It describes the phenomenon of hypersensitivity of the teeth when eating or drinking something cold-hot-sweet-sour, causing a sharp pain for a few moments, which generally disappears after a few seconds, and repeated again with the stimulus. It can be a temporary, non-recurrent or permanent phenomenon that interferes with the functioning and quality of life of people who suffer from it. Each group has its own characteristics and treatment methods.
Temporary and transient sensitivity: It usually occurs due to extreme temperature. Or after dental treatment.
Extreme temperatures (cold / heat) cause the tooth to contract or expand causing excessive stress to the tissues of the teeth, which have passed the tooth holding limit, especially with extreme cold (with very cold water or different types of ice cream) Think is like having ice in the hand after a few seconds we cannot withstand the cold, and we throw the ice immediately, This hypersensitivity can appear in children and adults, and there is no need for any treatment for this, and passes after a few seconds. Another condition is a tooth with metal restoration that the percentage change in volume at different temperatures of the tooth and reconstruction causes pressure of the reconstruction material to the dental tissue and therefore the nerve responds with acute pain. The metal reconstructions called amalgam also transfer the temperature directly through the metal to the inner part of the tooth so it is better not to use them when there are white and esthetic substitutes that prevent these phenomena. As long as the phenomenon passes by itself and does not recur again and again, it does not require special attention and there is no need to treat it.
Greater sensitivity after dental treatment: After removing scaling tartar or after the periodontal treatment, the root exposed due to retraction of the gums suffers from hypersensitivity and generically passes over time, and if the sensitivity increases over time you should return to the clinic for review and receive new instructions on how to help overcome the problem. A different cause of hypersensitivity is after the tooth is treated to eliminate tooth decay and restore. Sometimes the act of removing tooth decay and approaching the pulp “stimulates” and can cause more sensitivity in the first few days after treatment and over within a week and there is no need for treatment for this. Hypersensitivity may also occur due to the material with which the tooth has been restored after removing cavities and this is different if the material is metallic or if it is white. When the tooth is restored with metal restoration “amalgam” the temperature is rapidly drawn to the depth towards the nerve. Therefore, the pulp has the ability to overlap to cope with the strong stimulus when we feel the intense pain, so this induces the teeth to defend themselves and build a defensive bar of dentinal tissue over time, and thus the sensitivity decreases with time within two months. In the event that it does not pass or increase over time, it is necessary to approach the clinic for an examination in order to make a smart decision about the preferred treatment in that specific case. In case the sensitivity has passed and appears from time to time due to the extreme temperature, there is no need for any treatment because it is a phenomenon that cannot be eliminated. When the tooth was restored with white material and the sensitivity does not pass after a week of treatment it may be that there is an area where the material does not seal the tooth and you have to go to the clinic to replace the restoration due to the white material of tooth-like tone cannot be differentiated with the tooth tissue and it is impossible to know where exactly the sealing has failed, therefore it is desirable to remove the restoration and make it again.
Permanent or chronic hypersensitivity those who suffer from it, are reluctant to extreme temperatures, and are waiting for food or drink to reach the desired temperature for them and avoid the phenomenon of repetitive pain and this is very important to diagnose what is the source of sensitivity to adjust the correct treatment for the relief or disappearance of hypersensitivity
The reasons for permanent hypersensitivity are very different, and may be due to cavities, improper restorations, dental cracks, dental erosion and retraction of the gums. That is why your treatment is very different according to the source of the problem and only a dentist can diagnose the cause and decide the treatment.
Caries: Because tooth decay can respond with great sensitivity or pain with radiographs, caries can be verified, caries removal and tooth restoration is made.
Inadequate Restorations: Restorations also suffer from wear and tear and may rupture, lose their sealing, which will eventually cause more sensitivity requiring replacement of the restoration to resolve the problem.
Cracks or fissures in the teeth: a challenge for the dentist to diagnose the hypersensitivity that comes from a crack or fissure in the tooth, usually cannot see cracks in the radiograph, or clinically, since the thickness of the crack may be only a few microns and nowadays with the no existing technology there is no way to see them, however, this cannot always be solved immediately, only a control will be followed and the treatment will be with substances that calm the hypersensitivity and when this fissure increases over time sometimes after weeks or months until a good day a corner or a particular region of the tooth falls and just at that moment confirms the diagnosis that was a crack or fissure that we could not identify or locate at the beginning and the treatment will restore and complete the tooth.
Teeth Erosion : may cause more sensitivity. Loss of dentinal tissue by abrasion, traumatic tissue loss caused by too strong brushing, using hard, unrounded brushes or tooth whitening toothpastes. Of course, it is necessary to prevent the reuse of the cause of the problem in order to stop the deterioration process, and of course the solution will adjust to the severity of the damage the therapeutic treatment, is to use hypersensitive toothpaste and restorations when the situation aesthetics is very serious. Abasion: The effect is similar to tooth decay because of its acidity and is caused by acidic foods. These foods include all types of citrus fruits, pomegranates, tomatoes, pickled pickles, alcohol (due to fruit fermentation, with acidic pH) the patient often complains that even inhaling air causes pain. This treatment is usually done with pastes and substances in the clinic or at home that induce the teeth to build and re-seal the dental tissue. The process is very slow because it takes three times more time to repair itself from the moment the damage was caused. Destruction is faster, than reconstruction is more difficult and requires more time.
BRUXISM due to the friction of teeth especially at night, when the upper part of the tooth is lost, and causes closeness and exposure of the dentin close to the pulp. This process speeds up the loss of dental material. Treatment is the use of a night plate guard to avoid further deterioration and more serious damage that will be difficult to repair later.
Gums Retraction : Retraction of gums from the line of conjunction of the tooth between the crown and the root towards the apex of the root brings as a consequence a root exposed to the stimulus and attacks of plaque. Retraction can occur due to trauma, may be natural / genetic or due to periodontal disease. The exposed root of dentin tissue (the tissue that seals the nerve) is composed of minerals and organic material with channels and dentinal tubules that are extensions of the nerve of the tooth outward to the dentin, these tubules must be sealed, but the stimulus of temperature is transferred quickly and directly to the nerve that causes acute pain or sensitivity. The loss of sealing may be due to abrasion or erosion or combination of the two factors. Most of the trauma of brushing, combined with foods that dissolve the seal, causes the underlying sensitivity to appear due to retraction of the gums. The treatment is mainly to avoid damage and the treatment is the use of toothpaste for hypersensitivity and other materials that induce the tooth to re-seal these channels again. Of course, only a dentist can diagnose the source of the hypersensitivity and adjust the necessary treatment.
