Smile, it’s a new year

By Dr. Stephanie McGannDMD FAGD, Columnist, The Times

In the last few days the extreme cold temperature of the northeast has frozen pipes, chilled the soul and made people with sensitive teeth frown.

When even smiling in the cold is too much for the teeth it’s a real concern. So many times we are asked what can be done. This month I am going to go over some tips to help keep those winter smiles.

It’s important to know why teeth are sensitive.  For this discussion we are talking about otherwise healthy teeth that are just  very sensitive to cold.  Teeth are made of three basic layers.  Enamel is the hard shell covering the tooth. Dentin is the middle layer that comprises the bulk of the tooth and the pulp, the soft center composed of nerves, blood vessels and connective tissues.

Enamel has no nerve endings and is intended to insulate the teeth from the harshness of the oral environment. However, small chips or cracks in the enamel can allow external factors to reach the dentin. Dentin has nerve endings and can be sensitive to stimuli in many people. Sometimes gums recede and expose the root of the tooth. Tooth roots do not have enamel their outer covering is easily brushed away and exposed dentin results.  Thin enamel many  not adequately protect the tooth from changes in temperature.  In these situations we can address the sensitivity a few different ways.

The first line of defense against sensitivity is a toothpaste designed for sensitive teeth. These products have inert ingredients engineered to block the dentin and put a barrier between the nerve endings and the outside world. This could be thought of as a bandage. However dentin does not “heal” so it must be used continually. Avoid mouthwash that contains alcohol, instead focus on rinses that have extra fluoride.

The next option is a prescription toothpaste that incorporates a higher level of fluoride and or a calcium phosphate application to make the enamel denser and less susceptible to cold. In addition ask your dentist for a fluoride varnish treatment each time you get your teeth cleaned.

Enamel that is cracked, chipped or eroded away should be replaced with either a resin material or covered completely with a crown.  Adding this protective and insulating layer will reduce or eliminate the sensitivity.

Children often have sensitivity on newly erupted permanent teeth.  This is simply because the dentin gets thicker as we age, so newly erupted front teeth of children have less insulating dentin between their enamel and pulp. This will self correct with time.

Other factors that may impact sensitivity.  Whitening products tend to make teeth sensitive during the process. People with sensitive teeth in general may find it difficult to whiten.  Stay away from whitening toothpastes or over the counter bleaching aids.

Seriously sour candies can cause enamel thinning and erosion. If  it’s sour it contains citric acid and is dissolving enamel while you pucker.  Steer clear of sour candy.

Always discuss the sensitivity with your dentist.  If sensitivity persists there may be a larger underlying concern. Your dental professional can help guide you to a smile without fear of winter.

Dr. Stephanie McGann, who has more than two decades of dental practice experience, is a resident of the Unionville area and along with her partner, Dr. Marie Scott, practice at The Brandywine Smile Center, a family-friendly dental practice in Concordville. Dr. McGann also owns a practice in Valley Township, Rainbow Valley Dental. She is the current President of the Chester/Delaware Dental Society and she is a Fellow of the Academy of General Dentistry.

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