Why Do People Live with Tooth Pain?

June 2007

By: Dr. Scott R. Harden

An incredible number of people live with chronic or intermittent tooth pain. According to a recent survey, half of all American adults (46 percent) have experienced sensitive teeth in the past five years. Of these sufferers, almost half did nothing about their sensitive teeth.

Forty-two percent of people who have experienced sensitive teeth in the past five years felt that sensitive teeth are more uncomfortable than canker sores or ingrown toenails and, when asked what food would be the hardest to give up to decrease their tooth sensitivity, 23 percent of American adults indicated it would be ice cream.

Among the reasons for sensitive teeth, the most common were teeth-clenching or grinding (21 percent), receding gums (21 percent), and cracked or chipped teeth (18 percent). Of those living with the pain, only 40 percent talked to their dentist about the problem. Other predominant reasons for sensitive teeth include cavities, periodontal “gum” disease, improper toothbrush use, and drinking soft drinks.

Grinding teeth or “bruxism” occurs during sleep and results from a subconscious activation of chewing muscles. While you’re awake, the brain typically measures and limits the amount of bite force generated by jaw muscles to protect your teeth. Tooth grinding during sleep is not registered by the brain and results in tremendous forces upon the teeth, so strong that it will often wake up a sleeping partner. Some dentists believe grinding is due to a lack of symmetry in the teeth; others, that it reflects anxiety, digestive problems or a disturbed sleep pattern. Clenching or bruxism both produce abnormal force on teeth that can stretch tooth ligaments and cause tooth mobility and consequently cause tooth sensitivity. Bruxism can lead to significant wear of tooth enamel to a level where the softer dentin is exposed. This opens up the possibility of dental decay and tooth fracture, and in some people, gum recession, which all can lead to sensitive teeth. Early intervention by a dentist is advisable, who can fabricate a custom bruxism appliance worn at night that prevents tooth wear.

Receding gums, another source of tooth discomfort, is typically a normal part of the aging process. Gums may recede due to genetics but they may also be caused by harsh brushing, or “toothbrush abrasion,” as well as periodontal or gum disease. Receding gums may also be caused by teeth that are misaligned, (corrected by orthodontics, “braces”) or by excessive plaque build-up at the gum line. Treating receding gums is important, not only for comfort, but also to preserve the health of your teeth. When gums recede, the exposed portion of the tooth is much more sensitive, causing discomfort when consuming hot or cold foods and liquids. It can also lead to greater risk of tooth decay and other oral conditions such as a poor bite, sore jaw, periodontal disease and tooth loss. Sensitivity from minor gum recession can be treated with a conservative application of desensitizing medication. As gum recession advances, treatment can involve placement of white filling material or demand a surgical gum graft – both designed to cover the exposed root.

Cracked or chipped teeth can result from bruxism as noted above, also large fillings that weaken the surrounding enamel, and trauma to your teeth. Unfortunately, teeth are not indestructible. Trauma to teeth (by external forces or simply biting on a hard object) can cause an array of problems from a chipped tooth to a tooth that is completely broken off. Cosmetic and reconstructive dentistry is a special aspect of dentistry that addresses repairs to damaged teeth. The treatment for a chipped tooth will vary dependent on how badly the tooth is damaged.

Cavities spread slowly inside your teeth and can cause pain when the cavity is small or very large. Large cavities may advance to a level that requires root canal therapy or extraction of the tooth. Root canals are performed to remove an infected nerve out of the tooth and replace this open space with a rubber sealer material. Obviously, routine dental exams allow for better early detection of decay, thus preventing the need for more serious dental treatment.

Periodontal disease results from harmful bacteria infecting the gum attachment around your teeth. This creates “pockets” between your gums and teeth, allowing food and more bacteria to collect, thus advancing the stages of gum disease. Early gum disease is called gingivitis, while more severe cases are usually referred to as periodontitis or periodontal disease. While gum disease is most often associated with poor oral hygiene, there are also other causes including genetic tendencies toward the disease or deterioration of the gums due to chronic illness such as diabetes. Caring for your teeth and gums properly and visiting your dentist regularly are very important steps in preventing and treating gum disease.

Exposing teeth to soft drinks, even for a short period of time, causes dental erosion – and prolonged exposure can lead to significant enamel loss and thus tooth sensitivity. Consumers often consider soft drinks to be harmless, believing that the only concern is sugar content. Most choose to consume “diet” drinks to alleviate this concern. However, diet drinks contain phosphoric acid and/or citric acid and still cause dental erosion – though considerably less than their sugared counterparts. Drinking any type of soft drink poses risk to the health of your teeth. Patients should consume fewer soft drinks by limiting their intake to meals and drink with a straw, which will reduce soda’s contact with your teeth. It is best to avoid sipping soft drinks and to rinse with water and brush your teeth as soon as possible following consumption of a soft drink.

There is no need to live with dental pain and ignore an obvious signal from the body telling you there is something wrong with your oral health. The barriers to seeking dental care have been greatly reduced at present based upon technology that offers comfortable care, payment plan options making dentistry more affordable and more convenient locations. Early diagnosis and treatment is always preferred in any aspect of health care and means more conservative treatment and a lesser cost, with better results. Please don’t suffer with tooth pain – simply call and make an appointment with your dentist.