Lifestyle column: Making sense of sensitivity

Richard Guyver
Richard Guyver

Last time we looked at the causes of sensitivity. Now we will see what can be done to help.

How do we stop sensitivity?

Prevention

As you may expect, prevention is better than cure. Having an effective daily oral hygiene regime which removes the plaque and disrupts the bacteria in the mouth thereby reducing the chance of recession caused by gum disease is important. Ensuring that the technique you use is not traumatic to the gum and does not wear away the tooth surface will always be the best solution.

Acidic food and drink will also play a role. Fizzy drinks (including diet drinks), juices and acidic foods such as citrus fruits will cause superficial softening of the surface of the tooth. This softer area is then easily worn away e.g. with a toothbrush especially if used immediately. If left the softened area can harden again (with help from saliva).

This loss of the surface over time will accumulate and expose the dentine under the enamel. If you have exposed dentine then over time the tubules will close up with minerals from saliva. This process of brushing immediately after acidic food and drink, however, could erode away these protective mineral plugs and so open the tubules up again. Keeping the frequency of these acidic intakes to a minimum, and avoiding toothbrushing immediately after will help.

Cures

If it’s too late to prevent the problem, there’s still a benefit in adopting the correct cleaning techniques as this will mean the problem is less likely to worsen. Teeth do have a natural in-built healing process where the nerve gradually walls itself off so it could simply fade gradually with time.

All cures will either reduce the nerve’s response or block the tubules.

Home help techniques:

Reduction of the nerve’s response - A normal nerve cell contains potassium. If you ‘flood’ the area with extra potassium this is then taken into the nerve cells. This leaves the cells less able to activate in response to a trigger. This method can be helpful but typically takes time (normally two weeks of twice daily use) to be effective. It can take up to eight weeks for the maximum benefit to be felt.

Superficial tubule blocking products - Products containing strontium and arginine have been shown to have a benefit in blocking the tubules.

Deeper tubule blocking products - Mouthwash containing potassium oxylate crystal technology also does the same, except it blocks the tubules deeper down, so the effects can last longer and improve with each use.

Method of use of toothpastes - Many people find relief by using the paste as a normal toothpaste. Others find better relief (particularly if there are just one or two sensitive areas) if they use it like a cream. Applying it to the sensitive tooth and leaving the toothpaste to work its magic. The effects tend to be short lived as saliva and tootbrushing, chewing etc. eventually wear away the toothpaste.

The tubule blocking products tend to have better long term effects, and tend to give a quicker initial reaction than the nerve modifying techniques outlined above.

Professional intervention

On occasions these ‘home help’ remedies are not effective enough and people call on their dentist or hygienist to help them. There are a number of products professionals can use which can help reduce sensitivity. Although they bring welcome relief as you may expect many of these lose effectiveness over time and need to be replaced, particularly if the trigger (i.e. over zealous toothbrushing, acidic diet or gum recession) is continuing. They use a combination of tubule blocking and nerve modifying techniques.

Sensitivity prophylaxis

There are some products which are used as a polishing paste which can help reduce sensitivity, this can be carried out by a hygienist. They are effective in a number of cases particularly if they are used with appropriate instructions on home care afterwards.

Sealers

There are products which can be painted onto the sensitive surface of the tooth which help block the tubules. These work in a similar way to sensitivity toothpastes, however the effects can be deeper and provide longer lasting relief.

Dentine bonding and restorations

We sometimes need to cover over the dentine with a so-called dentine bonding agent, or place an adhesive bonded restoration over sensitive areas to help.

Devitalisation

Although it is the ‘ultimate’ nerve modifying technique, removal of the nerve from the tooth is only used in extreme circumstances, particularly in a tooth that is persistently sensitive despite other measures. This is definitely a last-resort option.

So sensitivity is a condition which can be prevented and treated. There are a number of options available so don’t suffer in silence, do try out some of the solutions here.

Richard Guyver is principal dentist at enVisage-emsworth dental practice and is author of the book Live Another 4006 Days And Improve Your Health With Dental Medicine.

Visit his website to find out more.