Tooth Sensitivity Remedies

tooth sensitivity when eating cold foods

The thought of ice cream makes you wince. Walking to your car on a cold winter day is only accomplished if your lips are tightly closed. When someone offers you ice water you want to laugh in their face. You are suffering. Sensitive teeth can be a huge interruption from day-to-day activities. Tooth sensitivity is not a disease like caries (cavities) or periodontal disease, but it is still a major source of pain and discomfort for many people. You do not have to live with sensitivity. There are many treatments available that work to treat sensitive patients.

What Causes Tooth Sensitivity?

dentinal tubules  tooth sensitivity

Enlarged image of exposed tubules in dentin

There are a several causes for a tooth to be sensitive. One reason is that the tooth has decay or other pathology. Sensitivity can also be caused by tooth whitening. The most common cause for tooth sensitivity is exposed dentin. Small openings in the dentin (dentinal tubules) are like an easy access route for sensations to reach the nerve. It is actually movement of fluid in these tubules that cause the feeling of pain. Often multiple reasons are causing the tooth sensitivity. It is important to let your dentist know if you are experiencing sensitivity so infections such as cavities and periodontal disease can be ruled out. Once the cause is determined, treatment can begin.

Pathology

smooth surface cavity, pit and fissure cavity, root cavity

Examples of areas cavities form: Smooth Surface Cavity, Pit and Fissure Cavity and Root Cavity.

Pathology is being used here to describe a tooth that is suffering from disease. The tooth may have decay, a fracture or other problem. In these cases you will need the tooth repaired to fix the sensitivity issue. No amount of sensitive toothpaste will fix this type of problem. If you are not sure of the cause of your sensitivity it is important to visit a dentist to rule out these issues.

Post Bleaching Sensitivity

dental whitening light

Professional Whitening with Lamp

Sensitivity is common after tooth whitening, both in office procedures and at home whitening. Higher concentrations of peroxide are more likely to cause a sensitivity reaction. The sensitivity caused by whitening is not permanent and only lasts a day or two after whitening is stopped. This type of sensitivity can be helped with over the counter and prescription desensitizers mentioned below. Also, using these products before whitening can often make the experience more comfortable.

Dentinal Hypersensitivity

labeled tooth anatomy

This is the most common cause of chronic tooth sensitivity. A tooth is made up of several layers. The innermost section of the tooth contains the pulp, which holds the nerves. This is the part of the tooth that allows you to feel sensations, such as sensitivity. Surrounding the pulp is dentin. In a healthy tooth all of this dentin is covered by either enamel or cementum. When the dentin is exposed fluid movement within the dentin can send signals to the pulp, which are interpreted as pain/sensitivity. There are many reasons that the dentin can be exposed.

  • Overly aggressive tooth brushing
  • Use of a medium or hard toothbrush
  • Use of an overly abrasive toothpaste (such as tartar control)
  • Grinding or clenching can cause enamel to fracture off the tooth
  • Loss of bone from periodontal disease exposes root surfaces, where cementum is thin and easily lost
  • Stomach acid exposure from GERD, Bulimia or morning sickness
  • Exposure to acidic foods as sucking on lemons, and beverages such as excessively drinking soda or energy drinks

Sensitivity Fighters

There are a variety of sensitivity products available to help with tooth sensitivity. Different ingredients work in different ways. If you try one product for your sensitivity and it isn’t helping trying a product with different active ingredients may bring you relief.

Fluoride

Several types, strengths and delivery methods of fluoride are available, both prescription strength and over the counter.

ProDenRx stannous fluoride rinse for sensitivityStannous Fluoride: Available in both prescription and over the counter strengths, stannous fluoride is beneficial in the battle against tooth sensitivity. Liquid and gel formulations are available. Sensitivity relief can be achieved with continued use for about four to eight weeks.11 The down side of stannous fluoride is that it can cause staining of the teeth. Stannous fluoride works by blocking dentinal tubules with metal particles that are part of its make up.4

Fluoridex 1.1% neutral fluoride toothpasteSodium Fluoride: This is active ingredient in most cavity fighting toothpastes. In higher doses it is used as fluoride treatments in dental offices. Prescription strength (1.1% or 5000ppm) gels and toothpastes are frequently prescribed to patients with tooth sensitivity6, as well as those at risk for decay and those with periodontal disease.1

Potassium Saltssensodyne toothpaste for sensitivity

Potassium Nitrate and Potassium Citrate are salts that have many uses outside of dentistry. Potassium Salts have shown to significantly reduce sensitivity. It is not known exactly how potassium nitrate desensitizes the tooth. The current theory is that the potassium ions travel through the dental tubules and inactivate nerves within the tooth.8 Regardless of how it works, it works. It can take about two weeks of regular use to desensitize the teeth.

Recaldent

MI Paste with recaldent
Recaldent is a combination of amorphous calcium phosphate (ACP) and casein phosphopeptide (CPP), obtained from milk casein. Recaldent has many beneficial uses in the oral cavity from remineralizing early decay, preventing decay, and aiding with tooth sensitivity. It works by blocking open dentin tubules. The resulting remineralization of the tooth is thought to be the reason for desensitization when using pastes with recaldent.5 Resulting desensitization using recaldent is equivalent to the use of potassium nitrate, but with the added benefit of reducing acid erosion. Acid erosion is a factor in tooth sensitivity so reducing erosion and help prevent more areas of sensitivity from appearing.12 While the pastes help with sensitivity, evidence has not shown that chewing gum with recaldent is any better at reducing sensitivity than regular chewing gum.9

Arginine and Calcium Carbonatesensitivity toothpaste with arginine

This combination also blocks the openings of the dentinal tubules. Arginine reduces sensitivity better than potassium salts and fluoride.7 There are not many toothpastes containing Arginine. Relief with an arginine and calcium carbonate toothpaste or treatment at your dental office is immediate.

NovaMinSensitivity toothpaste with NovaMin no fluoride

NovaMin is the trade name for an inorganic bioactive silica called calcium sodium phosphosilicate. NovaMin also blocks the open tubules in the dentin. Clinical studies have shown that NovaMin reduces sensitivity, with results lasting up to six weeks.10 Single applications of NovaMin may be applied at the dental office, or continued use in a toothpaste may be used at home. NovaMin rapidly block the dentinal tubules, bringing relief without the wait of many other products.2

Strontium Chloridetoothpastes for sensitivity

Strontium Chloride has been studied since the late ’70′s relating to tooth sensitivity. Alone or combination with fluoride it has the ability to reduce sensitivity.3 This was the first of the dentinal tubule blocking ingredients available. Dentinal tubules are blocked with metals which are part of strontium chloride’s make up. It is still available, but is not as common as it once was. The introduction of the potassium salts has overtaken strontium chloride in over the counter formulations.4

Some Sensitivity Remedies and their Active Ingredients

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[one_half]Fluoridex (Daily Defense SLS-Free, Daily Defense Sensitivity Relief), Colgate Prevident 5000 Sensitive, Colgate Prevident 5000 Enamel Protect[/one_half]
[one_half last]1.1% Neutral Sodium Fluoride, Potassium Nitrate[/one_half]
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[one_half]Clinpro 5000, Colgate Prevident 5000, Fluoridex (Daily Defense, Enhanced Whitening)[/one_half]
[one_half last]5000ppm Neutral Sodium Fluoride [/one_half]
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[one_half]Colgate SensitiveSensodyne(most products) [/one_half]
[one_half last]Potassium Nitrate, Sodium Fluoride [/one_half]
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[one_half]Crest Pro-Health Sensitive Shield, Crest Pro-Health[/one_half]
[one_half last]Stannous Fluoride[/one_half]
[clear]
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[one_half]Sensodyne Original, Sensodyne Rapid Relief[/one_half]
[one_half last]Strontium Chloride[/one_half]
[clear]
[/raw]

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[one_half]Fluoridex Daily Renewal Stannous Fluoride Rinse (similar products also made by ProDenRx, PerioMed, Gelato)[/one_half]
[one_half last]0.63% Stannous Fluoride[/one_half]
[clear]
[/raw]

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[one_half]Colgate Gel Kam[/one_half]
[one_half last]0.63% Stannous Fluoride or over the counter 0.4%[/one_half]
[clear]
[/raw]

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[one_half] MI Paste (once marketed as Tooth Mousse) [/one_half]
[one_half last]Recaldent [/one_half]
[clear]
[/raw]

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[one_half] MI Paste Plus(once marketed as Tooth Mousse Plus) [/one_half]
[one_half last]Recaldent and 900ppm Sodium Fluoride [/one_half]
[clear]
[/raw]

[raw]
[one_half]Colgate Sensitive Pro-Relief
[/one_half]
[one_half last] Arginine and Calcium Carbonate, in professional formulation is the USA, in Canada it is also in the over the counter version. The USA over the counter version contains potassium nitrate [/one_half]
[clear]
[/raw]

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[one_half]Dr. Collins Restore Toothpaste
[/one_half]
[one_half last]NovaMin [/one_half]
[clear]
[/raw]

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[one_half] Sensodyne NUPRO [/one_half]
[one_half last]5000ppm Neutral Sodium Fluoride and NovaMin [/one_half]
[clear]
[/raw]

This is only a partial list of some of the more common prescription and over the counter desensitizers, but it will give you the information you need to find something that works for you.  If you have had experience with a product that helped you with your sensitivity feel free to comment.  Also these products may or may not be available where you live.  Many companies market similar products under different names in other countries.

References

1Charles W. Berry, Nancy A. Yoon. The Antimicrobial Effect of Fluorides (Acidulated Phosphate, Sodium and Stannous) on Actinomyces viscosus. JDR August 1979 vol. 58 no. 8 1824-1829.

2Burwell A, Jennings D, Muscle D, Greenspan DC. NovaMin and dentin hypersensitivity–in vitro evidence of efficacy. J Clin Dent. 2010;21(3):66-71.

3Diane Cummins. Dentin Hypersensitivity: From Diagnosis to a Breakthrough Therapy for Everyday Sensitivity Relief. The Journal of Clinical Dentistry. 2009;21(special edition):1-9.

4Gedalia I, Brayer L, Kalter N, Richter M, Stabholz A. The effect of fluoride and strontium application on dentin: in vivo and in vitro studies. Journal of Periodontology [1978, 49(5):269-272]

5Kowalczyk A, Botuliński B, Jaworska M, Kierklo A, Pawińska M, Dąbrowska E. Evaluation of the product based on RecaldentTM technology in the treatment of dentin hypersensitivityAdvances in Medical Sciences · Vol. 51 · 2006 · Suppl. 1.

6Lutins ND, Greco GW, McFall WT Jr. Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis. Journal of Periodontology 1984, 55(5):285-288.

7Ilze Maldupa, Anda Brinkmane, Inga Rendeniece, Anna Mihailova. Evidence based toothpaste classifi cation, according to certain characteristics of their chemical composition. Stomatologija, Baltic Dental and Maxillofacial Journal, 14:12-22, 2012.

8Orchardson R, Gillam DG. The efficacy of potassium salts as agents for treating dentin hypersensitivity. J Orofac Pain. 2000 Winter;14(1):9-19.

9Tang; B. J. Millar. Effect of chewing gum on tooth sensitivity following whitening. British Dental Journal 208, 571 – 577 (2010)dOrchardson R, Gillam DG. The efficacy of potassium salts as agents for treating dentin hypersensitivity. J Orofac Pain. 2000 Winter;14(1):9-19.

10Tai, B. J., Bian, Z., Jiang, H., Greenspan, D. C., Zhong, J., Clark, A. E. and Du, M. Q. (2006), Anti-gingivitis effect of a dentifrice containing bioactive glass (NovaMin®) particulate. Journal of Clinical Periodontology, 33: 86–91

11Thrash WJ, Dodds MW, Jones DL. The effect of stannous fluoride on dentinal hypersensitivity. Int Dent J. 1994 Feb;44(1 Suppl 1):107-18.

12Laurence J. Walsh. The effects of GC Tooth Mousse on cervical dentinal sensitivity: a controlled clinical trial. INTERNATIONAL DENTISTRY SA VOL. 12, NO. 1.aThrash WJ, Dodds MW, Jones DL. The effect of stannous fluoride on dentinal hypersensitivity. Int Dent J. 1994 Feb;44(1 Suppl 1):107-18.

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