What Causes
Tooth Sensitivity?

What sensitivity actually is

A tooth has three main layers: enamel (the hard outer layer), dentine (the layer beneath enamel, full of microscopic tubules connecting to the nerve), and pulp (the nerve and blood supply at the centre).

Enamel does not contain nerve endings. When you feel pain or zinging from a tooth, what you are feeling is stimulation of the nerve via the dentine tubules. Anything that exposes dentine to the mouth — through enamel loss, gum recession, or fracture — will cause sensitivity.

The character of the sensitivity gives clues about the cause. Sharp brief sensitivity to cold drinks usually points to exposed dentine. A dull lingering ache after a hot drink may indicate pulpitis. A sharp pain on biting that disappears immediately on release usually indicates a cracked tooth.

Common causes

1. Gum recession exposing root dentine. Common with age, aggressive brushing, periodontal disease, or post-orthodontic relapse. Treatment focuses on desensitising and addressing the cause (improving brushing technique, treating periodontal disease).

2. Enamel wear from acidic foods/drinks (citrus, fizzy drinks, wine), reflux, or aggressive brushing. Enamel does not regrow once lost. Treatment focuses on stopping further loss and protecting exposed dentine.

3. Hairline cracks from grinding, biting hard objects, or large old amalgam fillings. May not be visible to the naked eye. Diagnosed clinically with bite tests and dental microscopy. May need a crown or onlay to stabilise.

4. Recent fillings sometimes cause transient sensitivity for 2–4 weeks. Should resolve. If sensitivity worsens or persists beyond 6 weeks, the filling should be reviewed — the pulp may be inflamed.

5. Recent professional whitening very commonly causes 24–72 hours of sensitivity. Usually resolves with desensitising toothpaste and avoiding very cold drinks for a few days. Tower Dental whitening protocols include desensitiser application to minimise this.

6. Cracked tooth syndrome — sharp pain on biting that disappears immediately. Often diagnosed late because hairline cracks don't show on standard X-rays. Treatment is typically a crown or onlay to stabilise the tooth.

7. Pulpitis (inflamed nerve) — usually presents as lingering ache to hot drinks, spontaneous pain, or pain that wakes you at night. Indicates the nerve is irreversibly inflamed and root canal treatment or extraction is usually needed.

When to seek clinical advice

Mild, occasional sensitivity that responds to desensitising toothpaste is usually not urgent. Make an appointment if:

- Sensitivity is severe or interferes with eating/drinking - Sensitivity is persistent beyond 2–3 weeks - You have lingering pain to hot drinks (more than a few seconds) - You have sharp pain on biting that suggests a crack - You have spontaneous pain or pain that wakes you at night - Sensitivity is associated with visible gum recession, a darkened tooth, or swelling

Tower Dental Blackpool offers same-day emergency appointments for acute pain (Mon-Fri 8:30am-5:30pm, Sat 9am-2pm), and routine appointments within one week for persistent sensitivity assessment.

What helps mild sensitivity

For mild, generalised sensitivity (not localised to one tooth, no severe pain):

1. Use a desensitising toothpaste containing potassium nitrate or stannous fluoride, twice daily for at least 4 weeks. Sensodyne, Colgate Pro-Relief, or Oral-B Sensitivity & Gum are well-evidenced. 2. Brush gently with a soft-bristled brush. Aggressive scrubbing accelerates gum recession. 3. Avoid acidic drinks between meals. Drink water afterwards rather than brushing immediately (acid softens enamel; brushing immediately accelerates wear). 4. Use a fluoride mouthwash at a different time from brushing. 5. Have a hygienist appointment to assess and treat any underlying gum recession or periodontal disease.

If sensitivity persists despite 4–6 weeks of these measures, book a clinical assessment.

Talk through your own case

If your sensitivity is severe, persistent, or you suspect a cracked tooth, the £40 consultation at Tower Dental Blackpool includes a full clinical assessment, X-rays where indicated, and a written treatment plan. Call 01253 353759.