Tooth enamel is pretty remarkable. It’s both the hardest substance in the body and one of the few tissues your body can never make more of. Once your teeth have developed, that’s it. You no longer have the specialized cells needed to build enamel.
Enamel protects the softer, more delicate tissues within the tooth, all the way down to the living pulp, with its complex network of nerves, blood vessels, and other structures. Those nerves extend into the dentin, which forms the part of the tooth between the enamel and pulp.
But while enamel is amazingly strong, it’s not invulnerable. It can be damaged. It can erode, exposing nerve endings in the dentin. A hot coffee or a sweet bite of pie can be more than enough to set those nerves buzzing and get you wincing in pain.
How Enamel Can Be Damaged & Lead to Tooth Sensitivity
Of course, your body has good defenses to keep this from happening in the first place. Most important is eating a low sugar, whole foods-based diet that delivers all the nutrients needed to naturally remineralize the enamel. Calcium, magnesium, and phosphorus are the most important, along with the fat-soluble vitamins A, D, E, and K, which help with calcium absorption and transport.
Delivered via saliva, these nutrients continually help reinforce the natural mineral structure of your teeth – a highly organized crystal lattice made mostly of calcium and phosphorus called hydroxyapatite. (In case you’re curious, the components that make up the remaining 4% of the enamel are proteins and water.)
But there are some things that can overwhelm such mouth/body defense mechanisms, leading to tooth sensitivity.
The most common is consuming a lot of food and drink that is acidic or contains sugars and other highly refined carbs, which temporarily turn the oral environment acidic. All this acid destroys enamel. And it’s why soft drinks and fruit juice are especially bad for the teeth. They contain both acids and sugars.
Another common cause is brushing too hard or using a brush that’s too hard. (Anything harder than soft bristles is too hard.) After time, all that friction is bound to wear anything down. Similarly, bruxing – the habit of clenching or grinding your teeth, often during sleep – can damage enamel over time, as well. It can also contribute to gum recession, which can be yet another cause of sensitivity.
What Kinds of Treatments Work for Sensitive Teeth?
When a patient comes to us complaining of tooth sensitivity, we always look first to the cause (or causes). After all, treating the symptom without treating the cause means, at best, only short term relief. Treating the cause means treating the source so you prevent the problem from occurring again.
So if diet is the issue, we look to help you improve it. If bruxing is the problem, we look to whether the bite needs to be addressed or if there are other factors contributing to the grinding habit. Where there’s recession, we can help repair the gum tissue with treatments like Chao Pinhole Surgery.
There are also good, biocompatible options out there for helping strengthen your natural enamel. While most toothpastes formulated for sensitive teeth work by blocking the nerves in the dentin or depolarizing them so they can no longer send pain signals to the brain, these products work by delivering to your teeth compounds that naturally occur in them.
One of these is calcium phosphate, a free form of the two minerals that make up the bulk of natural tooth enamel. Used in products like MI Paste and MI Paste Plus, Recaldent – the brand name for calcium phosphate – is a derivative of milk protein that adheres to teeth, desensitizing and remineralizing the enamel.
Another innovative biomimetic substance we love is nano-hydroxyapatite. This is what your enamel is made of (also your bones), making it completely biocompatible, 100% nontoxic. As one recent review of the science put it,
HAP [hydroxyapatite] is a biomimetic oral care agent, and its caries prevention has been tested in vivo, in situ, and in vitro with a high safety profile and no risk of fluorosis. While more research is needed to confirm the clinical effectiveness of HAP at preventing and arresting dental caries, the research suggesting its equivalency to fluoride toothpaste is promising. HAP-containing oral products can be considered as an alternative in young children where fluorosis is a concern. In addition to perhaps reducing the need for traditional dental restorations, HAP also offers relief from dentin hypersensitivity and reduces biofilm formation making it a multifunctional agent for preventive oral health care.
Due to its incredibly small particle size, nano-hydroxyapatite remineralizes the tiniest spaces where early decay occurs, while also acting as a barrier to harmful bacteria. And because your teeth recognize the compound, they deeply absorb it, reaching further into the teeth to make them stronger and more resistant to decay, without any toxicity.
There are an increasing number of hydroxyapatite toothpastes available, but our favorites, by far, are Boka and Risewell. They even have a teflon-free floss that can deliver the mineral to your teeth, as well, including those spots that toothbrushes can’t reach.
Even if sensitive teeth aren’t a problem for you, adding a product like this to your hygiene routine can offer extra support for natural remineralization, helping to keep your teeth – enamel and all – healthy and whole for a lifetime.