What Causes Tooth Sensitivity?

Tooth sensitivity is the irritation of the nerve endings inside the tooth.  Tooth sensitivity is caused by the exposure of the dentine (the layer of the tooth below the white hard enamel of the teeth) to the oral environment.

A lot of things can cause sensitive teeth.

Tooth sensitivity includes a painful response to hot, and cold temperatures as well as certain contact, and even air. Sometimes it can be unbearable. It can hinder you from enjoying simple things in life; like eating ice cream, drinking hot coffee or breathing in winter’s cold air. Some people even experience pain while brushing their teeth.

What are the top causes for tooth sensitivity?

Using whitening tooth paste – The most common one today is the excessive use of whitening product from over the counter, whitening tooth paste in particular. In my practice 9 out of 10 patients who complain from sensitivity everywhere in their mouth use whitening tooth paste. In that case I recommend using an anti sensitivity tooth paste at night just before going to bed, brush for two minutes and spit.  Do not rinse the mouth with water or mouthwash, eat or drink.  In the morning you can continue to use the whitening tooth paste unless the sensitivity is severe.

Brushing too hard – The second most common reason is due to harsh brushing often with a hard or medium bristle tooth brush resulting in recession of the gums at the neck of the teeth. The tooth usually looks long and yellowish it the neck because the gym pulled away at the neck of the tooth. In that case I also recommend using an anti sensitivity tooth paste at night just before going to bed, brush for two minutes and spit.  Do not rinse the mouth with water or mouthwash, eat or drink. In addition smear a pea size amount of that tooth paste on he neck of the tooth or teeth which are most sensitive. If there is no improvement in two weeks or the sensitivity worsens then you should have the tooth looked at by a dentist. The hard brushing may have caused some of the tooth structure to be lost necessitating additional treatment.

Drinking too much soda – Sensitivity may also be caused by the melting of the enamel due acids by excessive consumption of soda, citrus drinks, lemon in water, sucking on lemon, excessive swishing of wine,… Identifying the habit and taking steps to strengthening the remaining enamel with fluoride is key before restoring the damaged teeth. A dental consultation is needed to assess the extent of the enamel loss.

Cavities –  finally sensitivity maybe caused by cavities, however much less often then people think. Cavity melts first the outer enamel exposing the dentine thus causing sensitivity to cold and sweets. The cavity process is usually advanced when cavity causes sensitivity. So usually if you are getting regular checks and cleaning most probably your sensitivity is due to one of the reasons above. A dental consultation is needed to diagnose a cavity and propose the best way to treat it. Part of that treatment should be a nutritional counseling to identify why a cavity developed and what should change in the diet habit to prevent a new cavity from developing somewhere else. If you have a cavity, it will bring sensitivity and then pain will follow.

Try a little tenderness:  Sometimes, tooth sensitivity is caused by using a medium or hard bristled brush.  The bristles can remove the gum tissue from your teeth causing them to appear longer than usual. This also uncovers and exposes the root surfaces of the teeth. Instead try using a soft bristled brush.

Go easy on your pearly whites:  Using too much force while brushing is also damaging. It takes time, not pressure to clean teeth. Excessive force can also cause wearing of the gum tissue and enamel.

Grinding your teeth: We lead stressful lives and often that stress shows itself through our teeth. Many of our patients experience damaged teeth due to grinding at night. Protect your teeth by investing in a night guard and by finding ways to de-stress.

Clenching teeth: same as grinding teeth above.

Chewing ice: Like grinding and clenching, chewing on ice is hard on your teeth and can cause sensitivity. It’s best to avoid the practice and give your teeth a break.

–> Clean teeth are strong teeth: By regularly visiting your dentist and hygienist, you can identify these causing factors and choose a specific plan to help diminish or stop sensitivity to your teeth.

What Toothpaste Can I Use to Help With Sensitive Teeth?

If a dentist does not see an obvious reason for your pain, then the situation may call for treatment of the sensitive area with topical fluoride and the use of a desensitizing toothpaste for a short length of time. These toothpastes contain ingredients that block off the nerve-enriched tubules in the exposed dentin.

Although there are a few brands of tooth sensitivity reducing tootpastes, the best ones are only sold by prescription (in the US) or only bought at the dental office. These are some of the recommneded brands:

  • Clinpro
  • Prevident
  • Minimal Intervention (MI) Paste

Either brush with a super soft toothbrush for two minutes, no rinsing, no drinking or eating for at least one hour, use 1 to 2 times a day or apply with finger to the neck of sensitive teeth, no rinsing, no drinking or eating for at least one hour, use 1 to 2 times a day

In Europe, these brands are recommended for tooth sensitivity:

  • Elgydium
  • Sensigel:



Will it get worse?

Yes in general all types of sensitivity get worse if the cause is not identified and removed, such as proper selection of the tooth brush, brushing technique, diet modification etc.

If you are experiencing teeth sensitivity, we encourage you come into our dental office in Midtown Manhattan so we can properly diagnose it.