Tooth sensitivity affects 20% -35% of the population and can have significant repercussions on those who suffer from it. It is important to know the causes that cause it and the keys to its treatment in order to prevent and combat this annoying dental disorder.
Tooth sensitivity is defined as acute dental pain caused by dentin exposure and that appears after contact with apparently harmless external stimuli such as heat or cold, sweet or acid, or by touch, and that cannot be associated with any another type of oral pathology.
There is some controversy about the etiology of this pain, the hydrodynamic hypothesis being the most accepted. According to this hypothesis, the fluids that are within the dentin tubules are altered by thermal, physical or osmotic changes, stimulating pressure receptors that lead to nervous excitation, which results in dental pain.
In healthy conditions, dentin is protected from the oral environment by enamel (crown) and by cementum (root). Enamel is the hardest part of the body. Cement, much finer, weaker and more porous than enamel, is protected by the gum. However, in certain areas, especially in the neck of the teeth, there may be little enamel or cement that, if lost, expose the dentin tubules to the oral environment.
If there is gingival recession, the thin layer of cement remains in contact with the oral environment and is often lost, as it is worn away by tooth brushing and the use of floss or toothpicks.
The prevalence of tooth sensitivity is 25% -30%, varying depending on the population group studied (more prevalent in individuals with periodontal disease and smokers). It could be assumed that tooth sensitivity increases with age, since enamel wear and gingival recession would be greater. However, it is observed that the highest number of cases occurs in the population between 30 and 40 years of age, more prevalent in women. This is because with increasing age, the permeability of the dentin (becomes sclerosing) and the sensitivity of the nerves decrease. The sclerosed dentin and the secondary dentin that develops are less sensitive to these stimuli.
Most cases of tooth sensitivity are associated with gingival recessions (68%). The most common sensitivity is due to contact with cold, and its appearance is more frequent in the canines (25%) and premolars (24%), and in the vestibular faces (93%).
CAUSES OF DENTAL SENSITIVITY
Poor oral hygiene
Brushing with excessive force can cause gingival recession (especially in fine gingival biotypes), cervical abrasion, and opening of dentin tubules. In addition, the moment of brushing is important, since, if it is done just before or after having ingested acidic foods and drinks, the wear of the enamel and cement can be greater. On the other hand, poor oral hygiene allows the accumulation of oral biofilm (bacterial plaque), especially at the cervical level, which can destroy enamel and cementum.
Acidic drinks and diets
Certain foods have a low pH that contributes to the erosion of enamel and cement, such as citrus fruits, jams, yogurt, tea, wine or soft drinks.
Dental treatments
Periodontal surgery and, to a lesser extent, root scaling can cause slight removal of cement and an apical displacement of the gingival margin, which can result in gingival recession.
In-clinic whitening treatments use procedures and substances that can cause temporary tooth sensitivity, greater in the case of gingival recession.
Bruxism
Patients who suffer bruxism have incisal and occlusal wear and tear. The tensions derived from the grinding of the teeth cause their flexion at the cervical level and the loss of the crystals that make it up, allowing contact of the dentin with the oral environment.
General illnesses
The pathologies that occur with acids in the mouth and that, therefore, produce greater dental erosion (for example, gastric ulcer, anorexia and bulimia) can also cause tooth sensitivity.
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