A male patient scheduled a consultation with me through Skype. His question was, "Why do I have tooth-root sensitivity?"
He told me he had sensitivity on some of the roots of his teeth for more than three years. He wanted to hear my thoughts, since he had not been able to get relief. I explained some of the causes and some of the solutions to his distress.
Root sensitivity can be very painful for patients. It may be the least successfully treated chronic problem that involves the teeth. Some studies suggest that more than 60% of adults complain of root sensitivity on a daily basis.
An array of treatments has been used in the dental office to try to lessen or eliminate root sensitivity. Most of the treatment consists of "covering up" the root surface with different chemicals to protect the nerve endings within the tooth from irritating substances in the mouth. Cover-up treatments usually don't address the real causes and are usually temporary.
Causes of root sensitivity
Once you work through the possible causes, you can help your patients eliminate root sensitivity. The sensitivity has many many possible causes:
- A poorly placed filling in a tooth can cause root sensitivity.
- Incorrect and aggressive flossing could cause tears in the gum tissue resulting in root sensitivity.
- Active tooth decay on the root surface or leakage around an existing filling could cause this sensitivity.
- Heavy biting or chewing forces between the upper and lower teeth also could cause roots to become sensitive.
- Possible microscopic fractures in the root that may irritate the nerve might be a cause.
- Your patient's pulp might become inflamed, which could cause severe sensitivity and pain.
As the list indicates, there are many possible causes. Treating these causes might stop the sensitivity. If root sensitivity is not caused by any of these problems, then other causes need to be explored, such as root surface exposure from active gum disease, orthodontic treatment, and grinding and clenching habits.
All of these could cause gum recession, which exposes the surface of the roots. After these surfaces become exposed, the root's protective surface layer could be lost. Acids in the mouth from dental plaque, gum disease, or very acidic food and drink also could dissolve this protective layer.
Are your patients brushing too aggressively? Abrasion from aggressive tooth brushing on the exposed roots also could wear away the protective layer. It may be basic, but proper oral hygiene, treatment for gum disease, and elimination of bite problems may reduce root sensitivity. Also, I remind my patients to eat nutrient-dense foods, which can help harden sensitive root surfaces.
In addition, gum grafting over the sensitive roots might be able to decrease sensitivity.
As I mentioned, chemicals have been placed on the surfaces of sensitive roots to create a protective layer. Most of them are only temporary. However, two recently published peer-reviewed studies suggested two unusual and effective products.
A 2010 study from the Journal of Conservative Dentistry concluded that casein protein and minerals in milk have the potential to help remineralize sensitive root surfaces. Also, in a 2015 randomized controlled trial in the Journal of Clinical and Diagnostic Research, patients with sensitive roots were divided into an experimental group and a control group. The experimental group had to rinse with 2 tablespoons of milk at room temperature five times daily for five minutes for 15 days. The control group had to rinse with lukewarm water. The experimental group who used milk had a significant reduction of sensitivity and pain.
Another substance that may be useful is propolis. This is a substance collected by honeybees to repair their hives. Propolis is antimicrobial, antiparasitic, antiviral, anti-inflammatory, and anesthetic, according to a 2004 study in the Journal of Endodontics.
Adults with sensitive roots were studied in a randomized and double-blind, three-month trial published in the Journal of the Indian Society of Periodontology in 2014. Researchers applied topical preparations of propolis, 5% potassium nitrate, and distilled water onto different sensitive roots of these subjects. The preparation using propolis immediately provided significantly more reduction in sensitivity. In addition, by the end of three months, the propolis-treated teeth had even more reduction of root sensitivity.
I tell my patients that the first focus of treatment consists of reducing sensitivity by addressing the factors discussed above. If root sensitivity remains because of the loss of the protective layer, then a nutrient-dense diet along with the use of propolis or milk could solve the problem.
A version of this column first ran on Dr. Danenberg's blog. DrBicuspid.com appreciates the opportunity to reprint it. His book Crazy-Good Living is available on July 15, 2017, by Elektra Press.
Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.