Tooth Sensitivity: Causes, Treatments & Prevention Strategies

Dentin hypersensitivity occurs when enamel wears away or gums recede, exposing dentinal tubules that transmit stimuli to the nerve.

External (Acquired) Causes

• Enamel erosion: Acidic foods/drinks (citrus, soda, wine), GERD, frequent vomiting.
• Abrasion: Aggressive brushing, hard bristles, abrasive toothpaste.
• Gum recession: Periodontal disease, aging, orthodontics, tobacco.
• Bruxism (grinding): Wears enamel, fractures teeth.
• Whitening products: Peroxide-based agents transiently increase sensitivity.
• Dental procedures: Cleaning, fillings, crowns, scaling—usually temporary.

Internal/Medical Factors

• Xerostomia (dry mouth): Medications (antidepressants, antihistamines), Sjögren's, radiation.
• Systemic conditions: Diabetes, autoimmune disorders, eating disorders (acid erosion).
• Cracked tooth/filling: Allows fluid movement in tubules.

Treatment Ladder

1. Desensitizing toothpaste (KNO₃, stannous fluoride, arginine): Daily use, 2–4 weeks for effect.
2. Fluoride varnish/gel (in-office): Stronger, longer-lasting.
3. Bonding agents/sealants: Cover exposed root surfaces.
4. Gum graft: For significant recession.
5. Root canal: If irreversible pulpitis.

Prevention

• Soft brush, gentle circular motion, non-abrasive paste.
• Wait 30 min after acidic foods before brushing.
• Nightguard for bruxism.
• Limit acidic/sugary snacks.
• Regular dental cleanings.