Teeth can hurt or be sensitive for so many reasons! Sometimes tooth pain can indicate that you have a serious dental problem, or it could be something much more benign. If you haven’t seen a dentist for a check up recently (in the past 6 – 12 months), going in to have Xrays and an exam is the very best way to be sure nothing serious is going on and understand why my teeth hurt.
You may have cavities, a cracked tooth, an abscessed tooth, or gum disease that is causing the pain, and all of these conditions need to be treated as soon as possible to avoid more serious, painful, and expensive dental issues. Sensitive teeth can also be from gum recession, clenching or grinding, teeth whitening, sinus problems, or your diet.
Let’s break down some reasons your teeth might hurt, what different kinds of sensitivity can be from, and things you can do to help with the sensitivity.
Is it one tooth, or are all of your teeth sensitive?
If you can pinpoint the pain to a specific tooth, you may have a cracked tooth, a cavity, or an abscessed tooth, any of which require treatment by a dentist. It could also be that you simply have an area of gum recession or a tooth that you are grinding on, and you can address the issue with some of the advice below.
If all of your teeth are sensitive, it is less likely that there is a concern that needs to be addressed by a dentist. Generalized discomfort is most likely related to a behavior like clenching, products that you are using on your teeth, or your diet.
Is it all the time?
If your tooth hurts every time you bite down, or every time you have something cold, that is more concerning than if the sensitivity comes and goes. Lingering pain is more concerning than if the pain goes away quickly. Throbbing can indicate an abscessed tooth, which needs treatment immediately.
Why are my teeth sensitive to cold?
Cold sensitivity is not necessarily a sign that something is horribly wrong. Sometimes perfectly normal, healthy teeth are sensitive to cold liquids. It could also be from cavities, gum recession, whitening products, diet, or recent dental work.
Why are my teeth sensitive to hot?
Sensitivity to hot is a major red flag that the nerve of a tooth is dying and the tooth is starting to abscess, and you should see a dentist right away. Sometimes this is from a large cavity that has been left untreated, or from a crown or filling that was done in the past that was close to the nerve. It could also be from trauma to the tooth, either recently or years ago.
Why are my teeth sensitive to chewing?
If all your teeth are sensitive to chewing, it is most likely from clenching and/or grinding. If a single tooth is sensitive to chewing or biting hard foods, it could have a crack, cavity, or be the start of an abscess.
Why are my teeth sensitive to sweet?
Sensitivity to sweet usually indicates you have a cavity or multiple cavities, and you need to see a dentist. Areas of gum recession can also be sensitive to sweets.
Why are my teeth sensitive in the morning?
If you wake up with sore teeth, you have headaches, or if your jaw muscles feel a little sore or tight in the mornings, these are good indicators that you may be clenching or grinding at night. Many people clench and/or grind their teeth and don’t realize it.
Are you clenching or grinding?
If you are clenching or grinding your teeth, it can make them sensitive to cold, or feel achy, or sensitive to chewing. Clenching isn’t “as bad” as grinding in respect to causing lasting damage to your teeth, but either can make teeth sensitive.
If your teeth are hurting because you are clenching or grinding, a nightguard is going to be important to protect your teeth. You can get many inexpensive night guards over the counter to see if that relieves the sensitivity. Most people won’t usually notice a difference in one night, but within a week or two most people will see an improvement in symptoms. If after a couple of weeks you are seeing visible marks on the guard, that tells you there is grinding going on.
My advice on over-the-counter night guards versus professionally fit night guards is: it doesn’t matter how expensive the plastic you grind on is, as long as you will wear it to protect your teeth! Over the counter night guards aren’t as durable and don’t fit as well as custom-made night guards, but as long as they are not causing discomfort in your jaw joint, they are doing the job. Custom night guards are generally more successful in the long term and are worth the investment to prevent other issues like cracked, chipped, and worn teeth if you are a chronic grinder.
Are you using whitening products including whitening toothpastes?
If you have recently whitened your teeth, either with over the counter products or at your dental office, the bleaching products may be to blame for your sensitivity. Most products use hydrogen peroxide or carbamide peroxide, which temporarily dehydrate the teeth and cause them to be sensitive. Whitening toothpastes (or things like charcoal toothpaste) are more abrasive, which is how they remove stains, but can make teeth more sensitive, especially to cold.
Switching to a sensitivity toothpaste is an easy fix. Toothpastes designed for sensitive teeth are less abrasive, and usually have an additional ingredient called potassium nitrate that helps alleviate sensitivity. You can use it just like you would any toothpaste (brush, spit, rinse), or for extra benefit, I recommend brushing, spitting out the excess, and then NOT rinsing, to let the fluoride and potassium nitrate sit on your teeth longer, especially at night.
Toothpastes that advertise whitening AND sensitivity are probably not going to be very good at either.
Do you have receding gums?
Gum recession is where you can see part of the tooth root showing, and those areas are often sensitive to cold or brushing because they are not protected by enamel. Even very tiny amounts of recession that are less than 1mm can be extremely sensitive.
Sometimes you can see these areas just by looking, or you can feel for them by putting your fingernail on the tooth next to the gum and feeling for a ledge or notch. Recession can be a sign of gum disease, but it can also be from other factors like the position of your teeth where they are tipped in, or from orthodontics, where the tooth was moved farther out in bone that may have already been thin, or from abnormal forces on the tooth like clenching and grinding.
If your teeth are sensitive because of recession, try using a sensitivity toothpaste for at least a few weeks. You can even take a small amount of the toothpaste on your finger or a q-tip and rub it directly on the sensitive areas after your brush and leave it on there. The way this works is by blocking the dentinal tubules, which are essentially tiny pores in the root surfaces.
Are you having sinus issues?
The roots of your upper teeth are positioned right below your sinus cavities, so if you have pressure built up in your sinuses from allergies, a cold, or sinus infection, it can make your teeth hurt even though there is nothing wrong with them. Because there is pressure on the nerves of the teeth, it can “short circuit” those nerves, which can make your teeth feel achy, or cold sensitive, or sore with chewing.
Treating your sinus issues will resolve your tooth pain if it is the cause of the sensitivity. It might be as easy as taking allergy medication or a decongestant. If you have a sinus infection, you’ll need to see a doctor. It’s also possible for an abscessed tooth to be draining into your sinus cavity, and an x-ray is the only way to rule out an infected tooth.
Are your teeth getting exposed to too much acid?
Teeth can become sensitive if they are exposed to acids too frequently. This could be from acidic foods or drinks in your diet, or from stomach acid. Gastroesophageal reflux can be “silent”, meaning you don’t have normal symptoms like indigestion, but can cause stomach acid to pool in your mouth, often at night, which can erode tooth enamel, especially on lower back molars. Frequent vomiting from eating disorders, nausea with pregnancy, or other medical conditions can cause erosion on the back of upper front teeth.
Dietary sources of acid are usually from beverages like sodas, lemon water, kombucha, or energy and sports drinks. Sipping on these beverages throughout the day leads to prolonged acid exposure that damages tooth enamel. Foods high in sugar like candy and dried fruit can also be problematic.
If you are concerned that your tooth sensitivity is from acid exposure, you should see your dentist to be sure you don’t have cavities.
Did you have dental work recently?
Dental work including crowns and fillings are essentially surgery on teeth, so some recovery time is to be expected. A minor amount of sensitivity after dental procedures is normal, but if it isn’t improving after a week or two, you probably need to go back to your dentist. If you had a filling or crown done, the bite may not be quite right and may need to be adjusted. If the cavity was large, the nerve of the tooth may have been affected and you could need a root canal.
The bottom line is, going to see a dentist is always the best way to be sure there are no serious problems, but while you wait for your appointment, lay off the candy and soda, use a sensitivity toothpaste, and try an over the counter night guard.
