Why are my teeth so Sensitive? Wednesday, Aug 31 2011 

Tooth sensitivity is one of the most common of all dental complaints. In fact one in five adults suffer from sensitive teeth.  As long as you have adequate enamel and gum tissue around your teeth, sensitivity will not be much of an issue. However, once the gum begins to recede or shrink from around  your tooth for some reason, things change. This situation allows the dentin which is under the enamel to become exposed to the oral environment. This is the start of the problem.

At the center of the dentin is the nerve of the tooth. From the nerve, millions of tiny nerves travel through microscopic tubules to the surface of the dentin. These tubules are filled with fluid which protects the nerve fibers. But when you drink something really cold or hot, or sweet for that matter, the fluid in the tubules is stimulated and moves the fluid. This movement travels to the inside of the nerve chamber and results in pain.

Other things can cause the fluid to move and create pain. Some of these are dehydration of the tooth, which can be caused by tooth whitening chemicals. Decay at the gum line, a cracked or broken tooth, acidic foods like lemons, and grinding or clenching of the teeth can  combine with aggressive tooth brushing to create a sensitivity problem. In short anything that exposes the tooth surface (dentin) to the oral environment , can result in sensitivity.

Most treatments for this problem involve an effort to close or seal the microscopic dentin tubules. With the tubules closed, nothing can bother the small nerves and make the fluid move around in the tubules creating pain.  One method of treatment is using a tooth paste which contains potassium nitrate or a prescription strength fluoride rinse. So, you must clean and brush all parts of your teeth and use floss to keep the tubules sealed. Plaque on your teeth is another cause of tooth sensitivity. The bacteria create an acid that dissolves the dentin enough to open the tubules. Make sure your tooth-brush is soft since it will clean efficiently and  is gentle to your gums. Hard and medium tooth brushes can actually brush the gum from around your teeth.

If you are clenching and grinding your teeth you will need to use a night guard. Now, dental procedures can also cause sensitivity. Tooth cleanings, gum treatments, fillings and cementation or preparation of teeth for crowns can all result in sensitivity issues. These can be addressed by your dentist or will resolve by themselves.  For a quick fix, the dentist can apply desensitizing agents and make you feel better. But this is just a band aid. The real solution is proper brushing and flossing and maintaining your teeth. These two things combined with regular use of sensitivity tooth paste or fluoride rise will make you feel better and correct the problem.

So, You Want White teeth? Monday, Jun 13 2011 

Theoretically, one in a hundred people have white teeth. By this I mean that their teeth are noticeably lighter than most people. However, by todays standards, their teeth are not white enough. Today white means the color of a piece of copy paper or a bleached white shirt.

Well, you can get your teeth that white, but it will involve some effort, money and possibly pain. The cheapest method would be Crest White strips. A good method but you must follow the directions perfectly and be consistent with wearing the strips. There can be some problems with bleaching the areas between your teeth with the strips, but that can be solved. I should mention that the whitening mouth wash and tooth paste can help lighten your teeth, but it is a slow process and will produce only modest results.

The next upgrade in whitening is bleach trays made by the dentist (best method but I am a dentist ) or some kit you can purchase at the pharmacy or Wal-Mart. The dentist trays will fit the best and last the longest and will bleach all of your teeth, even the spaces between them. Also, the bleaching solution the dentist provides is strong, 22%  carbamide peroxide. An hour or two a day wearing the trays and you should be really white in seven days. A better method is to start with the Crest strips and then use the bleaching trays. This works well with super results. The bleaching pens that you apply to each tooth also work well with the trays. In short a combination of methods will provide good results.

The final whitening up grade is the Zoom and other light activated techniques which use a strong carbamide peroxide solution in the hight 20’s or low 30’s.The gums have to be protected with a coating and eye protection worn. These techniques produce results, but there are a coupe of caveats. First, sensitivity will be an issue with all bleaching techniques, but the high power ones can produce some problems. Next, all bleaching techniques require that you “refresh” the bleach every few months to maintain the results. Yes, your teeth will betray you and slip back to their orignal color.

There are a few tricks to work  with these problems. Trays are easy to use and can last a long time– years, so they can be worn any time you need a recharge. It is easy to get more bleaching solution from the dentist and keep some on hand. Next,before you bleach start using a toothpaste for sensitive teeth a week or two before you plan to bleach. A fluoride rinse can also help but has to be used daily. The dentist can provide treatments for the sensitive teeth if it is severe and chemicals that can be worn in the bleaching trays to make the teeth more resistant to the sensitivity.

All of these methods will work, but the most important thing to keep in mind is that old fillings and crowns in your front teeth will not bleach. They have to be replaced. If you chose to bleach, wait until you have the results you want and then have the fillings or crowns replaced to match your new teeth. Of course, you can  just have crowns or veneers put on your teeth and not bleach at all!

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