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Tooth Abrasion & Root Sensitivity 

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Tooth abrasion comes from mechanical irritation. That irritation almost always is the toothbrush. The most obvious mistake one can make is to use anything but a soft brush. A medium or hard brush will cause the gum to recede and you will begin to abrade and notch the root surface. If you are too aggressive with a soft brush you can also cause damage. Correct technique is important.

The abrasion can cause a few problems:

• Damage to the pulp (nerves and blood vessels) of the tooth by direct violation of its space.
• Disturbing the natural, self-cleansing contour of the tooth allowing plaque to accumulate and then decay.
• Root sensitivity that can vary from minor sensitivity to extreme pain. Caused by the transmission of "sensations" through the dentinal tubules (small diameter tubes radiating from the nerve chamber of the tooth to the exterior surface of the tooth's dentin)

There are three approaches to treating the "root sensitivity":

• Using a toothpaste for sensitive teeth is my first choice. I use it because it is a non-invasive, low maintenance means of treating 95% of root sensitivity. I prefer "Protect" toothpaste, but it can be difficult to find. "Sensodyne" is my second choice. Crest and Aquafresh make their brands of toothpaste for sensitive teeth. They all work by blocking or sealing the dentinal tubules (usually with potassium nitrate) to prevent the "sensations" from reaching the nerve. They may need to be used for 4 to 6 weeks to initially control the problem and intermittently thereafter.
• Fluoride applications in our office and/or home applications. These also work by blocking or sealing the openings in the dentinal tubules. Is more expensive than the toothpastes. I will usually use fluoride in addition to the toothpastes in more severe cases.
• Placing fillings on the root surface. My least favorite way because it requires the placement of a filling and the continued maintenance and periodic replacement. Works by covering the dentinal tubules instead of sealing them.