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Have sensitive teeth evaluated by dentistDear Dr. Reitz: Sometimes when I drink hot beverages, the left side of my lower jaw aches. Conversely, my husband says one of his teeth hurts when he drinks cold beverages or eats ice cream. Should we worry? - L.P. Dear LP: To make an accurate diagnosis it will be necessary to have your sensitive teeth evaluated by a dentist, however I can tell you the usual reasons for pain from hot and cold. When a tooth becomes sensitive to hot it indicates the nerve has died and bacteria has taken up residence in the center of the tooth. If you are wondering why a dead tooth hurts, the answer is that as it rots pressure builds in the confined nerve space. Applying heat to the tooth increases the pressure and pain results. If this is the situation, your tooth requires root canal treatment. In your husband's case, there are many reasons for cold sensitivity and finding the cause may be more difficult. It's important to know the duration of the pain and whether the tooth ever hurts without the cold stimulus. If tooth decay is not present, and gum recession has exposed the roots of the teeth it's possible that the sensitivity is arising from exposed dentin in response to the external stimuli. In my practice I have found many of the toothpastes that have ingredients for tartar control and tooth whitening cause cold sensitivity. The roots of the teeth do not have the hard enamel coating that is present on the top of the tooth. The mechanism is not fully understood, but it's speculated that some roots have a heightened ability to conduct stimuli from the outside of the tooth into the nerve. A few products on the market are effective at coating the dentin and blocking the conduction of painful impulses. Adding potassium nitrate to toothpaste was one of the first treatments for root sensitivity. Although potassium nitrate has not been conclusively proven to be effective, it is found in most toothpastes that advertise sensitivity relief. Stannous fluoride has also been proposed as effective in treating root sensitivity. It's not unusual for toothpaste manufacturers to have both potassium nitrate and stannous fluoride as the active ingredients in their toothpaste for sensitive teeth. If you prefer a non-fluoride method, the ingredient calcium carbonate is purported to block the dentin with a coating of calcium. A few of my patients have reduced sensitivity after using the prescription product DenClude, which contains calcium carbonate. The column is written by John Reitz, DDS, and does not represent the opinion of the Pennsylvania State Dental Board. Dr Reitz answers questions from readers. E-mail them via his Web site at reitzdds.com or mail to John Reitz, DDS, 30 Commerce Drive, Wyomissing PA 19610 John
V. Reitz, D.D.S., F.A.G.D. Copyright
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