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Sensitive Teeth

SENSITIVE TEETH

This problem often happens when gums recede and/or cementum is not presence.  The gum tissue acts like a protective blanket to cover the roots of the teeth.  As the gums recede the underlying tooth roots are exposed.  They are not covered by hard enamel.  Thousands of tiny dentinal tubules (channels) leading to the tooth's never center (pulp) are than exposed.  These tubules allow more stimuli like heat, cold or pressure to reach the nerve in the tooth and you feel pain!.  Think of your gums and the enamel on your teeth as a down comforter covering and protecting your body from the cool winter air.  Over time, the gums may recede or the enamel or dentin on your teeth may wear down, creating the condition for tooth sensitivity.

Tooth sensitivity is caused by:

	Brushing to hard or with too much pressure which removes gum tissue.  2 our of 3 people brush too hard.
	Aging, sensitivity is highest between the ages of 25-30
	Using a hard tooth brush instead of a soft one
	Poor oral hygiene which leads to plaque build-up around the teeth and gums.  This plaque hardens into tartar.  The bacteria that live in plaque cause  gum disease  and gum recession
	The exposed roots contain small pores or tubules which lead directly to the nerve of the tooth.  Pain, pressure and cold stimuli  can travel down the tubules and trigger the tooth nerve causing pain and discomfort
	Stimulation from hot beverages or foods
	Tooth whitening-often beautiful, but sometimes uncomfortable, at least for a few days
	Hypersensitivy
	Cracked teeth
	Grinding your teeth
	Long term use of mouthwashes such as Listerine or Oraldene damage dentine and cause dentin sensitivity and reverse the beneficial effects of toothpaste
	Enamel erosion by acidic foods
	Root sensitivity can occur after having your teeth cleaned, following root planning , crown placement, or even having fillings.  The good news is this sensitivity will disappear in about four to six weeks
	People with sensitivities to sight, hearing, taste, smell and touch also usually have sensitive teeth. #
	Decreased saliva flow-simple test is to invert the lower lip, dry the mucous membrane off  and see how long it takes for small droplets of saliva to flow from the minor salivary glands.  If it takes more than a minute, the saliva flow is down.
	PH test resulting in an "acidic mouth"
	Dental treatments-simple cleanings, orthodontics or restoration
	Dehydration due to diuretics such as alcohol beverages, caffeine-containing drinks  like coffee and Mountain Dew. There are many other causes, some of which can require a more comprehensive treatment plan...

1. Broken, chipped or fractured teeth
2. Nerve damage in the root, cant' sleep at night-root canal
3. Grinding and/or clenching the teeth-mouthguard
4. Gum disease-begin a comprehensive oral hygiene regimen
5. Receding gums-gum disease and/or oral habits?

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     The key to preventing tooth sensitivity is to keep your gums healthy by reducing the pressure you use while brushing, use a soft toothbrush and to maintain good oral health habits.  This means brushing all your teeth for 2-3 minutes, not the usually 30- 45 seconds that most people brush. Flossing is crucial in order to reach the 35% of the tooth surfaces where brushing can not reach.
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Use a toothpaste for sensitivity.  They work in a cumulative fashion to cover the open tubules.  They contain strontium chloride and/ or potassium nitrate which act to remineralize the tooth surface by diffusing into the open pores (tubules) on the enamel.  This process  helps block transmission of sensation from the tooth surface to the tooth nerve. They need to be used 4-6 weeks before any changes can be noted.

	Continue to practice brushing gently and carefully around the gumline so you do not remove more gum tissue or continue demineralize the tooth surface
	Avoid highly acidic foods like citrus or soda pop that can work against the sensitivity toothpaste
	Brush gently with a soft toothbrush twice/day using a low abrasion desensitizing toothpaste
	Use fluoride mouth rinse to help remineralize the tooth surface.  Fluoride gels and varnish are effective also.
	Don't use a tartar control toothpaste, use a fluoridated toothpaste or desensitizing toothpaste
	Try spreading a thin layer of desensitizing toothpaste on the exposed roots with your finger or a Q-tip before you go to bed
	Avoiding very cold foods
	Monitor intake of fruit drinks or sports drinks that are high in sugar and/or acid; tomatoes; pickles; citrus, pop; tea
	Always use a de-sensitizing toothpaste for 2-3 weeks prior to having your teeth "cleaned" or before having Root Planning and Scaling
	Avoid teeth grinding and clenching by using a nightguard
	Having professional tooth cleaning, oral hygiene instructions and fluoride treatments.  Our office uses ultrasonic scaling to help minimize dentin sensitivity
	Home care must be evaluated and adjusted as necessary.
	Chemical desensitization (Gluma/ Hurriseal / Pain-Free) provided by your dentist is the most common method of treatment.
	Surface sealers or self etch primers (Seal & Protect/Clearfil SE Bond ) can be a costly
	If you drink orange juice in the morning and than brush soon after you may want to either wait at least an hour before brushing, or at least use water only when brushing, then rinse with mouthwash. This gives give time for your saliva to remineralize the enamel.

....................................................................................................................................................................If these suggestions do not give you relief please see your dentist. One way your dentist can gauge the severity of your sensitive teeth is by using the air test.  The dentist sprays the air gum across each area of a your teeth to pinpoint the exact location of sensitivity.  The decision of whether a restoration is needed comes in after an in-office desensitizer has been applied and you have been sent home for a week with desensitizing tooth paste to see whether a more aggressive approach is needed. An in-office desensitizer can be painted or sprayed on.  This is a wuick and relatively painless procedure. Your dentist can apply varnishes; high fluoride mouthwashes and toothpaste or gel; dentin sealer or white fillings (bonding) to cover exposed surfaces and close the pores of the tooth root.

Tooth sensitivity

You don’t have to suffer with sensitivity!!

Delay Brushing After Eating Erosive Foods.
If you are at risk for erosive tooth wear you should avoid brushing your teeth for at least 60 minutes after consuming erosive food or drink such as fruits, salads and sports drinks.
Instead of brushing right after eating erosive foods try :

• 	1.Rinsing with water
  	2. Rinsing with a fluoride solution
  	3.Chewing sugarless gum. # And always remember to brush with a soft bristled toothbrush.

Dental emergencies

some common dental emergencies:

Acute toothache: A toothache is an aching pain in or around a tooth. In most cases toothaches are caused by problems in the tooth or jaw, do not ignore the pain. Seek an appointment with your dentist. The steps outlined below can provide temporary relief: Rinse your mouth with warm salt water and gently use dental floss to remove any food or debris that may be lodged. Do not use a sharp or pointed instrument to remove any debris as this may damage teeth or cause injury. A painkiller may be taken for relief till you consult the dentist. Try massage your aching tooth by hand, this can ease the pain by 50 percent. Place a cold compress on the outside of your cheek to minimise the swelling. A few doctors also recommend the use of cloves and clove oil to soothe the pain. Lost filling: Immediately report to your dentist. As a temporary measure, fill a sugarless gum in the cavity or over the counter dental cements. Dislodged Crown:  Crowns sometimes fall out. This can be caused by a lack of cement or an improper fit. If this happens, place the crown in a secure, zip- top plastic bag. Then bring it to your dentist to have it cemented back in place. If you are in no discomfort and your appearance is not affected, don't try to put the crown back in place yourself. If you do need to put it back in your mouth, clean it well on the inside. Use a toothpick to loosen and remove any cement or debris that is stuck to the crown. A wet cotton swab can finish the cleaning. You can replace the crown temporarily using denture adhesive or temporary cement. This is sold in many pharmacies. Contact your dental office immediately and try to schedule a visit for the next day.  Lost crown: If the crown falls off, make an appointment to see your dentist as soon as possible and bring the crown with you. If you can't get to the dentist right away and the tooth is causing pain, use a cotton swab to apply a little clove oil to the sensitive area. If possible, slip the crown back over the tooth. Before doing so, coat the inner surface with toothpaste or denture adhesive, to help hold the crown in place. Do not use super glue. Dental Abscess: Place a dry black tea-bag or a piece of potato against the sore tooth in for a couple of hours or overnight. This reduces the infection and drains the pus. The result is diminished pain and swelling. Swish your mouth with Hydrogen Peroxide 1.5% as a mouthwash in order to disinfect the inflamed area. In case of abscess discharge brush your teeth (with a baking soda/peroxide toothpaste) and repeat the disinfectant per- oxide gargle. You can assist the drainage by lightly pushing against your cheek near the abscess. BUT, only lightly! If you press strongly you may push pus into the bloodstream or nearby tissues which can cause a more serious infection. Consult a dentist for starting appropriate antibiotics. An oral infection, like tooth abscess is a serious condition and can cause problems in other areas of the body, like inflammation of the heart or facial bones. Seeking medical help is essential. Gum Abscess and Periodontal Abscess:  A gum abscess is the result of irritation caused by toothpicks or other objects or aggressive brushing. Due to a break in the gum surface, bacteria invades the area, causing a local infection. Initially, the area appears red,later the area becomes pointed and filled with pus . You can use salt water and clove oil to temporarily reduce the pain before you seek dental help. Sometimes using mouthwashes and peroxide flushes also bring temporary relief. Antibiotic therapy also causes relief but you should visit the dentist within 24-48 hrs. Broken Dentures or Lost Dentures: Accidents do happen and because dentures are a vital component to daily life, people should have a denture repairs service in mind before they are faced with a denture emergency. Safeguard the pieces of your broken denture and report to your dentist. He is the only person who can fix it. Do not try to use any adhesive or try to repair it yourself.