Big Red Tooth – Dr Candice Schwartz

Where teeth and health meet

Tooth Sensitivity…..

Tooth Sensitivity is a common problem I am faced with on a daily basis. Patients come in and complain of varying degrees of sensitivity and seek help and solutions. The treatment of tooth sensitivity is a tricky one. The most common cause of tooth sensitivity is gingival recesion resulting from aggressive brushing techniques. The susceptibility of the gums to recession increases with age. As the gum recedes upwards, the root surface of the tooth becomes exposed. The crown of the tooth is covered by a protective layer of enamel. The root however does not have this enamel covering and is thus far more sensitive (particularly to changes in temperature).

All the television adverts for sensitive toothpastes claim to cure patients instantly and miraculously of their painful sensitive teeth. It would truly be a miracle if these toothpastes worked so well! However the fact is, they dont. The other ugly truth is that once the gum has receded it will never move back down into its original position- the damage is therefore permanent.This means its time to trade in your frayed and aged brush, for a soft gentle brush which will not cause further damage to your gums. If you are battling to find a really soft toothbrush, just buy something from the kiddies range!

There is only one product (which is not available from retail stores but only through dentists) that I feel truly treats and improves tooth sensitivity. It is not the purpose of this blog to market any specific products, so I will not mention the name, however if you email me I will gladly provide you with the name of the product.

The “sensitive brand’ toothpastes on the market do, in theory provide some relief, but it is minimal in my experience. Most of the time, patients just learn to live with the fact that they have sensitive teeth. They steer clear of ice cold drinks or ice creams and just take a lot more care in choosing the colder foods. Some people are so sensitive (like myself) that they cannot even bite into a piece of fruit that has been inside the fridge.

The most important thing is to not let the gum recession get any worse. Your dentist will provide you with specific oral hygiene instructions to ensure this. The good news is, with time, the longer the root is exposed to the oral environment the less sensitive it becomes. As you get older the sensitivity will ultimately decrease, however this may take years.

In closing, brush gently to prevent tooth sensitivity. Prevention is better than cure- especially when there isnt one!

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Gum Recession

Question:

What causes gum recession and can it be prevented?

Answer:

Gum recession occurs gradually, over months or years and gets worse with age. The gumline rises with time which results in the root surface of the tooth being exposed to the oral environment.The tooth crown is covered by a hard layer of enamel which protects it against decay and toothbrush wear. The tooth root does not have this protective enamel covering and is a lot more vulnerable. One of the most common signs of gum recession is teeth that are highly sensitive to cold and touch at the gumline. Gum recession is a common problem I see in my practice, and if left untreated over time it can leave teeth more susceptible to cavities and continued discomfort and sensitivity.

When gum recession occurs on the front teeth it is quickly noticed by patients because it is esthetically displeasing. However it is less commonly diagnosed early on the back teeth.

Some factors that contribute to increase gum recession are poor oral hygiene, tobacco use, and a genetic predisposition to thin bones and gums. Sometimes when teeth have been moved outwards during orthodontic treatment (braces) recession can be seen later in life as the gums are thinner in these areas. Clenching and grinding the teeth at night can exacerbate the problem, and wearing a bite plate at night may help. Gum recession resulting from a bacterial infection is also coupled with bone loss around the teeth. This is severe and leads to loosening and eventually loss of the teeth. Newer research is pointing towards “abfractions” as the cause of gingival recession. These are “wear” points at the neck of the tooth , where the enamel has disappeared and dentin is exposed.

The most common cause of the gum recession is aggressive brushing techniques with a toothbrush that is too hard. Incorrect brushing causes daily insult to the thin gum tissue around the tooth neck and in response to this the gum recedes. The best way to prevent gum recession is regular visits to the oral hygienist and dentist. Early treatment is the best way to avoid tooth decay, tooth loss, and infection.

Dental Erosion is the acidic dissolution of the teeth-starting with the softening (demineralization) of the enamel and underlying dentin and subsequent structural tooth loss. It’s caused by acids in food and beverages as well as by regurgitated stomach acid resulting from reflux disease (in contrast, cavities are caused by acid-producing bacteria on the teeth, which feed on sugars). Overbrushing, abrasive toothpaste, tooth grinding, and other excessive mechanical wear and tear can dramatically worsen the damage caused by dental erosion.

Gum grafting surgery is a treatment option for gum recession and often involves taking tissue from the roof of the mouth and attaching it to remaining gum tissue. However the success rate is low.

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