Tooth Sensitivity: “A pain in your …”

Tooth Sensitivity Dentist in La Jolla discusses the problem and ways to help prevent it.

By Dr. Joe D’Angelo & Dr. Ashley Olson

Tooth Sensitivity Dentist in La Jolla discusses the problem and ways to help prevent it.
So, you’re enjoying your favorite flavor of Haagen-Dazs ice cream or See’s candy and “#*@!&*#”! You feel a shooting pain that destroys the pleasure of the moment. This tooth sensitivity you have experienced (probably not the first time) has most likely been an unwelcomed diet remedy.

Needless to say, tooth sensitivity is annoying and uncomfortable. Eating and drinking hot, cold, sweet, sour, or hard foods can bring on an alarming sensation, not to mention unattractive facial contortions. While dental sensitivity can be dismissed and ignored, it’s a good idea to consider the possible causes.

Why does tooth sensitivity occur?

There are many contributing factors of tooth sensitivity. The structure of a healthy tooth is comprised mostly of dentin, with a covering of enamel (the hard outer layer). In the middle of the tooth is a pulp chamber, housing the nerve and blood vessels that provide sensation and nourishment to the tooth. Within the dentin, there are millions of microscopic channels called dentinal tubules that communicate directly to the nerve. The exposure of these tubules, either from recession of the gums, dental decay, or wear of the enamel, greatly heightens sensitivity. Dentin exposure is a common finding with tooth sensitivity.

The interesting thing is that the exposure of the dentinal tubules alone does not


result in that familiar electric-like shooting pain. Therefore, it is clear that other factors are involved.


Dental decay, or cavities, eat away at the surface of the tooth, right into the dentin. Typically, a reparative dentin layer is formed in response to a stimulus, such as decay. The result of this is that most dental decay does not create sensitivity, until the decay is very deep. At this point, the nerve might be compromised.

It is important to understand that the lack of sensitivity

does not

indicate the absence of decay.
Rarely is a patient aware of decay.


The exposure of a tooth’s root surface, commonly referred to as gum recession, can have many causative factors.
  1. Chronic Periodontal Disease: The progression of periodontal disease results in the loss of bone and supporting structures. As bone height decreases, gum tissue height is eventually lost, exposing potentially sensitive root surfaces.
  2. Anatomic Predisposition: The part of the jaw in which the teeth sit, is called the alveolar ridge. The width of the ridge is highly variable. In patients with a narrow ridge, gum recession is much more likely. Gum tissue thickness is also variable. Thinner tissues are more prone to recession. In addition to this anatomic predisposition, the width of the ridge and the thickness of tissue typically decrease with age. Patients with recession are more likely to have tooth sensitivity.
  3. Aggressive Brushing: In people with a thin tissue biotype, aggressive brushing can contribute to recession and tooth sensitivity.


Brushing too hard or using abrasive whiteners or toothpastes can gradually cause enamel wear. Preserving dental enamel and dentin is important because it does not regenerate. In those patients with gum recession, it is the abrasion on the exposed root surfaces on that cause the most concern. These root surfaces wear much more easily than enamel. Many patients with this condition experience sensitivity.


Rubbing and grinding the teeth together during sleep is called bruxism. Squeezing the teeth tightly at night is known as clenching. The resulting strain causes change in the dentinal structure, leading to heightened communication of cold and sweets with the nerve. Bruxing and clenching also contribute to gum recession, periodontal disease, and can cause notching of the tooth at the gum line. These phenomena play a huge role in dental hypersensitivity, and the effects are compounded when multiple factors are present. In our experience, bruxism and clenching are the most significant causes of tooth sensitivity.


Fractures may develop through the tooth structure. When pressure is applied to a fractured tooth, signals can be transmitted to the nerve causing a sharp pain. Seeing a dentist to diagnose and treat this problem is very important as these fractures can propagate, leading to the need for root canal treatment or tooth loss.


: Frequent consumption of highly acidic foods or drinks, such as tomatoes, citrus fruits, vinegar, and especially carbonated drinks can cause tooth enamel to demineralize and erode away. In addition, some people have more acidic saliva or acid reflux causing their enamel or exposed dentin to chemically dissolve. Eroded teeth are typically more sensitive and are also more susceptible to decay.


: When the nerve of a tooth is compromised by decay or trauma, an infection may occur, which can spread to the surrounding bone. Initially, the tooth might be hypersensitive, and as the problem progresses, a throbbing deep pain may arise. Sensitivity to heat is sometimes indicative of a dental abscess. Diagnosis and treatment by a dentist is imperative.

Remedies & Prevention of Tooth Sensitivity

If you’re one of many Americans suffering from tooth pain due to sensitivity, you’re not alone. Find out how to manage the condition with our 5 top recommendations.

To prevent worsening of your condition, use enamel-safe toothpaste and a soft toothbrush. Be sure to brush daily to ward off dental disease and prevent decay and gum recession. Floss regularly -- once a day is enough to keep bacteria between the teeth in check. Desensitizing toothpastes can also be helpful by helping to fill microscopic channels in exposed dentin.

Fluoride rinses can help manage the pain associated with tooth sensitivity. We will be happy to help with a recommendation specific to your needs. For more advanced cases of sensitivity, you can visit us for a prescription strength formulation.

Enamel can be gradually worn away when exposed to highly-acidic foods and beverages. Remember, the name of the game is keeping as much of your enamel as possible to avoid issues of sensitivity. Keep acidic foods such as vinegar, lemon juice, fruit juices or soda away from the surface of teeth by limiting consumption and rinsing with water afterward. If acid reflux is suspected, it is best advised to consult your physician.

Many people grind their teeth while sleeping and don’t know it! Preserve your enamel and reduce the strain on your teeth by wearing a night guard when sleeping. This ensures protection against grinding, clenching and the resulting damage to the surface of the tooth. Although an inexpensive nightguard can be purchased at a drugstore, they’re often ineffective and counterproductive. A professionally custom fabricated nightguard can ensure proper fit, comfort, and function.

Certain kinds of over-the-counter whitening treatments, brushing with firm bristles, or eating hard foods can gradually deteriorate the surface of your teeth with continued exposure. It’s important to avoid any kind of activity that can cause pressure or erosion of your dental enamel. Be sure to see a dentist regularly to keep your teeth clean and beautiful –

for a lifetime.

Remember, a tooth ache is a very different condition than tooth sensitivity! Visit

or call us at 858-459-6224 with any questions or to schedule your consultation.