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After a tooth is extracted, it leaves an empty hole or socket in the jaw bone that needs to heal. If the empty socket is left to heal naturally the bone in the area will usually shrink, leaving a concavity or defect in the jaw. In many cases, this shrinking can be prevented by performing a non-invasive bone graft at the time of the extraction. If the missing tooth is not replaced the teeth next to it tend to drift or tilt into the open space. This undesirable tooth movement can cause problems with the way the upper and lower teeth fit together. Tilting teeth also leads to oral hygiene challenges and can often result in inflammation to the gums and damage to the bone that supports the remaining teeth.

One of the amazing things about modern dentistry is the availability of dental implants. Dental implants can be installed in the jaw to replace the root of a missing tooth. After a few months an abutment and crown can be attached to the implant. The abutment and crown replace the part of a tooth that we see and chew with. Together an implant, abutment, and crown are an excellent way to replace a tooth and return your mouth to ideal esthetics and function.

When you are missing a tooth, the remaining teeth have to work harder and must take on more force than they were intended to. Replacing missing teeth helps distribute the work of chewing and prevents accelerated wear on remaining teeth. Patients often experience better digestion after the completion of implant restorations, because they can properly chew their food. If you are missing one or more teeth and would like to prevent further damage and regain esthetics and function implants might be right for you.

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As a dentist, I get questions about this topic nearly every day. Most patients that have sensitive teeth have at least one of the following problems; gum recession, acid erosion, toothbrush/toothpaste abrasion, or a nighttime habit of grinding their teeth. The most common presentation is a quick and uncomfortable sensation when eating cold foods or drinking cold beverages. The sensation can range from annoying to painful, but it disappears within a few seconds and everything is back to normal. This is not a toothache that wakes you up at night or has a pulsing pain, both of those require a visit to your dentist and are indicative of more serious dental needs.

Why are my teeth sensitive?

To understand sensitivity, you really need to know a little about the parts of a tooth. Every tooth has a nerve in the center. The pearly white portion of the tooth, which is mostly what we see, is made up of enamel. Enamel is a very hard protective layer that covers the portion of the tooth that you can see. Enamel is very tough, and it also insulates the tooth from feeling temperature. The root of the tooth doesn’t have any enamel, so when roots are exposed, temperature changes can cause discomfort. Root exposure can be caused by overly aggressive brushing, using a firm or medium toothbrush, using a highly abrasive toothpaste, grinding, gum disease, and acid erosion. Once you have root exposure it is much more likely you will have sensitivity, but you don’t have to live with it.

What is a cost-effective way to minimize sensitivity?

Here are my recommendations if you suffer from sensitivity in your teeth. First, make sure you are using a soft-bristled toothbrush with light pressure. A soft manual toothbrush can work great, but some of the newer electric toothbrushes will warn you when you are brushing to hard, which is very helpful when trying to break the habit of over-aggressive brushing. My second tip is to choose the right toothpaste. First, make sure your toothpaste is not a whitening toothpaste, these tend to make teeth more sensitive. There are a few ingredients in toothpastes that work well to reduce sensitivity. The best two, in my opinion, are fluoride and potassium nitrate. I recommend using any over the counter toothpaste with potassium nitrate in the morning and a high fluoride prescription toothpaste at nighttime. This combination is an easy and cost-effective way to eliminate or greatly reduce sensitivity in just a few weeks.

Most, but not all toothpastes that advertise sensitivity relief will have potassium nitrate. I always recommend you check the active ingredients on the back of the box. Just about every brand of toothpaste has a version with potassium nitrate, so if there is a brand you prefer, you can stick with it and still get relief. You can talk to your dentist about getting a prescription for neutral sodium fluoride toothpaste.

What if I still experience tooth sensitivity?

Grinding may contribute to your sensitivity. You should talk to your dentist about whether a nightguard is right for you.

In rare cases, sensitivity may be so extreme that the root exposure should be covered up with either an in-office varnish or white composite filling material.

Jake Wolf, DDS is a general dentist and owner of Organ Mountain Dental Is Las Cruces New Mexico. He blogs about common dental questions and topics. If you have dental questions or suggestions for future blog topics please send us an email from the contact page.

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