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Hypersensitivity is a common condition. A lot of things can cause sensitivity. These stimuli include thermal (cold), tactile (touch), or osmotic changes (sweets or drying the surface).

You have little tiny (dentinal) tubes in your teeth that when exposed become really sensitive/painful. The pain is equivalent to exposing any nerve in your body to the open air!

The most common cause for exposed dentinal tubules is gingival (gum) recession.

When gingival recession occurs, cementum is exposed. Cementum is a very thin outer protective layer of the dentin. And it is easily abraded or eroded away. This leaves the underlying dentin, which consists of tubules which contain nerve endings. When these nerve endings are disturbed then you have pain. The pain has a rapid onset and is usually of short duration, but it can persist as a dull ache.

The initial diagnosis should eliminate any possible reasons such as decay, cracked tooth, or irreversible pulpitis that may mimic dentin hypersensitivity.

Treatment of dentin hypersensitivity is challenging for both the patient and the dentist for two reasons. It is difficult measuring and/or comparing different patient's pain and it is difficult for patients to change the habits that initially caused the problem.

In addition, hypersensitivity can resolve without treatment or may require several weeks of desensitizing agents before improvement is seen. There are two principal aims of treatment.

You can either:

1. plug or block the dentinal tubules preventing fluid flow, or

2. desensitize the nerve, making it less responsive to stimulation.

There are really only three types of treatment:

1. Mechanical solutions

- Gum Surgery

- Filling

- Crown

Because the main cause of sensitivity is gum recession you really have only a handful of things you can do for a permanent solution. Gum surgery, fillings and crowns can all be used. Ideally, fixing the gums is the best solution. Putting a filling into a good tooth/root will not be recommended by any dentist unless the situation becomes drastic. The same goes for a crown.

2. Chemical solutions

There are only 2 chemicals that (are widely recognised to) work:

Potassium Nitrate - Currently there is only one chemical that claims to desensitise the nerve. That compound is potassium nitrate, the ingredient found in sensitive toothpaste. Essentially, it works by numbing the nerves.

Fluoride - this occludes the tubes preventing the stimulation of the nerves.

3. Sealants

There are various sealants that act to prevent stimulation occuring. They are placed on the exposed dentin. These sealants have been moderately successful: their effect can last for a short or medium length of time.

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