The Challenges of Dentistry Part 4

Last time I started talking about tooth sensitivity. I covered sensitivity to sweets, biting and chewing.  This time I’ll cover temperature sensitivity.

Temperature sensitivity is the hardest tooth sensitivity to diagnose. All the issues I discussed last time can cause temperature sensitivity.  Those included decay, cracks, bad bite and infection.  If you have sensitivity to colds, hots, sweets or have biting sensitivity, it’s time to have that area looked at.

In addition, sensitivity can stem from root surface exposure. The roots of teeth generally begin below the gum line.  Roots are not covered by enamel like the tooth surface above the gums.  This lack of enamel means these surfaces are more likely to have sensitivity to cold or hot temperatures.  The term for root surface exposure is recession.  Let’s talk about the reasons for recession.

Root surfaces become exposed for various reasons. One is gum disease.  Gum disease, or periodontal disease causes loss of bone as well as gum tissue recession.  I will discuss this in a later blog.  Another reason for recession is age.  There is a moderate amount of gum recession as we get older.  This is usually a gradual process that often does not increase tooth sensitivity.

Clenching or grinding your teeth can also cause gum recession. In extreme cases the grinding can cause the tooth to crack along the gum line causing abfractures.  Abfracures appear as grooves in the tooth structure right at the gum line.  These are often very temperature sensitive.  In these cases, we recommend a bite splint to protect the teeth from the grinding. It will also help slow down or arrest the gum recession and the potential for abfractures.

If you like a hard tooth brush, like to really scrub your teeth or over use an abrasive whitening toothpaste you can cause tooth brush abrasion.  Tooth brush abrasion mimics abfractures in that it manifests itself as grooves in the tooth structure along the gum line.  These grooves are often very temperature sensitive.  If you are diagnosed with tooth brush abrasion you will be instructed to do several things.  First, switch to a mechanical tooth brush.  We recommend a Sonicare. The reason for a mechanical brush is to cut down of the scrubbing and the use of a brush that is too hard. Second, switch to a “sensitive” toothpaste. Sensodyne, Crest and Colgate all have toothpastes for sensitive teeth that work well.

As you can see, tooth sensitivity is a big deal. The sooner you get your sensitivity check out the better.  Don’t let a little sensitivity become a big problem.


Thanks for reading,

Dr. Bruce