Sensitive Teeth Explained
A sharp twinge from cold water or ice cream is one of the most common things patients mention. It's usually manageable, but it's worth knowing when it's simple sensitivity and when it's your tooth telling you something else.
Why Are My Teeth Sensitive? What a Dentist in Edinburgh Can Do
Sensitive teeth usually come from exposed dentine, where gum recession or worn enamel lets hot, cold and sweet things reach the nerve. A desensitising toothpaste used correctly helps many people, and if it doesn't, a fluoride varnish or bonding over exposed roots can. At Comely Bank Dental in Edinburgh, an examination is £70 and is the first step to finding the cause.
Why Do Teeth Become Sensitive?
Sensitive teeth almost always mean that dentine, the layer under the enamel, has become exposed. Dentine is full of microscopic tubules running towards the nerve. When something cold, hot, sweet or acidic touches it, fluid moves in those tubules and the nerve fires. The result is a short, sharp pain that fades within seconds once the trigger is gone.
Dentine becomes exposed in two main ways: the gum shrinks back and uncovers the root, or the enamel wears away. A few other things, such as a crack or recent treatment, can produce similar symptoms. Working out which applies to you is what decides the right treatment.
The Common Causes
Gum recession. Roots have no enamel, only a thin layer of cementum that wears away easily. Recession can follow gum disease, brushing too hard, a thin natural gum, or teeth that sit prominently in the arch.
Enamel wear. Acidic drinks and foods (fizzy drinks, fruit juice, citrus, wine, vinegar) soften enamel, and brushing straight afterwards removes more of it. Reflux and frequent vomiting have the same effect from the inside.
Grinding and clenching. Night-time grinding flattens the biting surfaces and can chip enamel near the gum line. Teeth often feel tender in the morning. A custom night guard protects them.
Whitening. Peroxide gels commonly cause temporary sensitivity, usually settling within a few days of finishing.
Cracks. A crack lets fluid reach the dentine and often hurts when you bite or release.
Decay and leaking fillings. Decay can cause sensitivity to sweet things in particular, and an old filling with a gap at its edge can behave the same way.
Recent dental work. A new filling, crown or a deep clean can leave a tooth sensitive for a short time while it settles.
Twinges That Won't Settle?
Book an examination and we'll find out whether it's sensitivity or something that needs treating, then talk you through the options.
Is It Sensitivity or Something More Serious?
The pattern of pain is the best clue. As a general guide:
| What you notice | More likely to be |
|---|---|
| Sharp twinge from cold or sweet, gone within seconds | Exposed dentine (simple sensitivity) |
| Several teeth along the gum line, often on one side | Gum recession or brushing wear |
| Pain on biting or as you release, one tooth | A cracked tooth |
| Pain that lingers for a minute or more after the trigger | Inflamed nerve, possibly from decay |
| Throbbing that wakes you or comes on by itself | Nerve or abscess problem |
| Pain with swelling, a bad taste or a raised gum spot | Infection |
Only an examination can tell for certain, but anything in the last three rows needs prompt attention rather than toothpaste. Our dental abscess page explains the warning signs.
How to Use Desensitising Toothpaste Properly
Desensitising toothpaste works well for many people with simple sensitivity, but how you use it matters as much as which one you buy.
- Choose an active ingredient. Potassium nitrate calms the nerve's response; stannous fluoride, arginine or calcium-based formulas seal the open tubules. If one type doesn't help after a month, try another.
- Use it twice a day, every day. It usually takes two to four weeks to make a difference, and the benefit fades if you stop.
- Spit, don't rinse. Leaving the toothpaste on your teeth after brushing lets it keep working.
- Dab some on. Rubbing a pea-sized amount onto the sensitive area with a clean finger before bed can help further.
- Be patient with whitening toothpastes. Many are more abrasive and can make sensitivity worse.
If you're still getting twinges after a month of using it correctly, or the pain is getting worse, it's time to have it checked.
Everyday Habits That Help
Small changes protect the exposed areas and stop the problem progressing:
- Use a soft or medium brush, or an electric brush with a pressure sensor. Hold it lightly and brush in small circles, not hard back-and-forth strokes.
- Wait an hour after acidic food or drink before brushing, so softened enamel can recover.
- Keep acidic drinks to mealtimes and drink them in one go rather than sipping over an afternoon. A straw helps.
- Finish a meal with a little cheese or milk, or chew sugar-free gum, to bring saliva back.
- Clean between your teeth daily so the gums stay healthy and don't recede further.
- If you grind, ask about a night guard rather than waiting for the wear to show.
What We Can Do in the Practice
If home care isn't enough, there are simple treatments that can be done at a routine visit:
- Fluoride varnish. A high-strength fluoride painted onto the sensitive area to strengthen it and block the tubules. It's quick and painless, and can be repeated every few months.
- Desensitising agents. Liquids that seal the dentine surface, often giving relief straight away.
- Bonding over exposed roots. Where recession or wear has left a notch at the gum line, tooth-coloured composite can cover and protect it, removing the trigger and stopping further wear. Fees depend on size, and a small filling is £170.
- Gum treatment. If gum disease is behind the recession, treating it is essential to stop it getting worse. See gum disease treatment.
- Replacing a leaking filling or crowning a cracked tooth to hold it together.
- A night guard if grinding is wearing the teeth.
In a few cases, where a tooth stays painful despite everything else, root canal treatment may be considered. That's a last resort for sensitivity, not a first step. Lost gum can sometimes be rebuilt with a gum graft, which is usually referred to a periodontist.
You'll always have a written treatment plan with fees before anything starts.
Sensitivity After Whitening or New Treatment
After whitening, a few days of sensitivity is common and expected. Using a desensitising toothpaste for two weeks beforehand helps, as does taking a night off between applications if it gets uncomfortable. It should settle once you stop. If you're planning teeth whitening, tell us about any existing sensitivity first so we can prepare your teeth.
After a filling or crown, mild sensitivity to cold for a week or two is normal while the tooth settles. Pain on biting usually means the filling is slightly high, which is a quick adjustment. Pain that is getting worse, or that lingers, needs checking.
After a deep clean, roots that were covered by tartar or swollen gum can feel sensitive for a few weeks. Desensitising toothpaste and good cleaning usually help it settle.
When Should You Book an Appointment?
Book a routine visit if:
- sensitivity hasn't improved after four weeks of desensitising toothpaste
- it's limited to one tooth
- you can see a notch, chip or dark area on the tooth
- your gums bleed or look like they're shrinking back
Ask for an urgent appointment if pain lingers after hot or cold, wakes you at night, hurts sharply when you bite, or comes with swelling. Our emergencies page explains how we handle same-week problems.
Getting Sensitive Teeth Checked in Edinburgh
At Comely Bank Dental we start by finding the cause. An examination is £70, or £95 if you're new to us. Katie Ventisei, our hygienist and therapist, can apply fluoride varnish, place bonding over exposed roots and treat gum problems, and works alongside our dentists if a tooth needs more.
We look after adults privately and the children of our dental plan members under the NHS, and we see patients from across north Edinburgh, including Stockbridge, Inverleith and the New Town.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.