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This month I would like to discuss another dental issue and problem that many people (approximately 40 Million Americans) suffer with: Sensitive teeth.

Teeth are composed of enamel on the outside and the dentin which lies just under the enamel. Dentin contains very small tubes that have fluid in them.  When hot, cold, chemicals such as whitening agents or sweets pass by the surface of the dentin on the exposed roots and edges of teeth it moves the fluid in the micro tubes and this causes the pain by stimulating the nerve.  So when pain is felt it is actually an indirect contact with the nerve through this system and not a direct touching of the nerve.

The following are the most frequent causes of tooth sensitivity:

• Brushing with excessive pressure with hard toothbrush bristles. Over time this aggressive act will take away the gum tissue, the bone and then the tooth leading to exposed root dentin which will make the teeth sensitive.  The use of a soft toothbrush using a gentle circular motion aiming at the gumline is the best way to safely brush the teeth without harm. I am often asked what is the best toothbrush?   I say a soft manual brush or even better is an electric brush like the Sonicare.  They are gentle on the teeth and effective on plaque removal while infusing oxygen into the plaque which helps to kill the bacteria between the teeth.
• Periodontal disease will cause bone loss around the teeth giving the “long in the teeth” appearance. Some people falsely believe that this is a part of the natural aging process but it isn’t.  Periodontal disease is caused by a bacterial invasion under the gum line which eventually causes the bone to be lost.  Smokers and uncontrolled diabetics are the ones who are most likely to be diagnosed with this disease.
• Grinding of the teeth from stress can create loss of bone and tooth structure where the root meets the gum. This is called an abfraction and is like a deep notch in the tooth.  When one grinds their teeth the teeth flex and under the right conditions these notches can deepen and become sensitive.  A small guard can prevent this from happening and an evaluation is necessary to make sure the bite is proper.  Sometimes it may be necessary to adjust the bite.
• Abrasive toothpastes such as those containing baking soda can be harmful and abrade the tooth roots.
• Acidic foods and beverages such as soft drinks can cause tooth pain by decaying the tooth. I had a patient recently ask me if lemon in the water can cause the sensitive teeth because she was using a lot of lemon.  This certainly increases the acid level in the mouth and causes them to be sensitive. Acid reflux especially at night is a contributing factor in that the stomach acid is very strong which leads to loss of enamel.  Bulimia  also makes the teeth exposed to the strong acids in the stomach, leading to really sensitive teeth.

These are the most common causes that lead to sensitive teeth.  Treatment includes such things as: fluoride rinses at home, tooth pastes such as Sensodine, Renamel and a number of other toothpastes which have a chemicals in them that literally “clogs” up the small microtubes in the dentin.  When these get “clogged up” they can’t transmit the fluid within the micro tubes and pain is reduced.  We have stronger “clogging agents”  that can be applied in the office which can make a significant difference in pain.   You must remember that  hard tooth brushing and acids will dissolve the reparative plugs that are formed so it is necessary to change the habits that have created the sensitive teeth in the first place.  It is best to visit your dentist to have this evaluated.  If you don’t have a current dental home then I would be happy to evaluate your situation so give us a call at (586)247-3500.

About The Author

Dr. Robert Antolak, DDS graduated from the University of Michigan in 1987 with his Doctor of Dental Surgery degree. He is dedicated to providing the highest quality and appropriate cosmetic, sedation and general dentistry in the most comfortable and gentle way possible. Because being a dentist has been a lifelong dream, Dr. Antolak has a passion for the profession. He enjoys helping people feel better about their smiles and therefore their self-image with dental implant and cosmetic dentistry. His Dental Practice is located in Shelby Township, Michigan.  For more information visit The Gentle Dentist.

Do you have bad breath, bleeding gums when brushing or flossing, loose teeth or history of tooth loss?  If you answer yes to any of these questions, then you may have periodontal disease. Gum disease is very common. Unfortunately most people don’t even know that they have periodontal (gum) disease.  It isn’t until it is too late when their teeth start getting loose that they want to do something about it and many times it is too late and they have to have their teeth removed or need extensive treatment.  In fact, with recent research linking the risk of heart disease, diabetes, stroke and low birth weight babies with periodontal disease and bleeding gums it is critical to have your mouth assessed for this infective disease. The bacteria in the gums leach out in the blood stream requiring the body’s immune system to constantly fight off these invaders.

This constant and chronic immune response is not a good thing because it causes chronic inflammation. Over the past 3-4 years research has been showing that chronic systemic inflammatory diseases such as periodontal disease can increase the level of a substance called c-Reactive protein. The liver releases this substance in response to systemic inflammation.  As the level of c-reactive protein increases so does the risk of cardiovascular diseases such as stroke, heart attack, and diabetes according to multiple clinical studies. In fact, testing for C-reactive protein in a blood test may be an effective early warning test for asymptomatic, or presymptomatic heart disease.

Listed are chronic systemic diseases that can increase the c-Reactive protein levels in the blood.

We find that the c-reactive protein levels can significantly fall once the periodontal disease is treated which in effect can reduce their risk for heart attacks, stroke, diabetes and low weight preterm babies. In addition to the treatment in our office, we work to boost the body/s immune system by using anti-oxidants. For smokers, we highly suggest to them that they become part of a smoking cessation program. If you are in a high risk category and don’t know your status of periodontal disease then have it evaluated.  The c-reactive protein levels are evaluated by blood tests and since this is important indicator your periodontal status should also be tested.  This is to protect you and your heart.  If you don’t have a dentist you can contact our office at (586) 247-3500.  Our Dental Office is located in Shelby Township, Michigan — Southeast Michigan in Macomb County.

Many of our dental patients in southeast Michigan come with multiple needs and wanted to be treated in very few visits.  Combining cosmetic dentistry, Implant dentistry  under a mild sedation is most beneficial for them. Rather than going to a number of specialists we at The Gentle Dentist in Shelby Towship, Michigan can do this.  The video demonstrates these done on Kathy, a professional who came in with many needs.  This is an outstanding presentation showing the emotional impact of having a beautiful smile and a full compliment of teeth. The smile is the first thing noticed by others and nothing else can compare.