Health Notes: Sensitive teeth – the causes and how to help this very common problem
Tooth sensitivity, often causing considerable pain, is one of the most common dental problems, affecting around half the UK population. It’s down to tiny tubules in the dentine, the softer underlying layer, exposed when tooth enamel and/or gums are worn away. The tubules are connected directly to nerves, which react sharply to triggers such as hot, cold or sweet food or drink.
Now researchers at University College London (UCL) have developed a new toothpaste, Ozen Daily Sensitive Formula Toothpaste, using a material called Aerograft, originally developed for bone grafting. While most toothpastes formulated to help sensitivity may help dull the nerves, this advanced formulation rapidly rebuilds tooth surfaces, helping all forms of sensitivity.
A significant cause of sensitivity is teeth whitening treatments, according to lead UCL scientist Dr. Niall Kent, an NHS oral and maxillofacial surgeon who has been researching sensitivity for over ten years.
Showing sparkling bright teeth when you smile is something of a beauty mantra. For many of us, a regular clean, scale and polish with a good hygienist does the trick nicely. But if you’re conscious of discolouration, teeth whitening treatments can be a tempting option.
A course of peroxide-based teeth whitening with your dentist often causes a short sharp bout of sensitivity to triggers for 24 to 48 hours after each whitening session because it temporarily opens pores in the tooth enamel, exposing the tubules. But it’s usually temporary. The options and contraindications are explained in the NHS guidance on Teeth Whitening here.
There’s also a raft of options available over the counter and online, including peroxide-free strips, at home LED kits where an LED mouthpiece is paired with a whitening gel or serum, whitening toothpastes and polishes, even nifty pens for on-the-go touch-ups. One consumer review site tested 27 products. Obviously, you won’t have a qualified dentist administering those products, which is less than optimal, and worryingly research suggests that people, particularly in younger age groups, may overdo teeth whitening treatments.
New polling of 2,106 adults commissioned by Ozen showed that a third of 25–34-year-olds whiten their teeth, compared with one in 20 over-65s. One in four of the younger age group now reports whitening-linked sensitivity, which many are reluctant to admit to.
According to Dr. Kent, ‘the generation chasing the whitest smile is feeling the most pain from it. They are whitening more, hurting more, and telling people less. That is not a good combination.’
An added and dangerous threat was uncovered last year by a BBC North West Investigation, which found a thriving trade in illegal teeth whitening treatments, mainly accessed via beauticians.
As the reporters explained: ‘In the UK, treatments using teeth-whitening products containing more than 0.1% hydrogen peroxide can only be carried out by dentists and other professionals registered with the General Dental Council (GDC). And products used in treatments offered by dentists cannot contain more than 6% hydrogen peroxide. However, products sold to undercover BBC reporters were sent to a laboratory for tests where results showed they contained hydrogen peroxide levels of up to 53%.’
The gels in the kits bought by the BBC were described by Dr. Shalini Kanagasingam from the University of Lancashire as ‘extremely dangerous’ for their potential to burn gums and destroy teeth.
‘Done properly, teeth whitening is safe,’ says Dr. Kent. ‘Done badly, it allows irritation of the nerve inside the tooth and strips away the protection that keeps everyday hot, cold and sweet triggers at bay.’ And the difference, he says, is basically whether you go to a dentist or not.
Dr. Kent’s advice is clear:
1. If you whiten, do it with a registered dentist. No exceptions.
‘A dentist checks your mouth is fit for it, uses a legal strength and stops if something is wrong. A kit bought off social media does none of that. [And] the BBC found gels at 53% peroxide being sold in car parks. That is not a beauty product, it is an industrial one, and it is going into people's mouths.’
2. Ignore the hacks doing the rounds online.
Lemon juice, baking soda, charcoal, neat hydrogen peroxide rinses: the viral favourites all share a flaw - they strip enamel to fake a whiter look. ‘They are not whitening your teeth; they are sanding them down. You get a brief brightness while you wear away the surface, and the sensitivity that follows is the enamel telling you it has gone. There is no undo button on enamel.’
3. Do not whiten through the pain.
Sensitivity during or after whitening is a signal, not a side issue to push past. Dr. Kent's rule is to stop and space treatments out rather than double down. ‘People assume the sting means it is working, so they go again sooner. All they are doing is whitening teeth that are already irritated and asking for a break. If it hurts, that is the cue to slow down, not speed up.’
Dr. Kent’s oral care brand Ozen offers two effective products to help anyone with sensitivity and particularly those going through teeth whitening treatments. ‘A daily sensitivity toothpaste builds up a protective layer over time, so the teeth are less exposed going into a whitening cycle. And for the flare-ups in between, an on-the-go gel can be applied at the first twinge, or before a known trigger like an iced coffee, forming a protective layer on the spot.’
Sensitivity Starter Pack/£25 for 1 Fresh Mint Sensitive Formula Toothpaste plus 1 Mint Free Oral Gel – buy here
Daily Sensitive Formula Toothpaste/£30 for 3 x 75ml pack in Fresh Mint or Cool Mint – buy here
On-the-Go Sensitive Formula Oral Gel/£30 for 2 x 30ml pack in Mild Mint – buy here
