may be surprised to hear this, but it’s the motion of brushing—not the toothpaste—that is responsible for disorganizing the biofilm on your teeth.

If you have small cavities that can be remineralized, you may want to try a toothpaste that contains nano-hydroxyapatite (NHa) particles. I’ll explain this in more detail below.

Other ways to improve your dental hygiene routine include tongue scraping, coconut oil pulling, and flossing. Remember, mouthwashes that contain alcohol can actually worsen tooth pain, so avoid them.

7. Regular and Preventative Dentist Visits

Developing a relationship with your dentist can help him or her observe and treat any problems as they arise, and before they cause sensitivity.

Not only will your dentist take x-rays and physically examine your teeth, s/he should also be looking at additional factors that can lead to sensitive teeth.

For example, I conduct nutritional counseling with all my patients to pinpoint any possible reasons for tooth pain. I also measure exposed tooth size in my aging patients to watch for gum recession.

In addition, regular cleanings to remove plaque are important for preventing the demineralization that can lead to exposed dentin and sensitive teeth.

8. Sinus Infection Treatment

The best way to prevent or treat sinus infections is to eat an anti-inflammatory diet like the one mentioned above.

There is no cure for a basic sinus infection (sinusitis), but you may use decongestants, saline rinses, and pain medication to deal with the symptoms. Chronic sinus infections, on the other hand, might require an antibiotic prescribed by your primary care doctor.

Over-the-counter sinus decongestant sprays like Neo-Synephrine may also help alleviate some symptoms of sinus infection.

If you use the spray and notice that your tooth pain goes away, that’s a great indication that a sinus infection is at the root problem. That’s a revelation that can save you an unnecessary trip to the dentist.

Using mouth tape, such as Somnifix, to force nose breathing can be a great way to prevent sinus infections in the future. People with chronic sinus infections have decreased nitric oxide levels overall, which can be increased if you train yourself to nose breathe. (2)

9. Resolution of Bruxism

If grinding is the cause of your sensitive teeth, you can discuss treatment with your healthcare providers.

More and more research suggests that underlying sleep apnea is often the trigger for night grinding. (3)

So, instead of a mouth guard—which just protects teeth from the effects of grinding—aim to get to the bottom of your sleep apnea or other sleep disruptions.

10. Stress Reduction

Chronic stress can lead to increased inflammation in the body and, in turn, pain. This is often a secondary cause of tooth sensitivity compared to more direct causes that directly impact the teeth.

In addition to altering your diet to include more anti-inflammatory foods, reducing some of the extra stress in your life can help to prevent or reduce tooth sensitivity.

Some cases of bruxism are also related to stress. (4) You may need to consider relaxation techniques to help your sensitive teeth caused by grinding.

11. Reducing Chronic Inflammation

Giving your body the best chance at low levels of chronic inflammation can help improve related pain in the teeth. This is especially true for people with diabetes.

Try eating foods that fight inflammation and avoiding the ones that cause it.

Sensitive Teeth FAQs

Do I need to see a dentist for my sensitive teeth?

At the onset of tooth pain or sensitivity, especially if that discomfort quickly rises in intensity, you need to see your dentist.

Worn enamel or a small, hidden crack in a tooth can be the wide open door for bacteria to enter, grow, and ultimately cause cavities.

You should definitely go to the dentist right away if your pain is in just one or a few teeth.

For sensitive teeth throughout your entire mouth, it’s okay to look at home remedies for tooth pain first. But call the dentist as soon as the pain becomes very severe, or if it doesn’t go away after treating it at home.

Should I use fluoride for sensitive teeth?

In the past, I’ve recommended prescription-strength fluoride for remineralization, including for teeth that have become sensitive. I’ve always advise against ingesting fluoride, but now a new scientific development has removed the need for fluoride altogether.

Toothpaste containing nano-hydroxyapatite particles strengthens and remineralizes teeth more effectively than fluoride and can help to desensitize teeth that have become particularly sensitive to hot or cold. (5, 6)

These particles are tiny, dissolved fragments of bone that integrate right into your teeth to help them rebuild. They’re also 100% non-toxic when swallowed, unlike fluoride.

What is the best toothpaste for sensitive teeth?

The best toothpaste for sensitive teeth is one that contains nano-hydroxyapatite particles. As I mentioned, these particles help remineralize teeth and also counteract demineralization that happens during the day.

My favorite nano-hydroxyapatite toothpaste is Boka’s Ela Mint Toothpaste, and I use it each night before going to bed.

You may also want to try a tooth desensitizing toothpaste like Sensodyne. However, many of these types of products contain products that may not be safe in large doses, so try to use it only as long as you need to in order to reverse the sensitivity.

Sensodyne’s regular formula is a great, short-term option for sensitivity.

How do you stop sensitive teeth pain?

The cause of your pain will determine how you stop the pain caused by sensitive teeth.

Localized pain needs to be corrected by your dentist. For pain throughout your mouth, you can probably start by treating it at home.

What causes sensitive teeth all of a sudden?

Sensitive teeth can sometimes come on very quickly. The most likely causes for this that I’ve seen are:

  • Rapid changes in diet (like eating a lot of acidic foods in a short period of time)
  • Teeth whitening
  • Growth of a tooth abscess or deep cavity (one day it doesn’t hurt, the next day it does)
  • Sinus infection
  • Trauma to a tooth that causes it to crack

How long does it take for sensitive teeth to go away?

If your sensitive teeth are caused by diet or other overall issues, you can expect them to get better within a week or two of altering your habits.

The length of time it takes to get rid of sensitive teeth varies by the cause. For treatments by your dentist, ask him or her how long you should expect to have any lingering pain.

Final Thoughts

The primary reason you experience sensitive teeth is that something has caused the enamel of a tooth or teeth to be worn away, exposing the sensitive dentin underneath. And since dentin is connected to your nerves, exposing this layer causes pain, which your dentist might call dentin hypersensitivity.

There are two basic types of sensitive teeth pain: localized and non-localized.

Pain in just one or a few teeth is a sign that you need to go to the dentist right away. This typically points to issues like cavities, abscess, cracked teeth, or problems with a recent dental procedure. For a severe toothache remedy, the dentist is your best choice.

Non-localized pain is more often caused by lifestyle changes, illness, or chronic inflammation. Most of the time, these issues can be treated at home.

To treat sensitive teeth, here are some of the major options you have for how to stop tooth pain:

  1. Have any damaged teeth repaired
  2. Get abscesses removed
  3. Treat your gum disease
  4. Have failed dental procedures corrected
  5. Change your diet (remove most acidic and sugary foods)
  6. Improve your dental hygiene habits
  7. Go to the dentist regularly
  8. Treat any sinus infections you develop
  9. Resolve bruxism
  10. Reduce stress
  11. Get rid of chronic inflammation

When you notice your teeth are sensitive, avoid over-the-counter mouthwash and start using an NHa toothpaste like Boka.

Image alt

Boka Ela Mint Toothpaste

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It’s also a good idea to try mouth tape like Somnifix to correct teeth grinding that could contribute to the pain.

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Somnifix Sleep Strips

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Since these articles always start with questions from my readers, please don’t hesitate to ask me anything else you want to know about sensitive teeth.

read next: How Does Desensitizing Toothpaste Work?

References

  1. Hosoya, H., Kitaura, H., Hashimoto, T., Ito, M., Kinbara, M., Deguchi, T., … & Takano-Yamamoto, T. (2014). Relationship between sleep bruxism and sleep respiratory events in patients with obstructive sleep apnea syndrome. Sleep and Breathing, 18(4), 837-844. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/24526386
  2. Deja, M., Busch, T., Bachmann, S., Riskowski, K., Câmpean, V., Wiedmann, B., … & Lewandowski, K. (2003). Reduced nitric oxide in sinus epithelium of patients with radiologic maxillary sinusitis and sepsis. American journal of respiratory and critical care medicine, 168(3), 281-286. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/12702547
  3. Oksenberg, A., & Arons, E. (2002). Sleep bruxism related to obstructive sleep apnea: the effect of continuous positive airway pressure. Sleep Medicine, 3(6), 513-515. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/14592147
  4. Sutin, A. R., Terracciano, A., Ferrucci, L., & Costa Jr, P. T. (2010). Teeth grinding: Is Emotional Stability related to bruxism?. Journal of research in personality, 44(3), 402-405. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2934876/
  5. Tschoppe, P., Zandim, D. L., Martus, P., & Kielbassa, A. M. (2011). Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. Journal of dentistry, 39(6), 430-437. Full text: https://www.sciencedirect.com/science/article/pii/S0300571211000832
  6. Vano, M., Derchi, G., Barone, A., & Covani, U. (2014). Effectiveness of nano-hydroxyapatite toothpaste in reducing dentin hypersensitivity: a double-blind randomized controlled trial. Quintessence International, 45(8). Abstract: https://www.ncbi.nlm.nih.gov/pubmed/25019114

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