Increased tooth sensitivity after installation of a filling: causes and solutions to the problem

Increased sensitivity of teeth (hyperesthesia) is a short-term occurrence of pain under the influence of temperature, chemical or mechanical irritating factors. Usually occurs when drinking cold water, sour, sweet, salty, or touching with a toothbrush. The intensity of pain varies from mild to unbearable.

According to WHO, every second person in the world suffers from hypersensitivity. In Russia it is about the same: 45–65% of adults aged 20–55 years. More often women make complaints.

A little anatomy

A tooth consists of a crown and root part, connected by a neck. The coronal part is covered with enamel, the root part is covered with cement. Beneath the enamel and cement there is dentin, a hard tissue. Inside there is soft tissue - the pulp; blood vessels and nerves pass through it.

Dentin is not sensitive, but consists of many tubules in which fluid circulates. The irritant causes fluid movement, which is detected by the nerve endings of the pulp. A person feels their reaction as pain.

Tooth sensitivity: causes

• Demineralization of enamel. It becomes more loose due to the leaching of calcium, phosphorus, and other trace elements.
• Thinning of enamel. As a result of increased abrasion due to malocclusion and the occurrence of wedge-shaped defects.
• Untreated caries or violation of the marginal seal of the filling.
• Exposure of roots as a result of injury, metabolic-dystrophic process or inflammation of the gums.
• Changes in the pH of saliva due to the consumption of certain drinks, foods, and medications. A pH of less than 5.5 is considered dangerous.
• Some diseases accompanied by gastroesophageal reflux and endocrine disorders.
• Vitamin deficiency, exposure to radiation, work in hazardous industries, living in a region with an unfavorable environmental situation.
• Smoking.

More often than not, several reasons are discovered at once. The enamel becomes thinner, loses strength, and cannot protect dentin from irritants. The result is pain.

Provoking factors

Hyperesthesia does not appear immediately. There are several factors that you need to pay attention to in order to eliminate them in time. Don't wait for discomfort to appear. It is better to initially develop healthy habits that will help you maintain your health so that you never experience acute dental pain. Sensitivity increases when any of the factors listed below are present.

1. Insufficient oral hygiene. Soft plaque is an accumulation of microbes that eat food microparticles stuck in crevices, releasing organic acids that dissolve enamel minerals. Externally, the dental unit looks intact, but the density of the enamel is significantly reduced. Its demineralization occurs. The first alarm bell is increased sensitivity, then caries develops.
2. Consumption of certain foods. Juices, wine, sweet soda, fruits, candies, and other sweets contain phosphoric and other acids that negatively affect the strength of enamel.
3. Constant use of aggressive whitening pastes containing abrasive and chemical components.
4. Ultrasonic cleaning. Under a dense coating, the enamel becomes thinner and becomes loose. After professional cleaning, it is exposed, its sensitivity increases sharply. Usually, dentists, taking this point into account, use strengthening pastes at the end of the procedure for the preventive treatment of tooth sensitivity.

Types of hypersensitivity

If sensitivity is increased on one or more teeth, it is called limited. If for everyone - generalized.

Table 1. Types of hyperesthesia

№	View	Reaction
1.	Light	for cold, hot
2.	Average	as with 1st degree plus for sour, sweet, salty
3.	Expressed	as in grade 2 plus mechanical irritants (when brushing teeth, eating)

Treatment of increased teeth reaction to sour foods

Why teeth react to acid in a particular patient can only be determined by a dentist based on the collected medical history and diagnostic examination data. Unfortunately, today the exact mechanism of the formation of hypertension is not known, but the mechanism of development of this pathology under the influence of certain factors is known.

Classic methods of treating dental reactions to acid are: physiotherapy (iontophoresis), remineralizing therapy, diet correction, changing personal hygiene products (performed taking into account the physiological characteristics of the patient), as well as the use of topical medications.

The specialized clinic "AlfaDent" in Orenburg offers high-quality dental services on favorable terms for the patient. If your tooth reacts to sour foods or there is severe pain after sour foods, make an appointment!

Sensitivity of teeth. Stages of treatment

1. Eliminate the cause of hyperesthesia: get rid of plaque, deposits, stones, caries, wedge-shaped defects.
2. Carry out professional oral hygiene.
3. Strengthen the enamel with calcium and fluoride.
4. Teach the patient how to use a toothbrush and floss correctly.
5. Choose suitable dental care products: toothpaste, mouthwash.

Table 2. Tooth sensitivity: causes and how to treat

№	Cause	What to do
1.	Soft coating.	Careful hygiene with home remedies.
2.	Hard coating.	Professional hygiene in dentistry.
3.	Caries in the white spot stage.	Deep fluoridation, remineralization.
4.	Caries, pulpitis, periodontitis.	Dental treatment.
5.	Exposure of the cervical part, wedge-shaped defect.
6.	Malocclusion.	Orthodontic therapy.

Precautions to reduce tooth sensitivity during rehabilitation

After caries treatment, the patient needs to follow simple precautions that will help quickly restore normal reactions:

• Use desensitizing toothpastes containing high doses of fluoride, potassium chloride, potassium nitrate or other remineralizing elements to help reduce tooth sensitivity. Pastes with abrasive particles are prohibited at this time.
• During the rehabilitation period, toothbrushes should be used with medium or low bristle stiffness; the front teeth should be brushed with strictly progressive movements up and down, and chewing teeth should be brushed with circular movements clockwise.
• Foods high in vitamin D (milk, fish, egg yolk, cheese, liver) should be added to your diet to further strengthen tooth enamel.
• To rinse the cavity, you can use various formulations, for example, tea tree oil (3 drops per glass of water). It has high antibacterial properties, prevents the development of caries, and eliminates unpleasant odors.

• The simultaneous consumption of cold and hot foods is not recommended; overly sour or sweet foods, as well as coloring foods, should be avoided. After every meal you need to rinse your mouth.

If sensitive teeth still cause significant discomfort, you can take non-steroidal anti-inflammatory drugs - consult your dentist.

Elimination of tooth sensitivity

Using ultrasound, the doctor removes soft and hard deposits from the teeth. After removing plaque, teeth become more sensitive for a short time, so remineralization or deep fluoridation is immediately carried out. During remineralization, the enamel is treated with active compounds of calcium and phosphates. Deep fluoridation – coating with sodium fluoride. Both procedures significantly strengthen the enamel's resistance to irritants.

The doctor uses agents that reduce the movement of fluid in the dentinal tubules. It “seals” them using desensitizers or reduces their volume through remineralization. Protecting exposed dentin reduces the force of transmission of the irritant impulse from the enamel to the nerve.

Methods of dental treatment for caries

The method of treating this disease depends on its stage. Let's take a closer look at what measures are applied at each stage:

• Chalk stain. In this case, it is still possible to carry out therapy without resorting to a drill and filling. Typically, enamel remineralization is carried out using formulations with a high content of sodium fluoride and calcium gluconate.
• At the superficial stage, it may sometimes be necessary to install fillings, and remineralization of the enamel is also carried out.
• In the middle stage, it is necessary to clean carious cavities and then fill them to protect them from bacteria.
• Deep caries is treated in several stages. First, the damaged dental structures are cleaned, then a temporary filling is installed. On the second visit, if no negative reactions occur, the doctor puts a permanent filling, grinds and polishes the tooth.

A competent dentist will try to preserve the patient’s teeth while treatment is possible. He will use the removal of carious units only at such a degree of destruction of dental structures that it is no longer possible to save them.

Basic points of proper hygiene

Use a synthetic, medium-hard or soft brush. Change it every three months.

The toothpaste should be suitable for very sensitive teeth. Typically, such products contain hydroxyapatite, strontium chloride, fluorides, potassium nitrate, or a combination of calcium carbonate and arginine.

Take enough paste. For children under 3 years old - the size of a grain of rice, from 3 to 14 years old - the size of a pea, for adults you need to squeeze out about one centimeter.

Brush your teeth for 2 minutes: 30 seconds on each surface, top and bottom. Monitor time using an hourglass or mobile phone timer. Electric toothbrushes emit a short beep every 30 seconds and a long beep every 2 minutes from the start of brushing.

Cleaning sequence

1. Using sweeping movements, clean the outer and then the inner surfaces of the bottom row. Move from molars to incisors. Then do the same on the top row. Hold the brush at a 45-degree angle and do not use a sawing motion. This leads to damage to the enamel.
2. Brush chewing surfaces with small circular movements.
3. Close your jaws and walk along your gums in a circular motion.
4. Brush your tongue using a leisurely four to five strokes from root to tip.
5. Treat the interdental spaces with dental floss.
6. Rinse your mouth.

It is more effective to clean with an electric brush or irrigator. The quality of hygiene increases 3–4 times. Hyperesthesia can be dealt with faster.

Is it possible to strengthen sensitive teeth at home?

Yes. If you can’t get to the dentist, you can try to help yourself. There are several remedies that can solve the problem of hyperesthesia at home.

Table 3. Popular products for home use

№	Name	Mechanism of action	Age category
1.	ROCS Medical Minerals, GC Tooth Mousse	Remineralizing gels	Adults and children
2.	Colgate Duraphat 2800 ppm	Fluoridating paste	10–15 years
3.	Colgate Duraphat 5000 ppm		From 16 years old
4.	ELMEX junior	Fluoridating paste	6–12 years
5.	ELMEX		From 13 years old
6.	LACALUT Extra Sensitive	Paste that reduces tooth sensitivity	For adults
7.	Colgate Sensitive Pro-Relief
8.	PRESIDENT Sensitive
9.	LACALUT Sensitive, 300 ml	Rinse for sensitive enamel	From 15 years old

Why does a tooth hurt after caries treatment?

The pain reaction depends not only on the professionalism of the doctor, but also on the individual characteristics of the human body, its pain sensitivity threshold.

Caries is the most common disease for which people consult a dentist.

It happens that after treatment, pain may occur when biting, tooth sensitivity, and soreness of the gums may appear.

What could cause this?

1. If the treatment was using local anesthesia, which was carried out directly near the tooth, then naturally the gums may react, because Anesthesia is an injection, therefore there is a small wound that heals over a certain period of time. (prick your finger, it will also hurt for a while).
2. When treating superficial and medium-sized caries, sometimes there is increased sensitivity of the enamel, which is manifested by sharp tingling sensations in the tooth. Such sensations usually occur after exposure to a certain irritant (cold, hot, sour, sweet). The fact is that in the process of treating caries and further placement of fillings, they are made as follows called etching of the enamel with a special agent, which is then washed off and the surface is dried. If the dentin is dried too much, the dentinal tubes of which it consists lose internal moisture, which leads to pain. Usually these phenomena disappear within 1-2 weeks. During this time, the overdried tissues are filled with moisture again and the sensitivity goes away. If symptoms continue, you should contact your dentist.
3. Pain can also occur due to under-drying of the tooth. In this case, the tooth reacts when you press and bite on it. And the point is this: after etching the enamel, a special adhesive is used to ensure good fixation of the filling, which penetrates into the dentinal tubules. After which the filling material is applied, which is then illuminated with a lamp. And in a place where there was excess moisture and an uneven adhesive layer was created, the seal comes off. And during the chewing process, i.e. When pressing on a tooth, pain appears.

1. If your tooth hurts after treatment of deep caries, do not worry. This is a normal tooth reaction. It should be remembered that in this case the pain can last up to several days. It gradually decreases and then goes away completely. This is due to the fact that the carious cavity comes very close to the dental pulp (neurovascular bundle) and all manipulations during tooth treatment in this case have an irritating effect. Over time, the pulp builds a “roof” over itself from new dentin - it hides, and the painful sensations gradually stop. But if the tooth still hurts even after 2 weeks, you need to consult a dentist. Perhaps complicated caries – pulpitis (nerve inflammation) – is already taking place here.

Algorithm of actions for hyperesthesia

1. Adjust your diet. Avoid completely or significantly reduce the consumption of foods and drinks containing acids and sugar. Especially fruit and berry juices, wine, candies. Eat more green vegetables, fiber-rich foods, and whole grains.
2. Change your toothpaste. Never use bleach. Choose from those labeled "Sensitive".
3. Check if you are practicing proper oral hygiene. If it's wrong, correct it.
4. Make an appointment with your dentist to find out the type of tooth sensitivity, find out the cause and get treatment.
5. Visit the dentist twice a year, even if nothing hurts.

The tooth reacts to sour: what to do and what are the reasons

If your teeth react to sour foods, or discomfort occurs when eating sour foods, immediately seek help from a dental clinic. The doctor will conduct a comprehensive diagnosis, determine the type and complexity of the problem, and prescribe adequate treatment that will help eliminate pain and discomfort.

Note! With increased tooth sensitivity to acid, it is not the enamel (protective layer) that becomes sensitive, but the dentin (loose layer), in which the neurovascular fibers are located. Pain can be caused by various reasons: from mechanical damage to the protective enamel to diseases of the gastrointestinal tract. The exact cause can only be determined after a comprehensive examination of the patient. Dentists note that in 95% of cases, the cause of hypertension is the following factors:

• Mineral deficiency is accompanied by gradual weakening, demineralization and subsequent destruction of hard tooth tissues. The main symptom of mineral deficiency in the early stages of the problem is increased tooth sensitivity to acidic foods;
• Pathogenic microorganisms - the penetration of pathogenic microorganisms into the mucous membrane of the oral cavity can provoke intense release of acid, which aggressively affects tooth enamel. The acid penetrates the protective barrier of the enamel and causes a pain reaction in the nerve bundle inside the tooth;
• Gastrointestinal dysfunction is one of the most common causes. A number of diseases of the human gastrointestinal tract can provoke a change in the composition of saliva - this composition has a destructive effect on the enamel (gradually destroys it) and increases the overall sensitivity of the teeth. In this case, the reaction will be not only to sour, but also to sweet, as well as temperature changes (cold/hot);
• Caries is the most common problem that causes tooth pain from sour foods. It is accompanied by carious lesions of the enamel, with further spread deep into the hard dental tissues. With the development of caries, the intensity of pain increases;
• Mechanical injuries - chips, cracks and microcracks in the protective enamel, are the gateway for the penetration of acid into dentin, which causes an increased pain reaction of the tooth to the irritant.

In addition to the above problems that can cause tooth pain after sour, it is also worth noting: pulpitis, malocclusion, pathological abrasion of teeth, wedge-shaped defect, diseases of the endocrine system, genetic predisposition, pathologies of the nervous system, etc.

Treatment of hyperesthesia in the “Family Doctor”

If hyperesthesia occurs, make an appointment with a dentist by calling the contact center in Moscow +7 (495) 775 75 66 or using the online appointment form. Our clinic has been operating for more than 26 years. Experienced doctors help patients cope with pressing problems, including hypersensitivity.

The doctor will find out the cause of tooth sensitivity and provide effective treatment. In most cases, it is enough to select suitable oral care products and carry out proper hygiene procedures. In more complex situations, full treatment is used, and if necessary, surgical treatment.

The clinic takes a gentle approach to patients. All procedures are accompanied by adequate pain relief, which eliminates the occurrence of discomfort and pain. Increased sensitivity of teeth is not just a feature of them. This is the beginning of a disease that must be cured. And it's better to do it as quickly as possible.

Treatment at home

At home, you can use special medicinal varnishes, gels, powders or foams that help restore the protective properties of the enamel. Depending on the form of release, these products are applied to the surface of the teeth or used to prepare a solution for rinsing.

• Varnish Bifluoride 12.
• Fluocal gel or solution.
• The drug Fluorlak.
• Powder for preparing Remodent solution.
• Strontium chloride paste 75% or its 25% rinse solution.
• 10% calcium gluconate solution.
• Dental gel Tooth Mousse.
• Dental cream MI Paste Plus.

These products help reduce tooth sensitivity caused by internal disturbances in the body and slight thinning of tooth enamel. These medications can only be used after prior consultation with a dentist.