Sensitive teeth: causes and treatment

A sudden sharp twinge from a sip of tea or a scoop of ice cream is a common reason people look for help with their teeth. Tooth sensitivity has several possible causes, and some are easy to manage while others need treatment. This guide sets out the causes, the home care that official sources describe, what a dentist may offer and when to book an appointment.

What causes sensitive teeth

Sensitivity develops when tooth enamel wears away or gums recede, exposing the dentine underneath. The Oral Health Foundation describes this as the common mechanism behind sensitive teeth.

The Oral Health Foundation lists these causes:

• Brushing aggressively or using a hard toothbrush.
• Gum recession.
• Acid wear from fizzy drinks, fruit juices, citrus fruits or stomach acid.
• Brushing straight after eating or drinking something acidic.
• Gum disease.
• Teeth grinding or clenching.
• Cracked or damaged teeth.
• Tooth whitening treatments.

The NHS website for England also lists sensitive teeth among the possible causes of toothache, alongside decay, abscesses, cracked teeth, loose fillings and gum disease. One symptom can therefore have different causes, which is why a dentist’s examination matters when the pain does not settle.

Home care

The Oral Health Foundation describes several steps people can take at home. They are general measures, not a treatment plan for your own mouth.

• Use a toothpaste containing potassium citrate, potassium nitrate or stannous fluoride.
• Spit out after brushing and do not rinse with water.
• Rub a small amount of sensitive toothpaste onto the painful area at night.
• Switch to a soft toothbrush and brush gently with small circular movements.
• Wait at least 1 hour after eating or drinking acidic foods before brushing.
• Cut down on acidic and sugary drinks.

The NHS website for England advises brushing with fluoride toothpaste twice a day for about 2 minutes, and cleaning between the teeth daily with floss or interdental brushes. Check the toothpaste packaging or ask a dentist or pharmacist which product suits you, because this guide does not recommend a brand.

Treatments a dentist may offer

The Oral Health Foundation says that if home measures do not work, a dentist may offer one or more of the following:

• A desensitising treatment applied to the tooth.
• A high-fluoride toothpaste.
• A filling placed over worn areas.
• Treatment for gum disease or another underlying cause.

Which of these applies depends on what the dentist finds. A worn area near the gum line is treated differently from a cracked tooth or gum problems. Routine examinations and fillings are part of routine dental care, and a hygienist can help if gum health is part of the picture.

In Northern Ireland, nidirect says Health Service dentists provide examinations, x-rays, scaling, polishing, gum treatments and fillings, among other treatments. It also says that before private treatment begins, your dentist will tell you what treatment you need and what the exact cost will be. Ask for the same information in writing, whichever route you choose.

Teeth whitening is a separate question. If you want teeth whitening and already have sensitive teeth, mention it at the consultation. The Oral Health Foundation lists whitening among possible causes of sensitivity, so a check beforehand is sensible.

When sensitivity needs a check-up

The Oral Health Foundation advises seeing a dentist if you have severe pain, sensitivity that lasts for weeks, sensitivity in a single tooth or sensitivity that starts suddenly. A single sensitive tooth can point to a crack, a worn filling or decay instead of general wear.

The NHS website for England gives separate guidance for toothache. It says to see a dentist if pain lasts more than 2 days, if painkillers do not help, or if the pain comes with a high temperature, pain when biting, red gums, a bad taste or swelling in the cheek or jaw.

It also says to go to A&E if swelling around the eyes or neck is making it difficult to breathe, swallow or speak, and to call 999 for an ambulance instead of driving yourself. That advice is for severe symptoms, not for ordinary sensitivity.

For urgent dental problems in Northern Ireland, nidirect and HSC Northern Ireland say registered patients should contact their own dental practice first. Unregistered patients can use the Dental Access Scheme on weekdays, or the Emergency Dental Clinics at weekends and bank holidays. The NHS website for England mentions the 111 service, but that is the England route, so use the Northern Ireland routes above.

Before the appointment, note which tooth or teeth react, what sets the pain off, how long it lasts and whether you grind your teeth or have recently whitened them. The Oral Health Foundation lists all of these as possible causes, so the details help the dentist work out what is happening. Mention any recent changes to your brushing routine or diet as well.

Dentists in Northern Ireland have duties to patients too. nidirect says dentists must explain treatment options, obtain consent, give access to records and allow second opinions, and that you may refuse treatment or stop if you are not satisfied. If a dentist proposes a treatment you do not understand, ask them to explain it in plain terms and to put the plan in writing.

Next step

If sensitivity is not settling, book an examination instead of waiting for it to pass. To find a practice that lists check-ups and routine treatment, start from the general dentistry hub, or read the guide to choosing a dentist in Belfast first. A listing is a starting point, so confirm the details with the practice.