Why do teeth react to cold, hot, sour, sweet and what to do about it?

During pregnancy

This is by far the most beautiful moment in every woman’s life is associated with numerous difficulties.
In particular, representatives of the fair sex who are carrying a fetus often exhibit hyperesthesia. This happens as a result of increased stress on the body, hormonal imbalances, metabolic disorders and decreased immunity. While studying available materials, how to soothe sensitive teeth and what to do at home, know that you cannot ignore alarming manifestations. Getting rid of pain and discomfort on your own is very difficult and often unsafe. Especially considering the position of the expectant mother. When pathology is discovered during pregnancy, you must immediately contact a specialist. Only an experienced dentist will be able to prescribe appropriate therapy and a course of health procedures.

Ideally, the condition of dental elements should be taken care of at the stage of maternity planning. Accustom yourself to preventive procedures, eat right, and don’t be afraid to visit the dental office once again. It is necessary to introduce into the diet foods enriched with vitamins C and D, magnesium and calcium.

As a reaction to hot and cold

This is the first sign of hypersensitivity. The range of sensations in this case can be different, from sharp, bright pain in one point, which quickly disappears, to a prolonged pain syndrome of a weak nature in several at once. Manifestations can be caused by minor thinning of the enamel layer or more serious pathological processes. This is why you should not put off going to the doctor. Only a professional will be able to understand the problem and recommend effective methods for eliminating hyperesthesia. If a pathology is discovered, the doctor will carry out appropriate treatment, and he will decide what to do and how to treat highly sensitive teeth only after examining the patient.

Causes of hyperesthesia

Dental hypersensitivity is caused by many factors and may indicate problems with the teeth and periodontal tissues. Hypersensitivity is one of the most common diseases in dental practice and, according to WHO, is increasing every year.

The mechanisms of the occurrence of pain syndrome due to irritating factors stimulate increased interest among both researchers and practicing dentists, prosthetists, and hygienists. This attention is explained by the fact that pain is a key symptom of most dental diseases. However, the increased susceptibility of hard tissues cannot be justified by the known pathways of nerve signal transmission. This fact prompted a series of studies to be carried out, which resulted in several theories of the development of hyperesthesia:

• odontoblastic;
• receptor;
• threshold;
• hydrodynamic.

Sufficient evidence has been collected in favor of the hydrodynamic theory. It is supported by most dental clinicians. The dentinal tubule, according to theory, is considered as a capillary tube containing fluid inside.

Exposure to air, high temperatures, etc. it shifts, the pressure in the dentin changes. This leads to increased activity of nerve endings. Penetration of irritants into the tubules is possible when dentin, the main hard tissue of the tooth, is exposed. It is exposed not only against the background of carious lesions and diseases of periodontal tissues, but also as a result of non-carious defects: hypoplasia (underdevelopment of teeth), enamel erosion, etc.

How to treat and eliminate tooth sensitivity at home

Before starting therapeutic measures at home, you should consult with your dentist. Usually, doctors strongly recommend using only professional remedies to eliminate the problem. Among them:

• "Fluocal".
• "Diplen Denta F."
• "Profokar" and others.

Yes, they are sold freely in pharmacy chains, without a prescription, but it is still necessary to first listen to the recommendations of a specialist. After all, these drugs are characterized by a high fluoride content, and this substance may be contraindicated in some categories of patients.

Remember, hypersensitivity itself is not a disease. But it is precisely this that acts as a consequence of the course of pathological processes. To reduce the risk of dental problems, you must first make an appointment with a doctor.

When starting home therapy, do not forget that you have to strengthen and restore dental elements not only from the outside. Their condition is directly affected by everything that happens to our body from the inside. To speed up recovery, you should take medications prescribed by your doctor, and also review your diet plan and introduce foods enriched with beneficial compounds into it.

If hyperesthesia worsens, try to eliminate possible irritants. In some situations, it is advisable to choose a brush that is more suitable for hygiene procedures.

When figuring out how to relieve severe tooth sensitivity at home, and what to do if alarming symptoms appear, do not forget that you need to strengthen not only bone tissue, but also gums. After all, the health of the oral cavity largely depends on their condition.

Hypersensitivity after tooth filling and preparation for dentures

Most often in dental practice, increased sensitivity is observed after filling. Patients come to the clinic with complaints of sensitivity, especially to cold, without precise localization of pain. Upon visual examination, sensitivity in the basal part is not detected. There is no evidence of open pulp or caries on the x-ray.

The causal unit, however, can be identified. To do this, use ice, which, wrapped in a paper napkin, is applied to the cheek area or to the surface of the tongue. An area with a violation of integrity in hard tissues is a source of irritation, so severe pain occurs in the tooth. Removing all filling material will allow you to detect the break.

The reason for increased susceptibility, often to cold or too hot food, may be the appearance of microgaps between the filling and the hard tissues of the tooth due to compression of the composite material. The gap formed in the cavity near the root canals opens up space for the movement of dentinal fluid, thereby causing a response from the nerve endings of the pulp.

The area of ​​contact of the material with the walls of the internal space of the tooth can also contribute to the formation of hypersensitivity after filling. Since filling composites have a high elasticity index, they cause stress in the contact layer “filling - hard dental tissue”. The tension in the tooth tissues is greater in cases where the surface of the restoration in contact with the walls is extensive.

After preparation (grinding) of a tooth for prosthetic structures and microprostheses, normal sensitivity is observed, which is characterized by mild pain. If there is no inflammatory process in the pulp, the pain is considered causative and disappears a few minutes after the drill stops working. If hypersensitivity persists for a long time (2 or more days after the procedure), treatment of pulpitis is required.

Provoking factors for the development of dental hypersensitivity

Most often, increased sensitivity is a consequence of a violation of the integrity of the enamel or destruction of the hard tissues of the teeth, which increases the risk of irritation of the endings of the nerve fibers.

The key provocateurs are caries lesions, exposure of the necks and roots of the teeth. Hyperesthesia is diagnosed as a sign of a number of non-carious lesions - enamel defects, progressive loss of enamel and dentin with a decrease in crown height, local destruction, acid necrosis, traumatic injuries, periodontitis with an aggressive course, metabolic disorders of the body, endocrine diseases, mental disorders.

The disease can also occur when consuming large quantities of acidic foods and drinks. Under the influence of acids, the enamel softens and loosens, and erosion appears on its surface.

Increased sensitivity of teeth can be observed after removal of hard dental tissues in order to create a prosthetic space for metal-ceramic structures.

One of the provoking factors is bleaching, during which aggressive chemical bleaching agents are used.

The most common provoking factors also include:

• pulpitis, other dental diseases or pathological conditions that cause destruction of tooth enamel;
• disruptions in the body caused by uncontrolled use of hormonal drugs;
• stress;
• chronic gastrointestinal diseases;
• malocclusion;
• incorrectly selected hygiene products (hard bristled brushes, highly abrasive paste);
• bad habits.

The tooth reacts to sour: what to do and what are the reasons

If your teeth react to sour foods, or discomfort occurs when eating sour foods, immediately seek help from a dental clinic. The doctor will conduct a comprehensive diagnosis, determine the type and complexity of the problem, and prescribe adequate treatment that will help eliminate pain and discomfort.

Note! With increased tooth sensitivity to acid, it is not the enamel (protective layer) that becomes sensitive, but the dentin (loose layer), in which the neurovascular fibers are located. Pain can be caused by various reasons: from mechanical damage to the protective enamel to diseases of the gastrointestinal tract. The exact cause can only be determined after a comprehensive examination of the patient. Dentists note that in 95% of cases, the cause of hypertension is the following factors:

• Mineral deficiency is accompanied by gradual weakening, demineralization and subsequent destruction of hard tooth tissues. The main symptom of mineral deficiency in the early stages of the problem is increased tooth sensitivity to acidic foods;
• Pathogenic microorganisms - the penetration of pathogenic microorganisms into the mucous membrane of the oral cavity can provoke intense release of acid, which aggressively affects tooth enamel. The acid penetrates the protective barrier of the enamel and causes a pain reaction in the nerve bundle inside the tooth;
• Gastrointestinal dysfunction is one of the most common causes. A number of diseases of the human gastrointestinal tract can provoke a change in the composition of saliva - this composition has a destructive effect on the enamel (gradually destroys it) and increases the overall sensitivity of the teeth. In this case, the reaction will be not only to sour, but also to sweet, as well as temperature changes (cold/hot);
• Caries is the most common problem that causes tooth pain from sour foods. It is accompanied by carious lesions of the enamel, with further spread deep into the hard dental tissues. With the development of caries, the intensity of pain increases;
• Mechanical injuries - chips, cracks and microcracks in the protective enamel, are the gateway for the penetration of acid into dentin, which causes an increased pain reaction of the tooth to the irritant.

In addition to the above problems that can cause tooth pain after sour, it is also worth noting: pulpitis, malocclusion, pathological abrasion of teeth, wedge-shaped defect, diseases of the endocrine system, genetic predisposition, pathologies of the nervous system, etc.

Diagnostics

When diagnosing dentin hypersensitivity, it should be borne in mind that it is often a symptom of a disease. Therefore, when a patient approaches, the dentist begins treatment with a survey, during which he receives answers to the following questions:

• duration and nature of the pain syndrome;
• number of units with dentin sensitivity;
• localization of increased susceptibility;
• characteristics of stimuli that cause pain.

After the examination, the patient is required to undergo probing of sensitive areas and other diagnostic tests (thermal, electrical, osmotic, evaporative), as well as percussion (tapping on individual areas of the tooth). At the same time, they find out whether the element is sensitive when biting, identify microcracks in the enamel, damage inside and around the filling, malocclusion, and signs of bruxism.

In addition, diagnostics are carried out using hardware methods and “hidden” carious lesions and periapical changes are identified if they are present.

Much attention is paid to determining the level of pain and the degree of tooth sensitivity:

• no pain;
• mild discomfort;
• medium intensity;
• severe pain or unbearable.

The patient's pain reaction may occur to a greater extent to thermal stimuli (cold, heat), tactile (tactile), evaporative (air), electrical or osmotic (solutions of weak acids).

Dentists note that the reaction most often occurs to cold, brushing teeth, heat and sweets.

The more dentin is exposed due to dental diseases and other factors contributing to enamel loss, the higher the degree of hyperesthesia. This is explained by the fact that in completely exposed dentin there are more dilated tubules with open holes.

Why is this happening?

The most common causes are the following factors:

• Presence of carious cavities. In this case, pain occurs when eating. Discomfort extends to the entire dentition.
• A cyst localized on the root of a tooth. When it reaches its maximum size, the neoplasm can compress the nerve endings, which is what causes this alarming sign.
• Inflammation of the pulp. In the presence of this dental disease, acute, unbearable radiating pain occurs. The problem is only in one tooth, but it feels like the entire dentition is bothering you.
• Enamel hyperesthesia. We are talking about increased sensitivity of units. When eating foods that are too hot, cold, sour or sweet, a person feels severe pain.
• Trinitarian neuralgia. The most common cause of this symptom. The pain is very piercing; there is a feeling that absolutely the entire lower part of the face, including all the teeth, is bothering.

There are also a number of pathological processes that are not dental. For example, we can talk about ear pain. Discomfort spreads to the jaw, the pain is throbbing and acute. Having eliminated the root cause (that is, inflammation in the ear), pain in the oral cavity will go away on its own; no separate treatment is required.

Initial measures to eliminate signs of hyperesthesia

To eliminate unpleasant sensations, the doctor primarily gives the patient the following recommendations:

• exclude predisposing factors;
• do not consume food acids, that is, refuse those products that contain them;
• Carry out hygienic teeth cleaning long before or after meals;
• Reduce the time you spend brushing your mouth to one minute and use a soft-bristle brush.

The patient's teeth are treated with desensitizers. They reduce the sensitivity of teeth of various etiologies by sealing the dentinal tubules. The use of special toothpastes is prescribed.

When the root and neck of a tooth are exposed, mucogingival surgery (vestibuloplasty, etc.) is used to correct gum recession. During surgery, the soft structures of the oral cavity are moved to those areas that require restoration.

For pulpitis, the doctor resorts to pulpotomy. During a dental operation, the pulp is partially amputated using a vital method. At the same time, that part of it that is located in the root canal remains viable.

If sensitivity to irritants persists, additional diagnostics are carried out to exclude chronic pain syndrome, and a more effective treatment plan is drawn up.

Prevention of tooth reaction to sour foods

The best way to get rid of an unpleasant dental problem is timely prevention, which allows you to prevent the development of factors that provoke increased tooth sensitivity to sour foods.

Prevention of tooth sensitivity to acid is classic and involves a number of measures that significantly reduce the likelihood of hypertension. The best prevention is considered to be:

• Regular oral hygiene - it is recommended to clean the crop using special hygiene products (toothpaste and toothbrush) at least 2 times a day after meals. This approach prevents the accumulation and development of pathogenic microflora in the oral cavity with all the ensuing consequences;
• Timely contact with the dentist - if you have any dental problems: darkening of the enamel, bleeding gums, exposure of the neck of the tooth - contact your dentist immediately. Eliminating the root cause of the problem will help avoid increased tooth sensitivity;
• Correction of the daily diet - if the diet contains a large amount of acidic foods, it is necessary to reduce the amount of them taken. Excessive consumption of acidic foods can lead not only to increased sensitivity or pain in the teeth, but also to a whole range of other problems, including gastrointestinal problems.

To avoid wondering why your teeth hurt after eating something sour, take preventive measures in advance. If this problem occurs to you periodically, consult your dentist. He will collect anamnesis and conduct an examination. It is highly likely that the problem can be prevented without dental treatment.

Treatment methods for tooth sensitivity

For treatment, medications, combination therapy, complex therapy and physical methods are used.

Algorithm of the doctor’s actions in the treatment of dentin sensitivity:

• decreased excitability of the neuroreceptor apparatus of the dental pulp;
• decreased dentin permeability;
• blocking the entrances and obstructing the lumens of the dentinal tubules;
• mineralization of hard tooth tissue.

Based on the clinical picture, complex therapy may be prescribed, including obturation of the lumens of the dentinal tubules and electrophoresis with sodium fluoride solutions. The entrances of the tubules are closed with resin-containing or salt-containing desensitizers.

Laser therapy, a procedure for reducing pores using remineralizing gels, restoring gums in case of receding gums, filling teeth in places where the protective layer is thinning, and coating the enamel with fluoride varnish can also be used.

At home, the patient is recommended to use pastes containing strontium chloride, potassium nitrate, and sodium citrate for hygienic care.

Medication treatment at home

Dentists consider the use of special gels, rinses, and toothpastes with or without very mild abrasives to be effective treatment at home.

When treating hypersensitivity, potassium nitrate is recognized as the most effective remedy. The therapeutic effect when using hygiene products that contain it occurs as a result of the penetration of potassium ions into the dentinal tubules, where they accumulate, surround the nerves in the pulp areas of the tubules and block their activity, thereby reducing the excitability of the nerve endings.

To achieve the effect, it is recommended to maintain a high concentration of potassium nitrate on the surface of the causative tooth or group of teeth. Potassium nitrate can be used as a solution, gel, paste, or other oral hygiene products.

When using toothpastes containing potassium nitrate or chloride and sodium monofluorophosphate, as when using potassium nitrate alone, hypersensitivity to tactile stimuli and cold air is reduced.

If, after two weeks of daily use in the morning and evening, the therapeutic effect of brushing teeth and applying products containing the substance is not observed, then the patient is recommended to wear mouth guards. They are filled with the same compositions and worn at night. Symptoms of hyperesthesia disappear after two weeks.

Also, positive dynamics in home therapy for hypersensitivity are shown by hygiene products that contain fluorides, strontium salts (chloride or acetate), calcium glycerophosphate or hydroxyapatite.

Sources used in writing the article:

• “Modern aspects of pain and local anesthesia in dentistry” (2003), Duiseeva G. Sh., Ruzuddinov S. R.
• “Dentistry: a textbook for universities” (2008), ed. N.N. Bazhanova.
• "Occlusion and Clinical Practice" (2008), Jaeger Klinenberg

Please rate this article

Stanislav Mezheritsky

Chief physician, surgeon, orthopedist

The author of the article is Stanislav Mezheritsky, a practicing dentist with 19 years of experience, chief physician and one of the founders of the Matisse Dent clinic. The main focus is orthopedic and surgical dentistry. Author of numerous publications, regular participant in specialized seminars.

Tooth sensitivity (hyperesthesia)

Encyclopedia of Health / Encyclopedia of Diseases

In general, there is nothing wrong with excessive sensitivity - but only if it is a property of your character, and not of your tooth enamel. If teeth react painfully to cold, sour and sweet foods, this can and should be dealt with.

What exactly hurts?

The pain with hyperesthesia of tooth enamel is short, no longer than 30 seconds, but at the same time stinging and sharp, like the blow of a dagger.

If more than a quarter of all teeth have excessive sensitivity, they speak of generalized hyperesthesia; if less, we are talking about a localized form.

Where does this pain come from? It is not the tooth enamel that is highly sensitive, but the looser layer underneath it, the dentin. Enamel, like strong armor, protects this vulnerable tissue from the aggressive effects of various factors. However, for a variety of reasons, tooth enamel can become thinner and even destroyed, and then the dentin remains defenseless.

However, destruction of tooth enamel alone is not enough for the development of hyperesthesia. Inside the dentin there are thin microtubules through which nerve endings pass. As long as these tubes are closed, the teeth are in relative order (even if there are enamel defects, nothing hurts). But when the dentinal tubules open, exposing the nerve endings, a sharp piercing pain occurs in response to any irritant.

Nature's mistakes and our own

Nervous and endocrine diseases, as well as special hormonal conditions (menopause, pregnancy), in which disturbances of mineral metabolism occur in the body, can make teeth too sensitive. Therefore, it is extremely important to determine your overall health before starting dental treatment. This is the key to not only more effective, but also safer treatment. The fact is that formulations containing fluorides, which are used to combat hyperesthesia, especially in high concentrations, can lead to hypofunction of the thyroid gland if the condition of this organ was not normal. So if you have sensitive teeth and your mouth is full, before visiting the dentist you should also visit an endocrinologist.

Other causes of hypersensitivity often include various dental problems: caries, erosion and cracks of enamel, wedge-shaped defects and bruxism (teeth grinding during sleep). Also, teeth can “become sensitive” if gum atrophy has occurred and their neck is exposed - then the roots of the teeth remain not covered with enamel. This happens due to periodontitis, as well as the characteristics of the bite.

Sometimes we ourselves are to blame for hyperesthesia: for example, if we really like sour foods and carbonated drinks that destroy tooth enamel. The habit of eating very cold and hot foods, as well as improper oral hygiene, also lead to cracks in the enamel. Moreover, the enamel can suffer not only from poor or irregular brushing of teeth, but also from excessive zeal in this matter.

Do not press the brush too hard on your teeth, and do not use brushes with hard bristles or toothpastes that contain a high percentage of abrasiveness.

For prevention

• Pay attention to your diet. The diet must be balanced so that the body does not lack minerals. By the way, one of the causes of hyperesthesia is a deficiency of vitamin A. Therefore, if you have sensitive teeth, it is important to have enough of it (it is found in carrots, eggs, and liver). Avoid carbonated drinks that contain acids - colas, forfeits, sour juices, as well as any acidic foods. After eating (especially if you ate something sweet or sour), you need to brush your teeth or at least rinse your mouth with boiled water;

• Brush your teeth with a soft-bristled brush. Movements should be smooth, vertical, not horizontal. It is better to start not with the incisors, but with the distant teeth.

• Buy pastes with a low degree of abrasiveness (better, special ones for sensitive teeth, for example, Sensodyne, Lakalut, Rembrandt). They may contain potassium salts (nitrate or chloride), fluorides, citrate, strontium. The most common and effective are potassium compounds: they reduce the diameter of the dilated dentinal tubules of sensitive teeth, reduce the flow of fluid inside them and reduce the reaction of teeth to irritants. The effect of using such pastes will be noticeable within a few days. True, after switching to regular paste, everything will return to normal.

• Fluoridated mouth rinses are useful, but they must be prescribed by a doctor, as such products cannot be used regularly.

• Avoid procedures that are risky for sensitive teeth. For example, chemical and mechanical bleaching is contraindicated for you - it is better to resort to ultrasound. This is the most gentle method, in which a low concentration of the active substance is used (5-15% instead of 35-40%), and the exposure time of peroxide on the teeth is minimal - only 12 minutes. There is no heating or injury to dental tissues during the session, so the patient does not experience any unpleasant sensations either before, during, or after the procedure. This method can be used in combination with laser whitening. Before and after the procedure, desensitizing pastes should be used for some time.
  Treatment for excess feelings

  SUBTLE NATURES Over the past 10 years alone, in Western European countries, the number of visits to the doctor for enamel hyperesthesia has increased by 35%. More than half of the world's population suffers from various forms of tooth sensitivity. Most often women complain about it.

  To treat hyperesthesia, dentists use either special varnishes, which close micropores in tooth enamel and empty spaces in dentinal tubules, or remineralizing preparations (usually containing fluoride). Thanks to the latter, the threshold of excitability of nerve fibers increases, and the hard tissues of the teeth are saturated with the missing calcium, phosphorus and magnesium. To make the strengthening substances penetrate the dental tissues more easily, iontophoresis is used (the drugs reach their destination using a weak electric current). So that the patient can continue treatment on his own, there are special mouthguards for home use, which contain desensitizing substances.