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Tender teeth: What’s behind your aching smile

Why your pearly whites may be in pain
tooth sensitivity

Does eating ice-cream or biting into a strawberry cause you to grimace in pain? Or, do you find your gums bleeding with minimal brushing or flossing? If daily oral discomfort is a regular occurrence, you may be experiencing a condition called tooth sensitivity.

“With teeth, there are only two sources of pain,” said William Wathen, D.M.D., an associate professor at the Texas A&M University Baylor College of Dentistry. “Pain can originate in the connective tissue fibers that attach the tooth to the bone it sits within, also called the periodontal ligament (PDL), and, in the nerve tissue inside the tooth.”

The teeth have ligaments? PDL pain explained

Ligaments are found everywhere in our body—even in the teeth! PDL tissue fibers are actually very sensitive and light trauma to this ligament can result in discomfort. Most trauma to the tooth will easily cause bruising—and where there is bruising, pain and soreness often follow. Conditions that may lead to an inflamed periodontal ligament include grinding your teeth and biting into something too hard.

Wathen added abscesses and infections of the mouth can further stress the PDL. “Periodontal disease—a condition caused when germs form around the teeth (because of plaque) and produce irritants that break down skin cells and gum tissue—is the most common source of oral pain,” he said. “This sets up the inflammatory process of how wounds heal.”

The hallmark of inflammation is redness, swelling, bleeding and pain. This process is no different when it comes to wounds in the mouth. “An abscess trying to heal may cause sensitivity because of the inflammatory process,” Wathen said. “Abscesses are created when immune cells in the body attempt to wall off and kill germs. This will begin to put pressure on the nerves in the tooth, and, as we know, nerves don’t like pressure.”

Unhappy nerves lead to unhappy teeth

Our gums act as a protective blanket to cover the roots of the teeth. When gums begin to recede, the roots are bared, exposing thousands of tiny dentinal tubules (nerve channels) that lead to the tooth’s pulp (nerve center of the tooth).

“There’s an old saying that as you age you become long in the tooth,” Wathen said. “This can be true. As your gums recede with age, they will expose these tiny nerve tubules to outside forces. This will cause teeth to become extremely sensitive to temperature, touch, and even toothbrushes and toothpaste.”

Tooth decay will also irritate the nerves and present symptoms of sensitivity and pain. “The enamel of the teeth contains no nerves, however, the consumption of large amounts of sugar and starches will create lactic acid in the mouth and erode enamel,” Wathen said. “This ‘melting away’ of enamel will expose the teeth’s sensitive nerve channels.”

Carbonated beverages—a ‘double dose’ of acid on your teeth

The culprit behind most tooth erosion and mouth sensitivity may be due to your diet—in the form of consuming too many carbonated beverages. As previously mentioned, acid is detrimental to the teeth and soft drinks are chock-full of acid. Level of acidity is determined by the pH scale range— with a measurement of one meaning a solution is extremely acidic, while a measurement of seven means a solution is not (seven is the pH of water).

“Dentists are very troubled by the large amount of carbonated beverages people drink,” Wathen said. [pullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“The average pH of a carbonated beverage is 2.5. To put into perspective, battery acid has a pH of one. This means carbonated drinks are 10,000 times more acidic than water, and consuming one is equal to drinking undiluted vinegar. To hide the acid, manufacturers fill these drinks with sugar, and germs in your mouth can convert the sugar to acid. So, by drinking carbonated beverages, you’re basically giving your mouth a double dose of acid.”[/pullquote]

Other common causes of tooth sensitivity

According to Wathen, sensitivity from tooth decay presents in four different forms: touch, temperature, pressure and spontaneous pain. Touch and temperature sensitivity are usually due to exposed nerves. While sensitivity to cold is more common, heat sensitivity is more dangerous—because this could mean nerve damage exists that won’t heal.

“Pressure and spontaneous pain arise from biting too hard or from having a split or cracked tooth,” Wathen said. “Cavities may also cause spontaneous pain. It’s important to remember any pressure on the nerve will register as pain.”

Worth noting, excessive brushing with a stiff toothbrush can also lead to tooth sensitivity. Dental professionals always recommend using a soft toothbrush to clean your pearly whites. “Plaque doesn’t stick to teeth that tightly,” Wathen said. “You shouldn’t treat cleaning your mouth like scrubbing a kitchen floor. Stiff bristles can also be sharp and cut the gums—creating a wound. These wounds could form scar tissue when they heal. People who experience tooth and gum pain should also brush with a sensitivity toothpaste to help relieve symptoms.”

Another surprising cause of tooth sensitivity is aggressively using products to whiten the teeth. Wathen said if the solution is too strong—or used too often—it can cause sensitive reactions. He added dental work, deep cleanings and anything that causes swelling in the mouth will lead to soreness in the mouth.

Wathen recommended to always consult with your dental health provider if you’re feeling any sort of tooth sensitivity or oral discomfort. “Problems in the mouth are a huge indicator of overall health and wellness,” he said. “Regular cleanings and check-ups with your dentist are crucial to maintaining a healthy lifestyle.”

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