Causes of Tooth Sensitivity

In a perfect world, every dental procedure we ever do would be completely painless and problem-free.

Unfortunately, we don’t live in a perfect world.  None of us is perfect, and neither are the teeth we work on (if they were, we wouldn’t be working on them in the first place!).  Sometimes people experience sensitive teeth, or even significant pain after a dental procedure, in spite of our best efforts.  In these cases, we are often asked, “Why does my tooth still hurt?” and “How long will this tooth sensitivity last?”

The short answer is, “We don’t know.”  A lot of factors enter into tooth sensitivity, and it is impossible for us to anticipate or do anything about some of them. Some people experience no tooth sensitivity at all, some very little and short lasting, and occasionally someone will have significant and long-lasting pain.

Factors That Cause Sensitive Teeth

There are many reasons for these variations.  There is always some trauma to the tooth from preparation, bonding chemicals, cements, etc.  In deeper preparations we may be closer to the nerve of the tooth, or sometimes there are microscopic projections of the nerves close to the surface which may be exposed during the preparation.  Often times with significant decay or large old restorations the nerves of the teeth may not be healthy to begin with, and unable to respond well to the trauma of the procedure.  Some people may be in a somewhat debilitated state of health, and their natural body defenses may not be as strong as normal.  Then there are occasional people who just always have sensitive teeth after any procedure, not matter what is done. (Learn more about preventive dentistry.)

Fortunately most people experience little or no sensitivity, and only for a short period of time.  If you are one of those who experiences significant or prolonged tooth sensitivity, these are the options which need to be considered.

Causes & Treatments For Tooth Sensitivity

• Cause: Post-visit sensitivity is due to inflammation of the nerves in the area.
  Treatment: Consider taking an anti-inflammatory medication (Advil, Aleve or Aspirin) to minimize the sensitivity.  For most people this will be adequate to eliminate the tooth sensitivity, and will only be necessary for a few days.
• Cause: Significant sensitivity or pain.
  Treatment: Anti-inflammatory medications may be needed for a longer period of time.  If pain is moderate-severe, take 3 Advil combined with 2 extra-strength Tylenol every 6 hours as needed.  This combination is as effective as a narcotic prescription, without the side effects.
• Cause: Severe pain.
  Treatment: Please let us know.  Prescription medication may be needed for a short time.  Prolonged significant pain may indicate that the nerve may not be healthy enough to recover from the trauma.  In this case a root canal may be needed to remove the unhealthy nerve tissue.
• Cause: Chronic, prolonged sensitivity.
  Treatment: Sometimes sensitive teeth can persist for a long time – many months in some cases.  If it is just an annoyance, you may wish to just put up with it, and allow us to monitor it until the sensitivity subsides.  The other alternative would be to have a root canal to remove the unhealthy nerve tissue.

Please know that we do everything we can to minimize sensitivity during your visits.  But everyone is different and every tooth is different, and sometimes things happen beyond our control.  Please let us know if you experience what you consider to be significantly sensitive teeth.  Our goal is always to give you as pleasant and pain-free an experience as possible.