DISCLOSURE: Noelle Copeland RDH is the oral care specialist and dental consultant to the Brilliant and Baby Buddy oral care lines through Compac Industries. See terms below
Using a soft toothbrush for sensitive teeth isn't always the answer for tooth sensitivity. Even the softest toothbrush for sensitive gums and teeth will fail to address the problem and will only focus on the symptom, if something greater is the driving force of discomfort. Read below to learn how you can investigate some of the more common causes of sensitive teeth. This is not a complete list but the circumstances encountered most often as culprits, and can be applied to children and adults alike. Always see your dentist about sensitivity to get a diagnosis and advice on how to treat it.
Causes of Sensitivity
Poor Oral Hygiene
- Gingivitis can happen when a person has poor oral hygiene, and plaque begins to build up on the teeth along the gum line and starts to aggravate and inflame the gum tissue. This plaque buildup causes inflammation and redness, bleeding and sensitivity. If gingivitis is left untreated, it can eventually progress into periodontal disease and cause irreversible damage to the supportive structures in the mouth.
- Decay is the primary cause of chronic tooth sensitivity in children. When a tooth has a cavity in it, this creates a hole, this hole continues to grow if left untreated, and as it grows, it gets closer and closer to the pulp/nerve of the tooth, creating sensitivity to temperatures and chewing. There are instances where children can have cavities and have no sensitivity or pain at all, this is why it's important for children to see the dentist regularly.
Erosion - Erosion happens in children's mouths typically due to implications from their diet. When children consume unhealthy amounts of sugary foods and drinks, like candy, sodas, and sports juices, these have an eroding effect on the teeth. The enamel in children's teeth can become pitted and erosion can occur when these food items are consumed on a regular basis, henceforth leading to the possibility of sensitive teeth.
Fluorosis- Fluorosis is caused by an overexposure to fluoride during a child's formative years. Inappropriate use of fluoride containing products like toothpaste or mouth rinses are typically the culprit. Fluorosis presents itself as specs and stains on the teeth that are discolored and possibly chalky looking with white and dark spots. These areas tend to be pitted, rough and are more difficult to keep clean. This happens due to systemic ingestion of fluoride that damages the enamel of the teeth. Anytime the enamel of the tooth is damaged it can cause sensitivity.
Wear- Believe it or not, kids and teenagers can clench and grind their teeth in response to stress, anxiety, and change just like adults. This can cause enamel wear, which can lead to sensitive teeth. When a child's permanent teeth start to erupt into the mouth, crowding can occur. This stage is when active movement is taking place in the alignment and bite structure of the mouth, potentially impacting teeth leading to sensitivity.
Trauma- Oral trauma while growing up can cause chronic and acute sensitivity. Trauma can occur at any time, from a small slip and fall at home where a child bumps their mouth, to a more traumatic accident that needs immediate remediation. If small incidences are happening and a parent isn't always aware, say a child bumps their face on the playground equipment slightly fracturing a front tooth but not enough to break it? That small fracture can grow larger and cause sensitivity. Any injury to the mouth where a tooth is broken and tissue trauma occurs will cause sensitivity and pain.
Infections- Sinus infections can cause pressure in the mouth, making teeth feel sensitive and achy, this occurs on the top teeth versus the bottom.
Eruption- Everyone is pretty familiar with the teething stage of eruption for babies and how drastically that affects their mouth and well-being due to sensitivity and pain. Likewise, as the baby teeth are starting to become loose and getting pushed out by newly erupting adult teeth, sensitivity can ensue for older children during this stage, called mixed dentition. This stage for older children can buzz by with nothing more than joyous exclamations of incoming tooth fairy visits, or it can produce sensitivity in the bone from an ever-growing and expanding jaw and the teeth that are actively moving and shifting to make room for the larger adult teeth. Most kids fall somewhere in between these two dichotomies, having some sensitivity but not so much that it's a repeat of the long nights of dealing with a fussy and teething baby who is in pain.
Treatment for Sensitivity
Increase Oral Hygiene
Oral care should be the number one, top priority on everyone's list when it comes to dealing with sensitive teeth. This not only includes the oral care routine performed at home, it also encompasses the professional oral care that's regularly needed through professional dental services like cleanings, exams and diagnostic x rays.
Oral hygiene at home should include the following:
Start Oral Care Early, before the first tooth erupts, wipe baby's gums, tongue and inside cheeks to remove milk residue, acids from spit up/reflux and bacteria.
- Use silicone brushes to continue oral care on the gums, from 3 months of age and up. Gently massaging baby gums while brushing.
- Introduce a bristle toothbrush as soon as the first tooth fully erupts. Continue to use silicone brushes on teething gums.
- Use fluoride free toothpaste or gels until spitting has been learned. Spitting out toothpaste is usually learned by age 3, but requires adult direction and continual supervision. Then implement pastes and gels as needed or directed.
- Choose appropriately sized toothbrushes. The head should fit your child's mouth, have soft bristles and the handle should be something you are comfortable using.
- Adults will perform all oral care for their children up until age 5, and later than 5 if needed. Adults should directly monitor and supervise all oral care thereafter.
- Introduce brush training around age 4. You brush their teeth first, then let them copy what you did. Their abilities and technique will mature as their grip and dexterity strengthens.
- Most children can effectively brush independently by age 7, but still need direct supervision.
- If the sides of the teeth touch, they can trap food and plaque, so they need to be flossed. I was always told that “ You only need to brush and floss the teeth you want to keep”... so that pretty much sums up the importance of brushing and flossing for longevity and health.
- Flossing should become a normal part of the nightly brushing routine no later than age 5. This will be done by the adult to begin with and taken over once the child can perform correctly.
- Using flossers is a great alternative if regular flossing is too challenging. Be sure to keep doing regular flossing to practice, so this skill is eventually acquired.
- The first professional dental visit should happen sometime between the first tooth erupting and the first birthday, whichever comes first.
- Regular dental checkups and cleanings usually start around age 3 and continue 1-2 times a year thereafter.
The number one rule to remember when oral care is being performed for children is that they cannot do it all on their own. Far too many times parents hand over the reins of oral care to their young children way too soon, before they've even learned how to correctly hold a toothbrush, let alone remove all the plaque from their teeth. This is the number one thing I teach my patients about taking care of their kids teeth and training their kids to take care of their teeth for the rest of their lives.
It is an ongoing process and it needs to be monitored, evaluated and re-evaluated as needed, it is never a once and done deal. Most children under the age of five should not be allowed to independently brush their teeth alone without direct adult supervision, and even then, the adult should be the one brushing the child's teeth first to remove the plaque and bacteria from the teeth, then allowing the child to copy what the adult has done. This back and forth training process will go on for some time before a child will have developed the strength and dexterity in their grip and motor skills that is needed to brush effectively.
It's a misconception on a parent's part to assume that because a child can hold a toothbrush and stick it in their mouth, that this means they are brushing their teeth, that is not what it means and that is not what's happening. A child under the age of five will inadvertently stick a toothbrush into their mouth and suck on it or bite down and chew on it, this is not brushing... this is not oral care!
Professional oral care includes the following:
- At least 2 professional dental cleanings every year, more if disease or inflammation is present.
- Diagnostic x rays to evaluate normal and abnormal findings including infections, decay, broken or fractured teeth, bone structure, the sinus cavity, the jaw joints, and head and neck anatomy.
- Application of oral therapeutics if prescribed.
- Comprehensive exams that include a detailed medical and dental history.
- Oral cancer screening.
- Dental restorations and treatment as prescribed.
In the absence of a fluorosis diagnosis, fluoride can be applied to baby teeth and adult teeth to help with sensitivity. This needs to be done professionally in a dental office either by the dentist or a dental hygienist. This is called a fluoride varnish and is often done after a regular yearly professional cleaning appointment. Another option is xylitol containing dental products like toothpaste, mouthwash, mouth gels, and even gums and mints that contain xylitol.
Dental professionals will often encourage patients to place molar sealants on the back chewing teeth, especially baby teeth, as they are more prone to cavities. A sealant is a flowable composite material that is cured into the pits and grooves of molar teeth in children and adults. Sealing the pits and grooves keeps them airtight and sealed off from the ever changing environment of the mouth, preventing sticky, gummy, and chewy foods from being retained in the spaces and decaying.
Restorations- This includes fillings, crowns, root canals, sealants and sometimes prosthetic appliances. A restoration is used to replace a part of the tooth that has become either decayed, broken, lost or worn down due to some sort of oral trauma or disease.
Sensitive teeth happen sometimes, and most of the time, there is a cause and a treatment for it. If you are still unsure about your child's sensitive teeth then be sure to schedule a visit to your dentist as soon as possible for a comprehensive evaluation.
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