Mouth Sensitivity

Tooth pain can be debilitating, and certain problems are more serious than others. Let’s take a look at the most common types of pain and their treatments, along with strategies to prevent them in the future.

Sensitive Teeth

Teeth are made up of enamel and dentin (which has pores that lead to the nerve). Inside the tooth is a nerve that, when irritated, can cause sensitivity to hot and cold, as well as pain. The sensitivity ranges, but it can be severe. Enamel can become abraded or eroded away from things like soda or lemon juice.  Here are some ways to treat teeth sensitivity:

• Eliminate the source of irritation. Replace hard toothbrushes with soft-bristle brushes. Use electric brushes such as Braun or Sonicare to further decrease this trauma.
• Avoid soda and sugary drinks that can change the way the nerve reacts. Limit or eliminate high-acid drinks, which have carbonic acid (what gives soda its fizz).
• Brush with toothpastes that say “for sensitive teeth,” as they contain medications that will plug up the small pores in the dentin and provide relief. These toothpastes can take six to eight weeks of continuous use to fully help.
• Ask your dentist for prescription-strength fluoride products to brush on your teeth to seal the dentinal tubules and stop the pain. If the tooth is really sensitive and no cavities are present, the dentist can use dentin-desensitizing medicines to offer immediate relief. These may need to be reapplied several times but can provide significant relief quickly while waiting for the over the counter medicaments to work.
• Lastly, see your dentist because sensitivity to hot and cold can be indicators of deep cavities that can be causing your nerve sensitivity. If you have severe lingering “pain” to cold, the nerve is dying and a root canal may be necessary. Pain to hot foods also indicates a dying nerve, with gases building up inside. It’s not uncommon to have on-and-off sensitivity to both cold and hot because as the nerve is dying, parts are alive and parts are dead, so the sensation can alternate. Root canal therapy is a technique where the tooth is opened up and the small nerve is removed and replaced with a rubbery material called gutta percha, which will allow you to retain the tooth and have no pain from the nerve. Contrary to popular belief, root canals don’t hurt. Typically the dentist will prescribe antibiotics and or pain medication to calm the tooth down prior to performing the root canal. The tooth is anesthetized in the same way it is for extraction. Most dentists perform these procedures and the filling for the tooth in a single visit.

Cracked Tooth Syndrome

If your tooth hurts when you bite down, it’s called CTS, or cracked tooth syndrome. Teeth that are at risk for CTS are those with previous large fillings or teeth where the bite has shifted due to trauma or extractions of other teeth.

Here’s how dentists treat CTS:

• Unfortunately, some teeth cannot be saved. If the pain won’t go away, you’ll want to get the tooth removed and the socket grafted to prepare for an implant or a bridge.
• The initial treatment for a cracked tooth is to take out the old filling, look for the fracture, remove any cracked cusps and desensitize the tooth and place a nice bonded filling. Next, the tooth should be taken out of occlusion and given a vacation by grinding it down slightly so it can’t hit when you are chewing.
• If the pain persists, you may need a root canal. If the root canal doesn’t stop the pain, the last thing a dentist can try is to shave the tooth down and place a temporary crown to see if this splinting together of the tooth structure can stop the fracture from flexing and stop the pain.
• If all these steps have been taken, and the pain persists, the tooth should be removed and options for replacement discussed.

If you can’t get to the dentist right away, here’s what to do for a cracked tooth in the meantime:

• Don’t eat on that side. Stop chewing gum and avoid sticky foods like caramels, taffy or any other food that requires you to squeeze down on the tooth.
• Make an appointment to see your dentist before it gets worse. If there is a hole in your tooth or a cusp has fractured off, you may go to the pharmacy where temporary tooth cements can be purchased to put over the area. Even carefully placing wax or sugarless gum over the area can protect it until you can see your dentist.
• If your tooth cracked in half and wiggles, don’t pull the pieces, as they may be attached tightly to the gums and can cause pain and bleeding upon removal. See your dentist or go to your local urgent care clinic as soon as possible.

Denture Pain

Denture pain can hurt like crazy. Here’s what to do:

• Since dentures are made of a hard acrylic and gum tissues are soft, the abrasion can lead to denture sores. Take out the offending denture and use warm saltwater rinses to decrease the pain. A teaspoon of salt with a glass of warm water will keep the area clean and dull the pain receptors.
• You may need to get your dentures adjusted, relined, rebased or remade. See your dentist to evaluate the causes of the pain.
• You can purchase creams such as Orabase with benzocaine from the pharmacy. It will act as a Band-Aid over sores until the dental visit. Medicines such as Orajel and Ambesol may provide some instant relief as well.
• Sores that don’t seem to go away or bleed easily or have irregular borders may be pre-cancerous or cancerous lesions. Have them evaluated, and perhaps biopsied, to ensure that no oral cancer is present.

Remember, mouth pain can be debilitating, and it should be a red flag that it is time to get in to the dentist. Most dentists will see same-day emergencies – so there is little excuse for “watching and waiting” and hoping it will get better by itself. See your dentist!