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When your teeth say “ouch!”: What causes sensitive teeth?

It’s no fun to bite into an ice cream cone and have your mouth say “Ow!” instead of “Yum!”

The Academy of General Dentistry1 estimates that over 40 million U.S. citizens regularly or periodically experience tooth sensitivity. But what does having sensitive teeth mean?

Tooth sensitivity, sometimes referred to as dentin hypersensitivity, can be caused by worn enamel, gum recession, a bad reaction to a toothpaste or mouthwash, or a recent dental procedure. Even some generally healthy practices—such as eating citrus fruits or crunchy almonds, or brushing one’s teeth—can aggravate sensitivity.

Fortunately, there are ways to minimize pain and prevent further sensitivity issues.

How to pinpoint the cause of tooth sensitivity

Rule out underlying dental health issues

If tooth sensitivity attacks suddenly and lasts more than a day or two, you may have a cavity, chipped tooth, or another undiagnosed oral health problem. Make an appointment with your dentist to screen and address any potential issues.

Watch your diet

There are at least four ways diet may contribute to tooth sensitivity:

  1. Sugar: Many less-than-healthful foods, like sweets and starchy carbohydrates like white bread, stick to teeth and encourage plaque buildup.
  2. Acid: Healthy but acidic foods, such as citrus fruits, strawberries, pickles, and grapes, can erode tooth enamel and irritate exposed nerves. This effect is more pronounced when consuming acidic foods in liquid form, like orange juice.
  3. Physical Stress: Hard and crunchy foods, such as whole almonds and baby carrots, can wear down or even crack enamel.
  4. Temperature: Very cold or hot foods and liquids induce the shock of sudden temperature change, which jolts nerves and may crack thin enamel.

If you’re suffering from tooth sensitivity, try limiting your exposure to the above foods for a week or two. You can eat bananas instead of grapefruit with breakfast, for instance, or drink coffee through a sip-top cup or straw, to see whether your tooth sensitivity lessens.

The good news is that you may not have to give up your favorite foods permanently. There are a few more options for lessening tooth sensitivity without making dietary changes.

How to reduce tooth sensitivity

Rinse your mouth after eating but before brushing

Acids weaken tooth enamel. Acids not only come from eating acidic foods directly. They can also come from eating sugary foods or simple carbohydrates like white bread by encouraging the buildup of plaque, a sticky white film that builds up from bacteria on your teeth, feeds off of sugar, and creates acid2, which may lead to cavities.

To lessen the harmful effects of acidic or sugary foods, end every meal with a glass of water. Swish it around evenly in your mouth to wash away what you can in-between brushings.

Soften harder foods

Almonds and carrots are great for your overall health, but they can put a serious strain on your tooth enamel. To enjoy foods that are traditionally eaten in their harder form, cook or soak them just enough to reduce the hard crack to a gentle crunch before eating, or try them grated, diced, or slivered instead of in full-size pieces.

Watch what you bite down on

Healthful but hard foods may not be the only ones that can break tooth enamel; for instance, no hard candy should ever be bitten into, as doing so may break your teeth or cause them to chip.

Floss nightly

Everyone knows it, and too many neglect it: flossing your teeth daily is vital to tooth and gum health. Flossing removes food particles your toothbrush can’t reach, especially if you have gum recession, which leaves more open spaces. Food particles not cleared away through brushing and flossing contribute to the buildup of plaque, cavities, tooth sensitivity, gingivitis, and more.

That being said, overenthusiastic flossing can increase gum recession and sensitivity. Work gently around the gum line; it’s not necessary to use strong pressure. Use shred-resistant floss, as cheap brands may leave new particles stuck between your teeth. Alternatively, invest in an electric water flosser.

If flossing causes significant bleeding, make sure to call your dentist. Bleeding gums may indicate periodontal disease , a serious gum infection that damages gums and can destroy the jawbone.

Brush correctly

Similar to flossing, make sure to brush your teeth gently to avoid damaging your teeth and gums. Use a soft bristled toothbrush, and spend at least two minutes going over the gum lines ,not just the tooth enamel, thoroughly. If you find yourself brushing too hard, an electric toothbrush can help encourage gentle but thorough brushing.

However, if you have sensitive teeth, brushing itself may be significantly painful. If brushing is uncomfortable for you, try changing toothpaste. Also, avoid ‘whitening’ toothpastes, as these typically contain abrasives that can further increase tooth sensitivity.

Cutting down acidic foods is ideal, but when you do eat acidic foods, avoid brushing your teeth immediately after. Since acid weakens tooth enamel, brushing immediately after consuming acidic foods or drinks can further damage tooth enamel. Try waiting at least an hour after eating to brush.4

Lastly, brushing with lukewarm water can be more comfortable than cold water.

If the pain persists, and especially if you begin to avoid brushing due to discomfort, see your dentist for professional advice.

Choose the right toothpaste

There are toothpastes sold for many specific purposes, including sensitivity reduction. These typically contain ingredients that help seal nerve channels in the teeth and gums. Some sensitivity toothpastes are sold by prescription, so ask your dentist for recommendations. Follow all directions carefully.

Other toothpastes may aggravate sensitivity. For instance, “whitening” brands frequently contain chemicals or abrasive substances that are abrasive on thin enamel. If white teeth are important to you, ask your dentist for advice on balancing whitening and sensitivity treatments.

Take care between brushing

It’s not always possible to find time and equipment for real brushing, especially during long hours in an office or other public places. When packing or buying lunch, avoid foods that stick,  stain, or that have high acid or sugar content. Softer, fibrous foods that require active chewing (which stimulates saliva flow) are best for minimizing plaque-buildup risk. 

High-calcium foods can also be helpful. Some examples include salads with minimal dressing, cheeses, fish, and soy proteins. Chewing sugar-free gum with acid-neutralizing xylitol after meals will clean your mouth further.

Get a mouth guard

Another common contributor to tooth sensitivity is tooth grinding. If you regularly wake up with a sore jaw, you may be grinding your teeth in your sleep. The best preventive measure is a mouth guard that fits over your upper teeth to reduce friction.

Generic, one-size-fits-all guards are available, but it’s better to invest in a custom-fitted one made from a mold of your own teeth to ensure comfort and thus compliance.

Women’s dental health

Tooth sensitivity tends to increase in the week immediately before menstrual periods and during the first few days of menstruation. Be extra careful to gently brush, floss, and limit acidic foods during this time. Ideally, schedule dental appointments shortly after the end of menstruation to minimize pain and bleeding during treatment.

In extreme circumstances

Even with all the above measures, some tooth sensitivity can’t be treated with conventional means. In the worst cases5, a dentist may even recommend surgery such as gum grafts or a root canal. Such procedures are uncomfortable and expensive, but the relief for patients can be worth it.

Get regular dental screenings

Whatever the source of your own sensitivity problem, or however it is eventually resolved, remember: there is no substitute for regular visits to a good dentist! Find a dentist in your area to help address your teeth sensitivity issues. If you have concerns about your current dental insurance coverage, it is important to review your policy.

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1. (Last accessed January 2020)
2. (Last accessed January 2020)
3. (Last accessed January 2020)
4. (Last accessed January 2020)
5. (Last accessed January 2020)

Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.

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