We think you’ll agree that there simply does not exist a sensation as horrifying and peculiar as that sudden bone-jarring reaction of a damaged tooth to something cold. It could be a bite of an ice cream or a sip of an ice-cold martini. Yes, we’re referring to that instant, sharp, searing jolt of pain as if a needle were piercing through your tooth.
Surprisingly, a whole lot of us in the UK have fairly sensitive teeth – more than one in three adults, as reported by the Oral Health Foundation in 2024.
The trouble is, this feeling of ‘sensitivity’ can be triggered by more than just cold; it can occur when you consume hot or sweet foods and beverages, too.
Sometimes, it can be hard to pinpoint the exact cause of tooth sensitivity. To get a better grasp of the condition, we’ve provided an overview of it, along with its causes and treatments. Keep reading to learn how you can protect your teeth from becoming sensitive. A tweak, I’d recommend is: Is there anything worse than finally getting the snack you’ve been craving all day, only to regret it the moment you take that first bite?
What Causes Tooth Sensitivity?
When the weather is dreary, the SAD-season remedy for most of us takes the form of a lively evening sipping on cocktails or a cosy night-in with our favourite hearty meal (think delicious savouries paired with a big bottle of a soft drink) snuggled up on the sofa.
On those rare, glorious days with plenty of sunshine, we love going out and celebrating with either lots of iced coffee or alcohol. The good news? It makes us incredibly happy. The bad news? These drinks are a huge culprit in causing sensitivity.
How, exactly?
To better understand the concept of tooth sensitivity, here’s a diagram of your tooth.
Via ADA
Your tooth structure is composed of three layers: the enamel, the dentin, and the pulp.
Teeth sensitivity usually occurs when the protective shell of the enamel wears off or gets damaged, and the dentin underneath is exposed.
This can happen when you:
- Brush your teeth too hard using a hard toothbrush
- Grind your teeth at night
- Are an avid consumer of acidic foods and drinks
- Have tummy issues that cause frequent vomiting
- Frequently use teeth whitening products
- Don’t take good care of your oral hygiene and let plaque accumulate around your teeth and gums
It can also happen when the roots of your teeth are exposed, in the case of gum recession (when your gums pull away).
In addition, if you have damaged, decayed, or chipped teeth or broken down old fillings or crowns, you might experience sensitivity, too. This will usually be confined to one or a few teeth instead of the majority of the teeth, as you might expect with the reasons mentioned above.
The dentin is threaded with tiny tunnels, and it covers the tooth’s soft pulp, which contains nerve cells.
But how do your teeth sense the cold? How does the message go from the outside of your tooth to the nerves within it?
There is fluid inside the tiny channels in your dentin that is sensitive to temperature changes. Any change in temperature puts pressure on this fluid, provoking a response in the concealed nerves.
Only recently, in 2021, researchers discovered that the cells present in dentin (odontoblasts) that produce and maintain dentin also produce a protein called TRPC5 that is sensitive to cold. When your teeth come in contact with something cold, TRPC5 pops open to form a channel that lets ions cross the cell membrane. That’s how you feel this chilly sensation of tooth sensitivity.
Oh, and you must have tried out the good old remedy of oil of cloves to treat tooth pain, or at least heard of it. Turns out, it actually is effective. The oil of cloves contains eugenol that keeps the TRPC5 from opening (and allowing you to feel pain).
Preventing Tooth Sensitivity
Tooth sensitivity can largely be prevented by taking care of a few important things that could trigger or worsen your sensitivity.
Step away from the charcoal toothpaste.
Although using charcoal toothpaste to whiten your teeth may seem like the ‘trendy’ thing to do, there really isn’t much of a whitening effect you can achieve with it. Instead, it can actually be quite damaging to your teeth.
A 2023 PubMed study suggests charcoal toothpastes are abrasive and can damage your tooth enamel.
Charcoal, being abrasive, erodes your tooth enamel, increasing its surface roughness.
A rough tooth surface can become a playing ground for bacteria real quick. A jagged and irregular tooth surface makes it easier for food debris and bacteria to get trapped and less likely to be cleaned thoroughly.
This increases your chances of tooth decay and tooth sensitivity.
And that’s not all. Charcoal particles can get lodged in your gum pockets, where they only make matters worse by causing more damage and even discolouration.
Curb your intake of acidic drinks and food.
The high acid content of your favourite seltzer or the indulgent one-, two-, or three- coffees a day from your local coffee shop may be causing enough damage to your teeth to make you wince in pain when you take a sip of anything, even slightly cold.
Acidic foods and drinks eat away at and erode your tooth enamel, causing it to weaken and demineralise over time. This can make your teeth more likely to experience tooth sensitivity.
Be gentle with that toothbrush.
Brushing hard won’t make your teeth cleaner or whiter. In fact, brushing aggressively can damage the enamel and expose the dentin underneath, leading to sensitivity.
Don’t skip regular dental visits.
A lot of dental problems can be avoided by seeing your dentist on a regular basis. Your dentist can detect potential problems before they get serious and start causing you trouble, thereby saving you a lot of pain and money down the road.
For instance, if you’re unaware that you grind your teeth at night, your dentist will easily identify the problem by looking at the signs in your mouth–something they’re trained to do–and provide you with appropriate treatment for it. Teeth grinding (bruxism) is one of the biggest causes of tooth sensitivity, among others.
To get your teeth checked, you can book a consultation with some of the experts in the field at Zental, an award-winning dental practice in London and many other locations across the UK that comes highly recommended.
Over-the-counter Remedies
Desensitising toothpaste, gels, and mouthwash
Desensitising toothpaste contains potassium salts (potassium nitrate), strontium salts (strontium nitrate), or fluoride. The function of these ingredients is to calm the nerve fibres in your teeth and block the perception of pain.
Remember the dentinal channels we talked about earlier? These toothpastes mainly work by forming plugs to block these channels and stop the movement of fluid through them. Without fluid movement in these tubules, you can’t feel any pain or sensitivity.
When you brush with a toothpaste containing these salts or use mouthwash, they coat the surfaces of your teeth and make your dentin less permeable, so you feel less sensitivity the next time you eat or drink something cold, hot, or sweet.
Here’s a pro tip from dentists at Zental: Use a mouthwash between brushing for maximum protective effects. Using it after you’re done brushing washes away the fluoride and other salts, and we don’t want that. We want these tooth-protecting ingredients to stay sitting on your tooth surfaces for as long as possible to work their magic.
Hydroxyapatite toothpaste for remineralisation
There is more than one active ingredient that is used in sunscreens to effectively protect against UV radiation. Similarly, as common as fluoride is, it is not the only ingredient that can help with the remineralisation of your teeth.
Emerging research shows that hydroxyapatite crystals in toothpaste are as effective as fluoride in helping prevent cavities and reduce sensitivity. One study even suggests it to be more effective than fluoride.
Chairside Dental Treatments
Sometimes, teeth sensitivity may go away on its own, especially if it occurs after a recent dental procedure, such as a root canal therapy, a filling, or sometimes after a professional cleaning session.
However, if the quest to treat your sensitivity at home using OTC remedies has lasted long beyond lockdown, we strongly urge you to seek professional treatment to have the root cause treated properly.
Chemically blocking the dentinal tubules
To chemically block the channels inside your dentin, dentists can apply chemicals like fluoride, glutaraldehyde agents, oxalates, and calcium-containing agents to your teeth.
Physically blocking the dentinal tubules
If your gums have pulled back to expose your root surfaces, your dentist might find it best to cover those areas with a tooth-filling material, like resins (dental bonding) and glass ionomers.
Desensitising the nerve
Applying agents like potassium nitrate is a way to stop the pain messages being sent from your tooth to your brain. They cause an increase in potassium ions inside the nerve endings – decreasing their ability to conduct sensory stimulation.
Using lasers
When less invasive therapies fail to do the job, laser treatment may be used to treat sensitivity. Lasers work by different mechanisms depending on their wavelengths. High-power lasers block the dentinal tubules, whereas low-power lasers interfere with nerve transmission.
Surgery
While not the most conservative option on the list, a root-coverage surgery can treat severely exposed roots by replacing the lost tissue from the root surfaces. A gum graft, or a small amount of tissue, is attached to the affected area. It has been shown to rid almost 70% of patients of sensitivity successfully.
Your dentist determines what treatment is best for you based on the extent of damage that’s been caused and your habits.
The Takeaway
Experiencing tooth sensitivity and pain with hot, cold, or sweet foods and drinks is a common problem that happens when your tooth enamel gets eroded or damaged, uncovering the dentin layer–and ruining your precious moments of culinary indulgence.
Of all the things you can do to prevent tooth sensitivity from occurring, keeping your oral hygiene in check is the easiest and the most important. And then, schedule a trip to your dentist–preferably as soon as possible.
