It never seems to amaze me how often I run into my patients while I am at the movies, in the mall, at weddings, in the airport, and even at my daughters' piano recital.
Outside of office hours, by far the most common question I am asked is, "Dr. Mark, this tooth right here is sensitive. What do you think it is?” And they are very sincere when they do this because they obviously want to give me the best view possible as they retract their cheek with one finger and slide another finger down into the recesses of their oral cavity.
While I always encourage my patients to approach me with any dental concern they may have, I always laugh to myself when I am asked to diagnose their dental problems on the spot.
So, what should my response be?
1.Give me a sec while I take out my dental instruments from my back pocket as I never leave home without them.
2.Let's have a look, open up. Oh I hope you don't mind me doing this without gloves.
3.Why don't we see if this piano recital concert hall has a dental examining chair and x-Ray.
4.While I don't mind talking about it, please schedule an appointment for me to properly assess your problem in a more appropriate setting.
Tooth sensitivity is very common and is a symptom of many dental conditions including:
1. A “cavity" - Decay, caries, or what is commonly referred to as a "cavity" is a very common reason for tooth sensitivity. When bacteria create a hole in a tooth it can penetrate deep enough to irritate the nerve and become sensitive heat, cold, sweets and sour. These holes can develop in the biting surfaces of teeth (i.e. in pits and fissures) or in between your teeth (if you don’t floss enough).
2. Gum Recession – The gums tissue sits around your teeth similar to a collar around your neck. If the gums are irritated by bacteria or get traumatized by an aggressive brushing technique they tend to move, or “recede”, away from the tooth. This will expose the sensitive root of the tooth making it more sensitive to temperature, foods or even touching it.
3. Crack – Due to the force of chewing, teeth undergo extreme pressure and may crack as a result. If the tooth or pre-existing filling break the sensitive layer of the tooth can be exposed and result in discomfort.
4. Abrasion – The bristles of a toothbrush can traumatize the surface of a tooth if you brush too aggressively. Scrubbing side-to-side, similar to a lumberjack’s saw with a tree, can be very abrasive to the tooth and lead to the formation of a groove that penetrates to the sensitive layer of the tooth.
5. Erosion - Dental erosion is the progressive, irreversible loss of tooth structure caused by chemicals such as acidic foods (citrus fruits, juices, carbonated beverages and sports drinks, herbal teas, pickled foods, candies), medical conditions (gastric reflux, vomiting during pregnancy, bulimia and anorexia) or environmental acids (improperly chlorinated pools or occupation). Erosion alters the appearance and anatomy of the tooth and can lead to extreme sensitivity and can compromise the esthetic appeal of one’s smile.
6. Clenching & Grinding - If you wake up with a headache or a sore or stiff neck you may have been clenching or grinding your teeth while you have been sleeping. Other signs may include sensitive teeth, notches in your teeth near the gums, worn down or chipped teeth.
7. Attrition – This is the gradual loss of tooth structure on the biting surfaces of teeth due to excessive wear and tear often caused by eating excessively hard foods for a prolonged period of time or grinding. Sensitivity develops because the outer protective layer of the tooth (“enamel”) has been worn away.
8. Sinus Congestion – When sinuses get inflamed and congested with mucus, this can apply pressure to the area above your upper molars, leading to sensitivity, especially when chewing.
9. Infection – When a tooth is in the early stages of infection, the nerve may become inflamed and sensitive as a result.
10. Recent Trauma – When a tooth is traumatized, either due to a fall or biting on something too hard, the nerve may become inflamed and sensitive to biting and temperature. This can linger for days, weeks and even months.
11. Uneven Bite – When teeth are moved to a different position with orthodontic appliances, or if a filling was placed recently in a tooth, the new bite may irritate the nerve causing it to become inflamed and sensitive to biting and temperature.
12. Healing from Recent Dental Treatment – Most dental procedures require some time to heal and inflammation is a natural process of healing.
13. Pre-Existing Restorations – If a tooth has received dental treatment in the past that required a deep restoration, nerve inflammation may develop at any point the life of the tooth, even many years after the work has been done, and this can result in sensitivity.
14. Recurrent Decay – With time, sugar and poor oral hygiene bacteria can create decay around pre-existing restorations. The spaces that are created allow for sweets and temperature to penetrate and irritate the nerve.
15. Nerve Damage, Hypersensitive Nerves and Neurological Disorders – Trauma and medical conditions can alter the way a nerve responds to stimulation. Pain and sensitivity without any obvious dental problems may indicate an issue with the body’s nervous system. A consultation with a Medical Doctor may be indicated.
16. Lesions – If a cyst and cancerous lesion grows and compresses the neighbouring nerves it may lead to altered sensations. Thankfully, the development of such oral lesions is rare and more commonly leads to loss of sensation.
About Westmount Dental
At Westmount Dental, we always recommend a thorough examination to determine the cause of your discomfort and provide you with treatment options that are not only conservative, but will also restore function and comfort as quickly as possible.
Westmount Dental is located in the heart of Thornhill. In an effort to make dental care easy and convenient for all of our patients, we provide a complete range of specialized treatments, all under one roof. From paediatric dentistry to orthodontics, implants, root canal and preventive treatments, we minimize the need for outside referrals.
About the Author
Dr. Mark Buzaglo is a graduate of the University of Western Ontario where he completed his Doctor of Dental Surgery Degree, receiving the Pierre Fauchard Academy Award for outstanding academic achievement. He completed his undergraduate degree at the University of Toronto where he earned a Bachelor of Science degree with Honours. Dr. Buzaglo is an avid believer in ongoing continuing education and has completed many certified courses in all aspects of dentistry with particular focus in the fields of Cosmetic, Invisalign Orthodontics, and Implant Dentistry. He is a contributing writer and editor for the oral health programs at AdvancingIn.com and mdBriefCase.com, Canada’s foremost on-line continuing medical education websites for Medical Doctors in Canada. Dr. Buzaglo has a creative passion that is evident throughout your experience in his office, Westmount Dental. He has personally designed the layout and features of the office to provide an esthetic appeal to the flow of the working space. His creative ability is truly reflected in the dental treatment he provides to his patients.
When I ask my patients what they would like to improve about their smile, the most common response is whiter and brighter teeth. If you are searching for a cost-effective and non-invasive way to esthetically improve your smile then whitening may be an excellent treatment for you.
The following information is the first instalment of a three-part series of articles that will address the most common questions and concerns I receive from my patients.
For Your Convenience
With 15 minutes per day you will notice a remarkable difference in your smile with our Take-Home Custom Whitening. Alternatively, our Laser Whitening in-office treatment can whiten your teeth in less than an hour. Both whitening systems offer safer solutions when compared to commercial brands. Now that’s something to smile about!
Whitening Treatment Options – Laser vs Trays vs Store-Bought
Tooth whitening is a safe and effective way to brighten most people’s smiles and is available in a variety of methods and concentrations. The most common methods are Custom-Tray Whitening which is done in the comfort of your home, Laser Whitening is performed in our clinic, and there is a variety of commercial products sold over-the-counter at retail stores.
Both Laser and Custom Tray whitening systems offer fast, comfortable and effective results. The choice of one system over the other simply depends on your personal goals. If you would like fast results, laser whitening takes an hour. If you have a history of tooth sensitivity or would like a more controlled and targeted approach, then custom-trays would be more suitable for you.
Strips are not custom fit to your anatomy and therefore your teeth are not properly isolated from the gums. Excess whitening solution then oozes onto the gums and burns them. Our whitening systems seal the gums, protecting them from the whitening agents.
Paint-on whitening products don’t work in my clinical experience. Personally, I don’t know how they could! You paint the stuff on your teeth and pray that it doesn’t wash away, but as soon as you close your mouth your lips rub against your teeth and it rubs off. So, good luck trying to keep your teeth isolated and your mouth open for an hour.
Meeting Your Expectations
For your safety it is imperative to have a comprehensive examination first by a Dentist to assess for conditions or limitations that may impact on the success of this treatment. We will also discuss additional treatment that would reduce the risk of complications, increase the success of treatment, and help you achieve reasonable expectations.
Priced Fairly
Compared to many cosmetic dental offices in Toronto, our whitening systems are reasonably priced. We will never expose you to teaser rates, fine-print surprises or gimmicks to attract you to become a patient of our office. We treat all of our new and loyal patients equally.
Compared to many cosmetic dental offices in Toronto, our whitening systems are reasonably priced. We will never expose you to teaser rates, fine-print surprises or gimmicks to attract you to become a patient of our office. We treat all of our new and loyal patients equally.
Dr. Mark M. Buzaglo
Hon BSc DDS
Stay Tuned for Parts 2 & 3 as they will address Safety Concerns and Limitations to Tooth Whitening.