Sensitive Teeth and Dry Mouth: The Everyday Things People Put Up With

The small persistent problems people never think to mention. What is usually behind them, what helps at home, and when they are worth looking into.

Some things never make it into the appointment. The tooth that catches when you drink something cold. The mouth that is uncomfortably dry by the middle of the afternoon. People live with these for years, decide they are not worth mentioning, and then mention them on the way out of the door.

They are worth mentioning at the start. Both have identifiable causes, both often improve, and occasionally both are the first sign of something that is easier to deal with early.

What sensitivity actually is

Underneath the enamel is dentine, and dentine contains thousands of microscopic tubes that lead towards the nerve. When enamel is worn away, or the gum recedes and exposes root surface that was never covered by enamel in the first place, those tubes are open. Cold, sweet or acidic things reach them, and you feel it.

That is why sensitivity is typically a short sharp sensation that stops as soon as the cold does. It is also why it tends to appear at the gum line and on teeth where the gum has receded.

Sensitivity can also follow perfectly normal dental work. A new filling, a deep clean or a crown fitting may leave a tooth reactive for a few weeks while it settles. That is common and usually resolves, but if it is still there after a couple of months it is worth mentioning.

The common causes

Brushing hard with a stiff brush, over years, wears both enamel and gum. Acidic food and drink softens enamel temporarily, and brushing straight afterwards removes more of it than it otherwise would. Grinding or clenching, often at night and often unnoticed, wears the biting surfaces and flexes the teeth at the neck.

Whitening also causes temporary sensitivity in many people. That is expected, it settles after treatment finishes, and it can usually be managed by adjusting how the treatment is spaced.

What helps: a soft brush used gently, a toothpaste made for sensitivity used consistently rather than occasionally, waiting an hour after acidic food or drink before brushing, and not rinsing after brushing so the fluoride stays on the teeth. Most people notice a difference within a few weeks.

When sensitivity is telling you something else

There is a distinction worth knowing. Brief sensitivity that stops when the stimulus is removed is usually the ordinary kind. Pain that lingers for minutes afterwards, pain that comes on by itself, pain on biting, or sensitivity in one specific tooth that has changed recently are different, and should be examined.

Dry mouth is not just thirst

Saliva does a great deal of quiet work. It washes away food, buffers acid, carries minerals that repair early enamel damage, and keeps the soft tissues comfortable. When there is less of it, the risk of decay and gum problems rises, and it often rises quickly.

The most frequent cause is medication. A long list of ordinary medicines reduce saliva, including some antidepressants, blood pressure medicines, antihistamines and diuretics, and the effect adds up when somebody takes several. Dehydration, mouth breathing, snoring, alcohol, smoking and certain medical conditions all contribute too.

Signs beyond thirst include a sticky feeling first thing in the morning, difficulty with dry foods, a sore or burning tongue, more frequent ulcers, bad breath, and dentures that no longer feel secure.

What helps a dry mouth

Sip water through the day rather than in occasional large amounts. Sugar free chewing gum stimulates saliva and is one of the more effective simple measures. Saliva substitutes are available from pharmacies. Reduce alcohol and caffeine where you can, and consider whether the bedroom air is very dry at night.

Do not stop or change prescribed medication yourself. Tell your doctor it is happening, because sometimes an alternative exists, and tell us as well so we can adjust how often we see you. People with a persistently dry mouth usually need shorter intervals between check ups and often benefit from a higher strength fluoride toothpaste.

Denture wearers notice it particularly, because saliva is part of what holds a denture in place and protects the tissue underneath. If a denture that used to be comfortable has started rubbing, dryness is one of the first things to consider.

Please mention it

Neither of these is trivial and neither is something to be embarrassed about. If either has been part of your daily life for a while, bring it up at the beginning of your next appointment rather than at the end.

It is usually a short conversation with a practical outcome: a change of toothpaste, a change of technique, a different interval between visits, or a look at one particular tooth. Occasionally it uncovers something worth treating early, which is precisely why we would rather hear about it.

It also helps to note when the problem happens. Whether the sensitivity is to cold, to sweet things or to biting, and whether the dryness is worse at night or after a particular medicine, tells us more than a general description does. A few days of paying attention before your appointment is time well spent.

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