The pain of hypersensitivity

Maxwell O’Neill considers the causes and solutions to the problem.

We are currently experiencing some chilly wintery weather in the UK. For most of us, it is time to wrap up warmly or turn the heating up. But for some people, cold breezes mean pain. Whether exercising, socialising or working outdoors, the exhilaration of a winter activity can be completely ruined for patients with dentine hypersensitivity. Obviously, a crack, break, cavity, a missing restoration or an exposed root is likely to cause pain. However, if there is no explainable dental defect or pathology, the chances are that the sensitivity derives from exposed dentine.

As we know, the sensitive parts of teeth are protected by an outer coating of enamel. However, loss of hard tissue can expose the dentinal tubules to the dentine surface. When the tubules are then exposed to appropriate stimuli such as cold, hot, chemical, tactile or osmotic, the pulpal nerves produce a short, sharp painful response. Usually the pain of hypersensitivity is localised and short in duration, but the distress that it can cause depends upon the individual and can range for minor to severe. Furthermore, it is not just a blast of cold air that can cause discomfort; patients have reported that pain is often initiated by hot or cold drinks as well as sweet foods and toothbrushing.