Sensitive teeth: what it actually means

Most people treat sensitivity with a special toothpaste and hope. Sometimes that is exactly right. Sometimes it masks something that is getting worse.

What is physically happening

Under the enamel is dentine, and dentine is full of microscopic tubules running inward toward the nerve. When enamel wears away, or the gum recedes and exposes root surface, those tubules open. Cold, sweet and pressure travel down them and the nerve reports it as a sharp jolt.

Reading your own symptoms

• Sharp, brief, stops immediately — classic dentine sensitivity from recession or wear. Usually manageable.
• Sharp on cold, then lingering for a minute or more — the pulp is inflamed. This one is heading somewhere and should be examined.
• Sensitive to sweet things specifically — often a cavity.
• Pain on biting down, or on release — suspect a cracked tooth or a failing filling.
• A whole quadrant sensitive at once — usually gum recession or aggressive brushing rather than one bad tooth.

The most common cause is not what people expect

It is brushing too hard, with a hard brush, often straight after acidic food or drink. That combination scrubs away enamel and drives the gum upward. Softened enamel takes around an hour to re-harden after something acidic — brushing inside that window removes it.

Use a soft brush. Hold it like a pen rather than a scrubbing brush. Wait an hour after anything acidic.

What actually helps

• Desensitising toothpaste used properly — smeared on the sensitive area with a fingertip and left, not brushed and rinsed away. Give it two weeks.
• A soft brush and lighter pressure
• Cutting the frequency of acidic drinks rather than the quantity
• Treating the underlying cause — a filling, gum treatment, or a night guard if you grind

When to stop self-treating

If it lingers after the trigger is gone, if one specific tooth is much worse than the rest, if it wakes you at night, or if it has not improved after three or four weeks of doing the right things — have it examined. Desensitising toothpaste over a deepening cavity buys time you do not want to buy.

General information only. It is not a substitute for an examination — book an appointment for advice about your own teeth.