In a previous post, I had discussed possible causes for teeth sensitivity in children and adults. Today we will see why many of us experience hypersensitivity shortly after a professional cleaning at the dentist’s office.
Sensitivity in teeth is a very common phenomenon. I will discuss the most widely accepted theory of why our teeth become sensitive.
Anatomy of teeth -
Crowns of teeth have 3 important layers - Enamel, Dentin, and pulp. The roots of our teeth are buried in the jaw bone and that bone is covered by gum tissue. However, due to inflammation in the gum tissue/ recession of gums/ loss of bone around the teeth, the roots of the teeth can be exposed to the oral environment. These roots are not covered by hard enamel, instead, they are covered by a semi-hard layer called the cementum.
The pulp tissue is the main vital tissue in the teeth. On dissection and inspection under a microscope, one can see tiny tunnels or tubules running from the pulp into the dentin. These tubules contain fluid which moves in response to change in temperature and/or pH. The movement of this fluid is what causes the feeling of sensitivity or pain. This explains why people will most often experience sensitivity when they eat or drink cold/hot/sweet/sour foods and beverages.
Reasons why teeth become sensitive -
Thinning of enamel due to clenching or grinding of teeth - This makes it easier for changes in temperature or pH to affect the fluid movement inside the tubules in the dentin layer of the tooth.
Cavities cause the breakdown of enamel and dentin, thereby making it easier for the pulp to send painful signals via the tubules.
Exposure of cementum to the oral environment also makes it easier for the tooth to “feel” more sensations since cementum is more permeable than enamel.
What happens during a professional cleaning?
During teeth cleaning, we are focusing on removing the plaque and tartar from the teeth and sometimes under the gums. This again exposes more tooth structure to the oral environment, which was previously covered by unhealthy material (which ironically was effective at preventing sensitivity). Leaving plaque and tartar for long periods of time causes gum recession and loss of bone around the necks of the teeth. This if left unchecked can be very harmful and lead to mobility or loss of teeth.
So while the pain from sensitivity is a common side effect of professional cleaning, choosing not to have your teeth cleaned can be more detrimental in the long run.
Another cause for hypersensitivity post cleaning is the acute inflammation of the gums. Gums feel attacked when cleaned with dental tools. Inflamed gums pull away from the necks of the teeth and again expose the layer of cementum which makes teeth more susceptible to sensing temperature and pH changes. This brief increase in inflammation subsides fairly quickly, within a week or so.
Solutions to this problem -
Using toothpaste with a desensitizing agent - Sensodyne is the most popular one. If your teeth are very sensitive, consider not rinsing your mouth afterward. Spit out excess toothpaste and let the rest sit on your teeth for a while. The desensitizing agent will block the tubules, thereby preventing fluid movement and subsequent pain/sensitivity.
Swishing with lukewarm salt-water is a natural way to reduce any swelling in the mouth. Use 1 tsp of salt in a cup of lukewarm water — swish for 30 seconds and spit. Repeat as often as you like.
Take an over the counter medication like Acetaminophen (“Tylenol or Paracetamol”) or Ibuprofen. This again would reduce any swelling in the mouth and provide some temporary relief.
Tip for prevention - Depending on the health of your teeth and gums, you should get your teeth cleaned every 4-6 months. Don’t go too long without a professional cleaning and do your best to maintain good oral hygiene at home.
If your discomfort persists after a week, do consult your dentist to see if there could be any other causes for your sensitivity.