Sensitive teeth: why cold hurts and how to get lasting relief

Tooth sensitivity is one of the most common complaints we hear in Mombasa, and one of the most treatable. The key is identifying which of several very different causes is responsible, because the remedies are not interchangeable.

The mechanism

Beneath the enamel lies dentine, which contains thousands of microscopic tubules leading to the nerve. When enamel wears away or the gum recedes, those tubules are exposed and cold, heat, sweetness or touch trigger fluid movement inside them — felt as a sharp, short jolt.

Cause 1: gum recession

Root surfaces have no enamel, so they are sensitive as soon as they are exposed. Recession is caused by hard brushing with a stiff brush, gum disease, and grinding. Treatment: soft brush, correct gentle technique, desensitising toothpaste, fluoride varnish, and gum treatment where disease is present.

Cause 2: enamel erosion

Frequent acidic drinks, reflux and vomiting dissolve enamel chemically. Treatment: reduce acid frequency, rinse with water after acidic drinks, wait 30–60 minutes before brushing, use high-fluoride toothpaste, and restore worn surfaces where necessary.

Cause 3: grinding and clenching

Bruxism flexes teeth at the gum line and wears the biting surfaces flat, exposing dentine. Treatment: a custom night guard, stress management and, where the bite is a factor, occlusal adjustment.

Cause 4: decay, cracks and failing fillings

Sensitivity concentrated in one tooth — especially pain on biting or lingering pain after cold — suggests decay, a crack or a leaking filling rather than general sensitivity. This will not respond to sensitive toothpaste and needs an examination and X-ray. Pain that lingers for more than 30 seconds after cold often indicates the nerve is inflamed and may require root canal treatment.

Cause 5: after treatment

Mild sensitivity for a few days after a filling, a deep clean or whitening is normal and settles. Sensitivity that worsens after two weeks should be checked.

Getting relief that lasts

Use a potassium-nitrate or stannous-fluoride desensitising toothpaste twice daily and smear a little on the sensitive area at night without rinsing. Switch to a soft brush and stop scrubbing. Give it two to four weeks. If there is no improvement, book an assessment at Ocean Smile Dental Clinic on 0713 276 793 — persistent, localised sensitivity is a symptom, not a personality trait of your teeth.