Sensitive Teeth

sensitive, dentists prefer to talk about dentinal hypersensitivity. This condition recognizes pathological causes; in this case, sensitive teeth may be a sign of:

Wear of enamel from bruxism (night grinding), excessive frequency or intensity of tooth brushing, etc .;
Incipient or advanced caries (depending on the patient's sensitivity threshold);
Major dental trauma or repeated microtrauma.

or non-pathological, as a result of:

Gingival recession from too aggressive and technically incorrect brushing, or from gingival inflammation);
Some dental therapies (eg scaling) and periodontal surgery;
Physiological variant in hypersensitive patients, i.e. with a low pain threshold.

Dentin hypersensitivity is that sensation of discomfort, and sometimes pain, caused by the exposure of the teeth to physical stimuli (hot and cold), chemical and osmotic (sweet and salty), and mechanical (contact with the toothbrush).

, a white, very resistant and mineralized tissue, which has the task of protecting the tooth from external aggressions.

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This protective layer can be eroded, however, by the acids produced by bacterial plaque, by particularly acidic foods (grapefruit, fruit salads, oranges, lemons, iced teas, orange juice, juices, carbonated drinks, tomatoes, etc.) or by use. inappropriate toothbrush or harsh toothpastes (such as whitening ones).

Under the enamel there is dentin, a very resistant yellowish bone tissue, which has the function of protecting the underlying pulp from temperature variations and mechanical stress.

Sensitive teeth: possible causes

Clumsy oral hygiene due to too much strength with toothbrushes with too hard bristles
Toothpastes that contain too much abrasive substances, such as whitening ones
Incorrect use of dental floss
Gastric acids in patients who have gastric reflux or bulimics (because they voluntarily vomit)
Acidic foods and drinks (fruit, fruit juice, yogurt, cola)
Night grinding (clenching teeth while sleeping)
Poor oral hygiene which causes inflammation and retraction of the gums

When the layers of enamel and dentin thin out, then the aforementioned stimuli indirectly reach the innermost dentinal layer, which covers the dental pulp, a structure particularly rich in blood vessels and nerve endings. The dentin is in fact crossed by microscopic canaliculi called tubules, connected to the pulp, vital and sensitive, where there are nerve endings that once irritated cause pain.

. In such circumstances, the collar of the teeth is discovered, ie the transition area between crown and root, normally protected and "sealed" by the gum. As a result, we witness the exposure of the dentin of the dental necks, tender and porous, therefore sensitive to painful stimuli - such as cold, heat or pressure - that are transmitted to the pulp nerves through the tubules contained in the exposed dentin. In the deeper layers, moreover, the dentin is no longer covered by the enamel, but by a thin layer of amorphous matrix and collagen fibers.

and specific toothpastes, containing fluoride or other remineralizing substances, capable of relieving sensitivity and protecting damaged enamel. As it is known, in fact, fluoride exhibits a "mineralizing action on the surfaces of the dental enamel (" hardening ") of young people and of remineralization on that of adults. This action is positively associated with a slight anti-plaque power and a "clear desensitizing activity (in adults), as it determines the formation of a layer of calcium fluoride which forms a protective, remineralizing and desensitizing film. Some specific fluoride toothpastes. for sensitive teeth, they are found in gel form, to be spread two or three times a day on the teeth without rinsing. In the presence of sensitive teeth, toothpastes based on hydroxyapatite, a natural component that acts by creating a physiological barrier against hypersensitivity, are also potentially useful , plaque, tartar and caries. Not surprisingly, hydroxyapatite is the main component of bones and teeth.

In cases of greater dental sensitivity, there are also professional interventions, based on the application of fluorinated resins that seal the dentinal tubules. These preparations are applied to sensitive areas of the enamel. The dentist can also use electro-medical devices (laser, iontophoresis) to promote dental remineralization and the closure of canals, while the "last resort" for the "cure" of sensitive teeth is devitalization (to be avoided, if possible). Finally, if the sensitivity is caused by gum recessions, it is possible to treat the problem with gingival surgery, in order to provide a new root coverage and protection that can solve the problem of sensitive teeth.