Sensitive teeth is sometimes caused by erosion--the dissolving of the enamel or dentin by a chemical process. A recent multicenter study found dental erosion is on the rise, with a surprising 30% prevalence among 10 to 14 year olds.

Erosion is often caused by the acids found in soft drinks, some fruit juices, sports drinks, and some herbal teas. When consumed in excess these beverages can easily strip the enamel from teeth leaving them brittle and sensitive to pain. Other sources of erosion can be medicines and some underlying medical conditions such as acid reflux disease and disorders associated with chronic vomiting, including bulimia, that bring stomach acids into the mouth.

If erosion is determined to be the cause of the sensitivity, the first step is to determine and control the source to prevent continued destruction. The eroded surfaces then may be replaced with appropriate materials to stop the sensitivity. Without first managing the cause, the reparative dentistry may also be destroyed.

An accurate diagnosis of why teeth are sensitive is the key. Hypersensitive teeth caused by erosion is just one of the possible causes. More serious conditions could be decayed or cracked teeth which also require preventative and restorative dental procedures.

Do you avoid ice in your drinks? Are you fearful of having a certain area cleaned by the hygienist? Teeth that are sensitive to temperature, touch, or even air are one of the most common complaints dentists hear.

There are many reasons for sensitive teeth, including cavities and cracked teeth. Fortunately, most sensitivities are a result of a less serious cause.

Underneath the strong outer layer of a tooth is the dentin layer, which is less dense. Dentin has microscopic canals leading to the pulp of the tooth. When these miniature tubes lose their protective layer, they allow temperatures, sweets, touch, or drying to transmit a stimulus to the nerve fibers located in the pulp. These nerve fibers signal the pain of a hypersensitive tooth. Fortunately, the painful stimulus does not cause permanent damage to the nerve of the tooth, but it can be extremely unpleasant. Most sensitivities occur near the gumline as a result of toothbrush abrasion, acidic erosions, or compressing and flexing forces of clenching. There are over-the-counter desensitizing toothpastes available that help block the canals from transmitting sensations to the nerves. These toothpastes are often the first step to managing the problem; but if they do not provide adequate relief, let your dentist know. There are several other professional approaches available.

As with most things in dentistry, accurate diagnosis is the key to relieving sensitive teeth; or more importantly, to separate hypersensitive teeth from more serious conditions such as decayed or cracked teeth that get worse with delay.

Next to “getting a shot” do you hate leaving the dental office with numbness, wondering if you are drooling on yourself or afraid you will bite your tongue when you eat? Help is on the way.

Novalar Phamaceuticles of San Diego has just won approval for OraVerse from the FDA. In clinical trials OraVerse cut the time it took for full sensation to return to the numbed area by more than half. The basis for the drug is a decades old anti-hypertensive drug. After a dentist finishes a procedure where anesthesia is used, the dentist would inject OraVerse into the same site. It doesn’t literally “reverse” the anesthetic, but utilizes an indirect approach. Here's how it works: When a dentist administer local anesthetics it is usually combined with another drug called epinephrine that acts to constrict the blood vessels. This keeps the blood from carrying away the anesthetic too quickly. OraVerse does the opposite, dilating blood vessels so the anesthetic can be carried away faster.

Some procedures, such as extractions, where longer anesthesia will keep the patient more comfortable would likely not be advisable for OraVerse use. Since an additional dental procedure will come with some cost to the patient, OraVerse may may be too costly for routine use. However, for patients concerned about being able to eat or speak without numbness after a dental procedure, the availability of this new dental procedure, may be worth the additional incremental cost.

Next to “getting a shot” do you hate leaving the dental office with numbness, wondering if you are drooling on yourself or afraid you will bite your tongue when you eat? Help is on the way.

Novalar Phamaceuticles of San Diego has just won approval for OraVerse from the FDA. In clinical trials OraVerse cut the time it took for full sensation to return to the numbed area by more than half. The basis for the drug is a decades old anti-hypertensive drug. After a dentist finishes a procedure where anesthesia is used, the dentist would inject OraVerse into the same site. It doesn’t literally “reverse” the anesthetic, but utilizes an indirect approach. Here's how it works: When a dentist administer local anesthetics it is usually combined with another drug called epinephrine that acts to constrict the blood vessels. This keeps the blood from carrying away the anesthetic too quickly. OraVerse does the opposite, dilating blood vessels so the anesthetic can be carried away faster.

Some procedures, such as extractions, where longer anesthesia will keep the patient more comfortable would likely not be advisable for OraVerse use. Since an additional dental procedure will come with some cost to the patient, OraVerse may may be too costly for routine use. However, for patients concerned about being able to eat or speak without numbness after a dental procedure, the availability of this new dental procedure, may be worth the additional incremental cost.

The primary bacteria responsible for tooth decay, Strep. mutans, has the specialized ability to survive in acid. Unfortunately, the breakdown of carbohydrates creates an acid environment that reduces other less harmful bacteria while the Strep. mutans can thrive and cause tooth decay. One of the reasons is the ability of Strep. mutans to make the fatty acid enzyme called FabM, which protects it from acid attack. When researchers shut down the production of FabM the Strep. mutans became almost 10,000 times more vulnerable to acid damage. Further research has shown FabM or close relatives may be responsible for all Strep. and Staph. bacteria’s resistance to the body’s defenses. These families of bacteria are responsible for meningitis, pneumonia, “flesh eating infections”, as well as infections around heart valves and stents.

The University of Rochester Medical Center has received a grant from the National Institute for Dental and Craniofacial Research to investigate FabM and other bacterial proteins. These studies could lead to our ability to develop a multi-prong attack on bacteria instead of the current single-prong antibiotic therapies. “Our goal is to force the major bacterium behind tooth decay to destroy itself with its own acid as soon as it eats sugar,” said principal investigator Robert G. Quivey, PhD. In addition to helping prevent cavities, it may also lead to new antibacterial combination therapies for other types of infections that have become resistant to currently available treatment.