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Learn Everything You Need To Know About Tooth Root Sensitivity

Tooth sensitivity to cold and/or sweets may be a sign of a cavity, but it may also be caused by root sensitivity. Teeth are made up of a very hard substance called enamel, which protects the nerve inside the tooth from the stimuli your teeth experience, such as hot, cold, sweets, and chewing.

The surface of the root of the tooth is covered by a material called cementum that is not as strong as enamel, but is protected by the overlying gum tissue. Tooth sensitivity basically occurs when something happens to cause the gum tissue to recede, leaving the sensitive cementum exposed.

Causes

One of the most common factors of gum recession is due to the toothbrush. The process is caused by brushing too hard or by using a hard bristled toothbrush, thereby causing the gums to recede. The use of a soft toothbrush with proper technique can help prevent this recession.

Chemical erosion is another cause of root sensitivity. This can occur in people who drink an excessive amount of carbonated beverages or suck on highly acidic foods, such as lemons or limes. The acids in these products can actually eat away the protective enamel coating of the teeth right along the gum line, leading to sensitivity.

This same type of tooth sensitivity may also occur after any dental treatment that affects the position of the gum tissue on the tooth. Some examples would be gum surgeries that expose more tooth structure or the extraction of teeth, which may cause shrinkage of the gum tissue in the area adjacent to other teeth.

Treatment of Root Sensitivity

The most critical aspect in treating root sensitivity is accurately diagnosing and treating the cause with your dentist. If the cause is not known and corrected, the problem will continue to recur in spite of treatment. Treatment is aimed at coating or sealing the surface of the exposed root to prevent the stimulus (cold, sweets) from transmitting to the nerve of the tooth, causing sensitivity.

There are toothpastes available at most stores that are specifically designed for sensitive teeth. These products decrease the sensitivity over time, although you may find if you stop using them, the sensitivity returns. This may be because the underlying cause has not been treated.

Another option is to have a highly concentrated fluoride gel applied to the sensitive areas at your dentist's office. Your dentist can also seal the area with a thin coating of resin. This is not like a filling, but more like a thin coat of a clear liquid that helps to seal your tooth when it is placed and cured.

Placing restorations (fillings) in the exposed areas will also seal them, but unless the cause of the tooth sensitivity is identified and corrected, the gum may continue to recede past where the filling was placed, causing a new area of root to be exposed below the level of the filling. If the recession is more extreme, a gum graft may be placed, where gum tissue is taken from another part of your mouth and grafted over the exposed area.

By Greggory Kinzer, DDS, MSD

Will I Be Comfortable During My Root Canal Treatment?

The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:

• Some patients associate tooth pain with past root canal treatment when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care, endodontic treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
• Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.

These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:

• Oral sedation involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less psychologically stressful.
• Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
• Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic modality for more lengthy dental procedures.
• Hospital dentistry is conducted in an environment where a variety of anesthetic modalities are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.

These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.

With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS