Sensitive Teeth: Causes and Treatments That Help

A sip of iced water or hot coffee, a bite of ice cream, even a cold breath of air can send a sharp, brief zing through a sensitive tooth. Tooth sensitivity is common and usually treatable, but it is also a symptom rather than a diagnosis. The right fix depends on the cause. This guide explains why teeth become sensitive, what you can try, and when to see a dentist.

Why teeth get sensitive

The ADA’s MouthHealthy site explains the anatomy. In a healthy tooth, enamel protects the crown (the part above the gumline) and a layer called cementum protects the root. Beneath both is dentin, which is less dense and contains microscopic tubules. When dentin loses its enamel or cementum covering, those tubules let heat, cold and acidic or sticky foods reach the nerves and cells inside the tooth. Dentin can also be exposed when gums recede. The result is hypersensitivity (MouthHealthy: Sensitive teeth).

Common causes

MouthHealthy lists these possible causes:

• Tooth decay. A cavity can expose dentin. See our tooth decay guide.
• Fractured teeth. A crack can cause sharp pain on biting or with temperature changes. Our cracked or chipped tooth guide explains what to do.
• Worn fillings. Old fillings can wear or leak at the edges.
• Gum disease. Inflamed or receding gums can expose roots. NIDCR lists sensitive teeth and gums pulling away from the teeth among symptoms of gum disease (NIDCR: Gum disease).
• Worn enamel. Enamel can wear from acid or from grinding. Our guide to teeth grinding and night guards covers grinding.
• Exposed tooth roots. When gums recede, the root surface is left without enamel. See our guide to gum recession and gum grafts.

Some people also notice temporary sensitivity after dental work such as a new filling or a whitening treatment. If you are considering whitening, our teeth whitening guide discusses sensitivity as a side effect.

Sensitivity or something more serious?

Typical sensitivity is a short, sharp twinge that fades quickly once the trigger is gone. Pain that lingers, throbs, wakes you up, or comes with swelling or fever points to something else, such as inflamed pulp or an infection. Our articles on toothache causes and tooth abscess signs explain those warning signs.

Treatments your dentist may suggest

MouthHealthy says sensitive teeth can be treated and the treatment depends on the cause. Options include:

Desensitizing toothpaste

These toothpastes contain compounds that help block sensation from traveling from the tooth surface to the nerve. MouthHealthy notes they usually need several applications before sensitivity improves, so give them time and use them consistently.

Fluoride gel

An in-office fluoride treatment strengthens enamel and reduces the transmission of sensations.

A crown, inlay or bonding

These can correct a flaw or decay that is causing sensitivity. Bonding uses tooth-colored resin over an exposed area.

Surgical gum graft

If gum tissue has been lost from the root, a graft can cover and protect the root and reduce sensitivity. The American Academy of Periodontology says gum graft surgery covers exposed roots, helps prevent further recession and bone loss, and may reduce tooth sensitivity (AAP: Surgical procedures).

Root canal

If sensitivity is severe and persistent and other treatments have not worked, MouthHealthy says your dentist may recommend a root canal to eliminate the problem. Our root canal guide explains the procedure.

Things you can do at home

• Keep up good oral hygiene. MouthHealthy calls proper oral hygiene the key to preventing sensitive-tooth pain. Brush twice a day and clean between your teeth daily.
• Use a soft-bristled brush and gentle pressure. Scrubbing hard can wear enamel and irritate gums.
• Try a desensitizing toothpaste for several weeks.
• Notice your triggers. Very acidic foods and drinks can contribute to enamel wear.
• Ask about grinding. If you wake with a sore jaw or your partner hears grinding, mention it.

What to tell your dentist

Helpful details include which teeth are sensitive, what triggers it (cold, hot, sweet, biting), how long each episode lasts, when it started, and whether you have had recent dental work or started a new toothpaste or whitening product. That helps the dentist narrow down the cause quickly.

Key takeaways

• Sensitivity happens when dentin is exposed, through decay, cracks, worn fillings or enamel, or receding gums.
• Treatment matches the cause, from desensitizing toothpaste and fluoride to bonding, gum grafts or, rarely, a root canal.
• Lingering or throbbing pain is not typical sensitivity and should be checked promptly.

How a dentist finds the cause

Because sensitivity has many possible causes, the visit usually starts with questions: which tooth, what triggers it, and how long it lasts. The dentist then examines the teeth and gums, looking for decay, cracks, worn or leaking fillings, worn enamel and receding gums. They may gently test the tooth with air, cold or pressure to reproduce the feeling, check your bite, and take X-rays if decay or a deeper problem is suspected. Gum measurements can show whether gum disease is involved.

The answer guides the treatment. A worn filling may simply need replacing. A crack may need a crown. Exposed roots from gum recession may respond to desensitizing toothpaste or fluoride, or may need a gum graft. Decay needs a filling, and our comparison of filling materials explains the options. This is why a desensitizing toothpaste is a reasonable first step for mild sensitivity, but not a substitute for an exam if the problem continues.

When to call the dentist

• Sensitivity in one tooth that is new or getting worse
• Pain that lingers after the trigger is gone, or throbs on its own
• Pain when you bite or release a bite
• Swelling, a pimple on the gum, or a bad taste
• Sensitivity that has not improved after several weeks of desensitizing toothpaste

Bring a list of any toothpastes, rinses or whitening products you have used recently, since a change in products is sometimes the trigger.

If you have several sensitive teeth at once, mention any recent changes in diet, such as more citrus, sports drinks or sparkling water, since acid exposure across many teeth can point toward enamel wear rather than a single problem tooth.

Frequently asked questions

How long does desensitizing toothpaste take to work?

MouthHealthy says it usually requires several applications before sensitivity is reduced. Use it consistently and tell your dentist if it is not helping.

Is sensitivity after a filling normal?

Short-term sensitivity after a filling is common. If it lasts, worsens, or the tooth hurts when you bite, call your dentist; our comparison of filling materials has more on fillings.

Can receding gums cause sensitivity?

Yes. When gums recede, root surfaces without enamel are exposed, and MouthHealthy lists exposed roots among the causes of sensitivity.

Can sensitive teeth go away on their own?

Sometimes mild or temporary sensitivity fades, but because it can signal decay or a crack, it is worth having it checked if it persists.

Should I stop brushing a sensitive area?

No. Keep brushing gently with a soft brush. Plaque buildup can make problems worse.

Sources

• ADA MouthHealthy: Sensitive Teeth
• American Academy of Periodontology: Surgical Procedures
• NIDCR: Periodontal (Gum) Disease

By the Dentist Review Editorial Team.

This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.

Featured image: “Toothpasteonbrush” by Thegreenj, via Wikimedia Commons, licensed CC BY-SA 3.0. Resized and compressed for the web.