Sensitive Teeth: Why It Happens and What Actually Helps

That jolt when cold water hits a tooth is one of the most common complaints in dentistry, and one of the most ignored. Sensitivity is usually fixable, and occasionally it is a warning worth listening to.

The short answer

Teeth are sensitive when the layer beneath the enamel, called dentine, becomes exposed. Dentine is full of microscopic tubes running to the nerve, so hot, cold and sweet things travel straight through. The two usual reasons for exposure are worn enamel and receding gums. Most cases settle with a sensitive toothpaste used properly, but pain that lingers for more than a few seconds is a different problem and needs looking at.

Why it happens

• Brushing too hard. The most common cause we see, and the most counter-intuitive. Scrubbing with a hard brush wears enamel away and pushes gums back, exposing the root surface, which has no enamel on it at all.
• Acid wear. Fizzy drinks, citrus, wine and fruit teas soften enamel. So does acid reflux, which quietly damages teeth overnight. Brushing straight after anything acidic scrubs away enamel while it is still soft.
• Receding gums. As gums recede the root becomes exposed, and root surface is far more sensitive than the crown of the tooth. Gum disease, ageing and heavy brushing all contribute.
• Grinding or clenching. Often done in your sleep without knowing. It wears through enamel and flexes the teeth at the gumline, which is why sensitivity from grinding often shows up as a notch where tooth meets gum.
• After treatment. Teeth are commonly sensitive for a few days after a filling or a hygiene appointment, and after whitening. This settles. If it is worsening after a week, get it checked.
• A crack or decay. This is the one that matters. Sensitivity in a single tooth, particularly a sharp pain on biting or an ache that lingers, points to something structural rather than general sensitivity.

When sensitivity is telling you something more serious

General sensitivity is a quick zing that stops as soon as the trigger is gone, and it usually affects several teeth. Be more concerned when the pain is in one specific tooth, when it lingers for thirty seconds or more after something cold, when it wakes you at night, or when hot things set it off more than cold. Those patterns suggest the nerve itself is inflamed and may need root canal treatment rather than a change of toothpaste. See our guide to toothache if the pain has become constant.

What actually helps

• Use a sensitive toothpaste, and use it properly. Most people rinse it straight off. Instead, rub a smear onto the sensitive area with a fingertip last thing at night and do not rinse. It needs weeks of consistent use, not days.
• Switch to a soft brush and stop scrubbing. Small circles, light pressure. An electric brush with a pressure sensor takes the guesswork out.
• Wait an hour before brushing after anything acidic. Rinse with water in the meantime.
• Keep acidic drinks to mealtimes rather than sipping through the day, and use a straw where you can.
• If you suspect you grind, mention it. A night guard protects the teeth you still have.

What it costs to get it looked at

A new patient examination is £89 including X-rays, or £60 for existing patients. Often the answer is a change of technique and a fluoride application rather than treatment. Where sensitivity is caused by a worn or decayed area, a filling from £125 usually settles it. Our full price list is on the fees page.

Wondering if you should call? Our urgency checker gives an honest answer in two minutes, including what to do while you wait.

Frequently asked questions

Does sensitive toothpaste actually work?

Yes, when used consistently and not rinsed away. The active ingredients either block the tubules in the dentine or calm the nerve, and both take a few weeks of daily use to build up. Most people who say it did not work stopped after a week or rinsed it straight out.

Why are my teeth sensitive after a filling?

The tooth has been through something and the nerve inside takes time to settle, particularly with deeper fillings. A few days to a couple of weeks is normal. Sensitivity that is getting worse, or pain on biting that does not settle, is worth a quick check because the filling may just need adjusting.

Can whitening cause permanent sensitivity?

No. Whitening sensitivity is temporary and settles within a few days of finishing. Using a properly prescribed system at the right concentration, with custom trays, keeps it to a minimum, which is one of several reasons shop-bought kits are a false economy.

Can receding gums grow back?

Not on their own, no. What you can do is stop the recession getting worse by correcting your brushing technique and keeping the gums healthy. Exposed root surface can be covered or desensitised where it is causing real trouble.

If cold drinks have started making you wince, it is worth twenty minutes to find out why. Call us on 01625 574609. We are an independent, family-run practice ten minutes from Macclesfield with free parking outside.

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