Dentin Hypersensitivity

What Is It, Causes, Signs, Symptoms, and More

Author: Lily Guo

Editors: Alyssa Haag, Emily Miao, PharmD, Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator: Jessica Reynolds, MS

Copyeditor: Stacy M. Johnson, LMSW

What is dentin hypersensitivity?

Dentin hypersensitivity, also known as tooth sensitivity or dentin sensitivity, refers to a condition in which the dentin, a layer of hard tissue under the enamel of the teeth, becomes exposed and sensitive. Pain occurs from everyday stimuli, such as hot and cold temperatures, sweets, and acidic foods. The pain is typically sharp and brief, often described as ‘shock-like’ and resolves when the affected teeth are no longer exposed to the stimuli. Dentin hypersensitivity is not life-threatening but can interfere with one’s quality of life. 

Cross section of a tooth showing the dentin layer under enamel.

What causes dentin hypersensitivity?

There are several possible causes of dentin hypersensitivity, including gum recession, which can occur from brushing too aggressively, dental plaque, tartar buildup, periodontal disease, or trauma or injury to the gum tissue. When the gums recede, dentin can become exposed and more sensitive to stimuli. Similarly, abrasion or erosion of the enamel from tooth grinding (i.e., bruxism), chewing ice, cavities, tooth decay, or tooth fractures can expose dentin and lead to sensitivity. Some tooth whitening products can cause sensitivity, especially if used frequently or in high concentrations. 

Factors that may increase the risk of developing dentin hypersensitivity include increased age, preexisting oral disease, poor tooth brushing habits, poor diet, and medications. Individuals with gum disease, such as gingivitis or periodontitis, are likelier to experience gingival recession and subsequent dentin hypersensitivity. A diet high in acidic foods and drinks (e.g., citrus fruits, soda, and sports drinks) can increase the risk of developing dentin hypersensitivity due to tooth surface erosion. Certain medications, such as antidepressants (e.g., escitalopram, sertraline) and high blood pressure medications (e.g., lisinopril, atenolol), can cause dry mouth, increase the risk of cavities and tooth decay and subsequently lead to dentin hypersensitivity.

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What are the signs and symptoms of dentin hypersensitivity?

The signs and symptoms of dentin hypersensitivity include sharp, brief pain of the affected teeth when consuming hot or cold beverages or food; pain when breathing in cold air through the mouth; and pain when consuming sweet or acidic foods and drinks. Those with dentin hypersensitivity may also experience pain when brushing their teeth or flossing. 

How is dentin hypersensitivity diagnosed?

Dentin hypersensitivity is diagnosed by taking a thorough medical history and conducting a thorough examination of the teeth and gums performed by a dentist or other health care provider. Individuals may be asked about dental history, including past diagnosis of gum disease, current oral hygiene habits, and medications taken. During the physical examination, the healthcare provider may look for signs of gum recession, tooth decay, tooth erosion, and other conditions that may be causing dentin hypersensitivity. They may also use a dental tool to tap on the tooth or blast cold air on the tooth to assess for hypersensitivity

How is dentin hypersensitivity treated?

Treatment of dentin hypersensitivity typically depends on the cause of sensitivity but generally, desensitizing toothpaste or fluoride gel can help reduce sensitivity and improve oral health. Desensitizing toothpaste contains ingredients (e.g., potassium nitrate and fluorides) that help reduce the sensation of pain in the teeth. Additionally, toothpaste containing calcium sodium phosphosilicate (CSPS) has been shown to relieve dentin hypersensitivity. Lastly, fluoride helps strengthen the teeth' enamel and can help reduce sensitivity. It can be applied to the teeth using a mouth tray under the supervision of a dentist. 

Practicing proper oral hygiene, such as brushing and flossing regularly and using mouthwash, can help reduce the risk of tooth decay and gum disease. A dentist may suggest changes to one’s oral hygiene routine, such as using soft-bristled toothbrushes, to minimize abrasion and erosion of the enamel, which can worsen dentin hypersensitivity. Other lifestyle changes can be implemented, such as refraining from chewing ice, avoiding acidic foods and drinks, and appropriately utilizing teeth-whitening products. 

In cases refractory to conservative treatment and lifestyle changes, or if there is an underlying cause, dental office treatments may be necessary, including filling a cavity, covering exposed dentin with a filling or crown, or treating gum disease.

What are the most important facts to know about dentin hypersensitivity?

Dentin hypersensitivity is when the dentin, a layer of hard tissue beneath the enamel, becomes exposed and sensitive to stimuli. Dentin hypersensitivity can cause sharp, brief pain in the affected teeth when exposed to hot and cold temperatures, sweets, or acidic foods. Possible causes of dentin hypersensitivity include gum recession, tooth decay, tooth erosion, and fractured teeth. Treatment options include dentin-desensitizing agents (e.g., toothpaste, fluoride gel), using a soft-bristled toothbrush, avoiding acidic foods and drinks, and practicing good oral hygiene. A dentist or another health care provider can determine the cause of the sensitivity and recommend the appropriate treatment. Regularly seeing a dentist for checkups and cleanings can help prevent tooth decay and gum disease.

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Related links

Anatomy and physiology of the teeth
Gingivitis and periodontitis
Anatomy of the oral cavity

Resources for research and reference

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