General Dentistry · Last reviewed May 2026
Sensitive Teeth: Find the Cause
Stop the Pain.
A diagnostic exam at Picasso Dental costs. Tooth sensitivity is rarely random, it points to a treatable cause: gum recession, exposed dentine, decay, a fractured filling, bruxism, or recent whitening. We diagnose first, then treat the cause, not just the symptom.
What is Tooth Sensitivity?
Sharp, brief pain when teeth are exposed to cold, hot, sweet, sour, or air. The pain is caused by an external stimulus reaching the dentine tubules and the nerve inside the tooth. It is distinct from a deep ache (which suggests pulp involvement) or pressure pain on biting (which suggests fracture or a bite issue). Knowing which pattern you have is the first step toward the right treatment.
8 Common Causes of Sensitive Teeth
Sensitivity has a cause. These eight account for the overwhelming majority of cases we see. Diagnosis decides treatment.
1. Gum Recession
Receding gums expose the root surface, which has no enamel. The exposed dentine connects directly to the nerve, so cold, sweet and acidic stimuli all trigger pain. Common with age, aggressive brushing, or periodontal disease.
2. Worn Enamel
Acid erosion (from soft drinks, citrus, reflux) or aggressive brushing wears down enamel and exposes dentine. Often a slow, progressive pattern affecting multiple teeth at once.
3. Cracked Tooth or Filling
A hairline crack or a fractured filling lets stimuli reach the dentine through the broken edge. Often presents as sharp pain on biting as well as cold sensitivity.
4. Recent Whitening
Peroxide whitening temporarily opens the dentine tubules. Sensitivity is transient and resolves within 48 hours. Desensitising toothpaste before and after whitening reduces it.
5. Recent Scaling
After deep cleaning, previously covered root surfaces may briefly be exposed and sensitive. Also transient, typically resolving within 48 hours as the gum tissue settles.
6. Cavity Reaching Dentine
A cavity that has progressed through enamel into dentine triggers cold and sweet sensitivity. Usually localised to one tooth. Caught early, this is a simple filling.
7. Bruxism (Grinding)
Night-time grinding or clenching wears down enamel, fractures fillings and microcracks teeth. Often presents with sensitivity plus jaw soreness on waking and flat, polished biting surfaces.
8. Dental Abscess
An abscess produces a different pain (deep, throbbing, often with swelling) but it is worth ruling out at diagnosis, particularly when sensitivity is severe and localised to one tooth.
Why Picasso for Sensitivity
Full Diagnostic Workup First
History, clinical exam, cold test, percussion test, and X-ray where structural concern exists. We identify the cause before recommending treatment, not the other way round.
Address the Root Cause
Treating sensitivity without finding the cause is symptom management. We treat the cause: cervical composite for exposed roots, fillings for decay, crowns for fractures, nightguards for grinders.
Fluoride and Desensitising Agents
In-clinic fluoride varnish and desensitising agents block the dentine tubules and provide immediate relief for many cases. Often the first-line treatment for mild to moderate sensitivity.
Restoration Where Indicated
If the diagnostic workup finds a structural cause (decay, crack, fractured filling), we restore it. Composite filling, inlay, onlay or crown depending on the size and location of the defect.
Nightguard for Grinders
If bruxism is the underlying cause, a custom nightguard protects the teeth from further wear and breaks the cycle of microcracking and sensitivity..
Escalation If Pulp is Involved
If pain has progressed beyond hypersensitivity into pulp inflammation, we escalate to root canal treatment rather than persisting with desensitising agents that will not help. Honest diagnosis, appropriate treatment.
Sensitive Teeth Pricing
Diagnostic exam is the entry point. Onward treatment depends on what we find.
| Service | Price |
|---|---|
| Diagnostic exam | |
| Fluoride application (under 7 teeth) | |
| Fluoride application (7 or more teeth) | |
| Cervical / Class V composite (exposed root) | |
| Composite filling (cracked or decayed) | 400,000 – 700,000 |
| Nightguard (for bruxism) | |
| Periodontal evaluation (recession concern) | 200,000 – 1,200,000 |
| Scaling and polishing | 300,000 – 600,000 |
| Root canal (if pulp involved) | 2,500,000 – 5,000,000 |
| Crown (if structural fracture) | 5,000,000 – 9,000,000 |
Need a full restorative workup? See fillings, root canal, or crowns.
Treatment by Cause
Sensitivity is a symptom, not a diagnosis. The right treatment depends on what is causing it.
Gum Recession (Root Exposure)
Cervical composite to seal the exposed root surface, plus fluoride varnish and a switch to desensitising toothpaste. Periodontal evaluation if recession is generalised.
Worn Enamel
High-fluoride toothpaste, dietary review (cut acidic drinks, switch brushing technique), and in-clinic fluoride varnish. For severe wear, restorative bonding may be needed.
Cracked Tooth
Composite for small cracks; crown for larger fractures or when a cusp is involved. X-ray and bite assessment determine which is appropriate.
Post-Whitening Sensitivity
Transient. Desensitising toothpaste, avoid cold drinks for 48 hours, no further treatment needed unless persistent beyond a week.
Post-Scaling Sensitivity
Transient. Same approach as post-whitening: desensitising toothpaste and time. Resolves within 48 hours as the gum tissue settles.
Cavity
Composite filling, sized to the cavity. Caught early, this is straightforward and resolves the sensitivity in a single visit.
Bruxism
Custom nightguard to protect the teeth from further wear. Restoration of any teeth already worn or fractured. Address daytime clenching habits where present.
Pulp Involvement
If the nerve is inflamed beyond what desensitising agents can manage, root canal treatment is the appropriate escalation. Followed by a crown to seal the tooth long-term.
How a Sensitivity Visit Works
Five steps from arrival to a clear treatment plan. Most diagnostic visits complete in a single appointment.
1. Medical & Dental History
What triggers the pain (cold, hot, sweet, biting), how long it lasts, when it started, what you have already tried. Recent dental work, whitening, scaling, or pregnancy all matter.
2. Clinical Exam + Cold & Percussion Tests
Visual exam for recession, decay, fractures, wear facets. Cold test to confirm the suspect tooth. Percussion test to rule out pulp inflammation or fracture under load.
3. X-Ray (If Indicated)
Where structural concern exists (deep decay, suspected crack, possible abscess), a periapical X-ray confirms the diagnosis before treatment is recommended.
4. Diagnosis Discussion
We tell you which of the eight causes applies, why, and what the options are. Cost, timeline and tradeoffs in plain language. No pressure to commit on the day.
5. Targeted Treatment Plan
From a single fluoride application through to crown or root canal, the plan matches the cause. Some patients leave with relief on the same visit; others book onward treatment.
Aftercare
What to do after your sensitivity visit, regardless of which treatment was performed.
Switch to Desensitising Toothpaste
Sensodyne, Colgate Sensitive Pro-Relief, or Crest Pro-Health Sensitive. Use morning and night, do not rinse heavily after brushing so the active ingredient stays on the teeth. Allow 4 weeks to feel the full effect.
Avoid Acidic Drinks
Soft drinks, sparkling water, citrus juices and wine all erode enamel and reopen dentine tubules. Use a straw where possible, rinse with water afterwards, and do not brush within 30 minutes of acidic intake.
Brush Gently with a Soft Brush
Aggressive scrubbing with a hard brush is a major cause of recession and sensitivity. Use a soft-bristled brush, light pressure, small circular motions. An electric brush with a pressure sensor is ideal.
Return at 6 Weeks
A follow-up visit lets us confirm the sensitivity has resolved or, if it has not, identify why. Persistent sensitivity beyond 6 weeks of consistent treatment usually means a second cause is also present.
What to Try at Home First
Honest version: a 2-week trial of desensitising toothpaste resolves many mild sensitivity cases without ever needing a clinic visit. Use Sensodyne or equivalent morning and night, do not rinse heavily after brushing, and give it the full two weeks before judging the effect. If pain persists, worsens, lingers more than 30 seconds after the trigger, or wakes you at night, see us. There is usually a treatable cause and continuing to ignore it tends to make the eventual treatment larger.
Risks & Honest Tradeoffs
What we tell every patient before starting treatment for sensitivity.
Some Sensitivity is Hereditary
A small minority of patients have constitutionally thin enamel from birth. These cases respond more slowly to fluoride and desensitising agents, and may need ongoing maintenance rather than a one-time fix.
Slow Response to Fluoride
Fluoride varnish and desensitising agents work by gradually blocking the dentine tubules. For some patients the effect builds over multiple applications spaced 6 weeks apart, not in a single visit.
Severe Long-Standing Sensitivity
Where sensitivity in a single tooth has been severe for months and has not responded to conservative treatment, the pulp may already be inflamed. Root canal becomes the realistic last resort, followed by a crown.
Identifying the Wrong Cause
Sensitivity can have more than one cause at the same time (recession plus grinding, for example). If treatment for the obvious cause does not fully resolve the pain, we re-examine for a second contributor before escalating.
Sensitivity Cases Led By
Your Clinical Team
Dr. Thao Tran
General Dentist. Diagnostic workup, fluoride therapy, composite restorations, and sensitivity follow-up. Conservative-first philosophy: we treat the smallest thing that solves the problem.
Dr. Nhung Duong
General Dentist. Cervical composites for exposed roots, desensitising treatment, preventive dentistry. Particular focus on patient education around brushing technique and dietary acids.
Dr. Emily Nguyen
Founding Clinical Director. Sets clinical standards group-wide. Reviews complex cases where pulp involvement, fractures or recession make the diagnosis less straightforward.
Common Questions
Why are my teeth suddenly sensitive?
Sudden sensitivity usually points to a recent change: gum recession exposing a root surface, a small crack in a tooth or filling, a new cavity reaching the dentine, recent whitening or scaling (transient 48 hours), or grinding wearing down enamel. Sudden onset rarely means nothing, it means something changed. A diagnostic exam identifies which cause applies.
Will sensitivity go away on its own?
Sensitivity from recent whitening or scaling typically resolves on its own within 48 hours. Sensitivity from gum recession, exposed dentine, decay, cracks or grinding will not resolve on its own and tends to worsen if untreated. A two-week trial of desensitising toothpaste is reasonable for mild cases; if pain persists or worsens, see a dentist.
Can I cure it with toothpaste alone?
Desensitising toothpaste (potassium nitrate or stannous fluoride) genuinely helps mild cases by blocking the dentine tubules over 4 weeks of consistent use. It cannot fix decay, cracks, exposed roots from gum recession, or worn enamel from grinding. If toothpaste alone has not worked after two weeks, the cause is structural and needs treatment.
Why are my teeth sensitive after whitening?
Peroxide whitening agents temporarily open the dentine tubules, allowing cold and air to reach the nerve more easily. This is a normal, transient effect that resolves within 48 hours after treatment. Use desensitising toothpaste before and after whitening, avoid very cold drinks for a day, and the sensitivity passes. Persistent sensitivity beyond a week suggests another cause.
Can pregnancy cause sensitivity?
Yes. Hormonal changes during pregnancy increase blood flow to the gums, often causing pregnancy gingivitis, which can recede slightly and expose root surfaces. Morning sickness exposes teeth to stomach acid, eroding enamel. Both make teeth more sensitive temporarily. Gentle brushing with a soft brush, fluoride toothpaste and rinsing with water (not brushing) immediately after vomiting all help.
Do I need a root canal?
Most sensitive teeth do not need a root canal. Root canals are needed when the nerve (pulp) is inflamed or infected, signalled by deep, lingering, throbbing pain rather than sharp brief pain to cold. If your pain lingers more than 30 seconds after the trigger, wakes you at night, or is accompanied by swelling, the pulp may be involved and a root canal becomes more likely.
What is the best toothpaste?
Look for active ingredients potassium nitrate (5%) or stannous fluoride. Sensodyne, Colgate Sensitive Pro-Relief and Crest Pro-Health Sensitive are the most clinically studied. Use it consistently morning and night for at least 2 weeks before judging effect, do not rinse heavily after brushing (let the active ingredient stay on teeth), and pair it with a soft-bristled brush.
Can I drink cold water?
Yes, but it will be uncomfortable. Use a straw to bypass the front teeth, drink at room temperature where possible, and avoid alternating very cold and very hot in the same meal. Persistent pain on cold water means there is a treatable cause, not a need to permanently avoid cold drinks.
When should I worry?
See a dentist promptly if pain lingers more than 30 seconds after the trigger, wakes you at night, is accompanied by visible swelling or a bad taste, follows a bite or fall, or worsens over days rather than improving. Sharp, brief sensitivity to cold or sweet is usually treatable and not urgent, but worth diagnosing rather than ignoring.
Can sensitivity be permanent?
Most causes of sensitivity (recession, decay, cracks, grinding, recent whitening) are treatable, and pain typically resolves once the cause is addressed. A small minority of patients have constitutionally thin enamel from birth and respond more slowly to fluoride and desensitising agents; severe long-standing sensitivity in a single tooth occasionally needs a root canal as a last resort.
Stop Guessing
Sensitivity Has a Cause.
We'll Find It.
Book a diagnostic exam. We'll identify which of the eight common causes applies, walk you through the options, and quote any onward treatment in writing before you commit.