Tooth Sensitivity: It can come on suddenly. You’re drinking hot coffee or eating ice cream and, without warning, your tooth twinges. Or it can develop over time; brushing your teeth might feel irritating instead of invigorating. No matter how it shows up, tooth sensitivity is a common complaint, and it can indicate more serious problems for your teeth.

“Tooth sensitivity is the irritation of the nerve endings inside the tooth,” said Dr. Ziad Jalbout, D.D.S. It’s caused by the exposure of the dentine—the layer of the tooth below the white hard enamel of the teeth—to the oral environment, he said, and it can get worse if you don’t treat it when you notice it.

Here’s what you need to know.

What Causes Tooth Sensitivity?

It can be hard to determine what the problem is because there are so many causes of tooth sensitivity. One of the most common, Jalbout said, is the overuse of whitening products, over-the-counter whitening toothpaste in particular.

“In my practice, nine out of 10 patients who complain from sensitivity everywhere in their mouth use whitening toothpaste,” he said.

Another common cause is brushing too hard with a hard- or medium-bristle brush, Jalbout said. Brushing too hard can cause the gum to pull away from the neck of the tooth, making teeth look long and yellowish.

Finally, sensitivity may be caused by the “melting” of the tooth enamel due to excessive consumption of soda, citrus drinks or lemon water, or from swishing wine too much. In this case, a dental consultation is recommended to determine the extent of enamel loss.

What Are Some Treatments for Sensitive Teeth?

No matter the cause of tooth sensitivity, identifying any troublesome habits and taking steps to strengthen the remaining enamel is key, Jalbout said. If it’s caused by whitening products, for example, he recommends an anti-sensitivity toothpaste at night before going to bed.

“Brush for two minutes and spit; do not rinse the mouth with water or mouthwash, or eat or drink,” he said. Use the whitening toothpaste in the morning only, unless sensitivity is severe.

For teeth that are sensitive because of too-vigorous brushing, Jalbout again recommends using an anti-sensitivity toothpaste at night without rinsing, eating or drinking. Then, smear a pea-sized amount of the toothpaste on the neck of the teeth that 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,” he said. “The hard brushing may have caused some of the tooth structure to be lost, necessitating additional treatment.”

Is There Damage?

Tooth sensitivity can also be caused by cavities, but Jalbout said it’s much less common than people think. “Cavities melt first the outer enamel, exposing the dentine, thus causing sensitivity to cold and sweets,” he said. “The cavity process is usually advanced when a cavity causes sensitivity. So usually if you are getting regular checks and cleaning, your sensitivity is most probably due to one of the reasons above.”

Dental consultations are recommended for any ongoing sensitivity that doesn’t get better. “In general, all types of sensitivity get worse if the cause is not identified and removed,” Jalbout said. Talk to your dentist if you have questions or concerns.


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