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Dentistry/Sensitivity in #18 and #31

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QUESTION: I get sensitivity/dull ache/awareness of #18 and #31 from air, sometimes after brushing, and sometimes no reason. Compression of teeth, roots sounds logical, but since I never had this before, I'm wondering if it could be related to anything else. Timeline on when this started:

8-30-13 Cracked inner/front corner off 18 eating popcorn. (18 already had large center filling.)
9-4-13 and 9-19-13 Prepped for and had gold Noble Alloy crown Argenco Y+ put on. First crown at age 60.
11-4-13 Ultrasonic cleaning caused sensitive teeth all over mouth with random pings. My gum measurements mostly 3s,2s.
12-10-13 Sensitivity/dull ache mostly continuing in 18 and 31. Dentist fitted me for bottom teeth mouthguard to replace top teeth mouthguard (had not worn top mouthgard for a year before cracking 18 and had not had such sensitivity even then). Also added 1.1% sodium fluoride prescription toothpaste to my Restore with NovaMin toothpaste. Quit using any Act or other rinse. Use OralB/Braun electric toothbrush.
12-30-13 Started wearing new bottom mouthguard. Like it better, but sensitivity still comes and goes.
1-9-14 I try to ignore the sensitivity, and I try to assume it will pass, but is there anything Iím missing on why I have this now?  Sincerely, Diane

ANSWER: Hi Diane,

I read over your history and also did a little research on my own about what to do with sensitive teeth.

First, I am liking what I am hearing regarding the approach that your dentist is taking by prescribing NovaMin toothpaste.  Believe it or not NovaMin is hard to obtain in the United States, and there were some comments in the forums saying that people have resorted to trying to order NovaMin from Canada.  Some of the comments that I read say that NovaMin is effective in treating tooth sensitivity.

There was also a lot of articles and forums saying that "Stannous Fluoride" was another type of Fluoride that can have the added benefit of treating hypersensitivity.  One product that I saw recommended was "Crest Pro-Health Toothpaste" with stabilized stannous fluoride that provides protection against cavities, gingivitis, plaque, sensitive teeth, tartar buildup and it freshens breath.

After giving NovaMin a try and you don't feel better, ask your dentist what he thinks about a Stannous Fluoride toothpaste.  You may want to experiment with both types to see which suits you better.

I am assuming that you are being careful about your eating habits, that could irritate your sensitive teeth.  Be care of very hot or very cold foods.  Try and stay away from foods that are very acidic.

As far as whether your mouthguard is worn on top or bottom, I suppose either way would be okay.  I personally prefer wearing a night guard on my upper teeth.  Now that you are wearing a night guard on the bottom, just make sure that the night guard itself is not rubbing against or irritating your second molars....#18 and #31.

Lastly, a random extra comment.....after brushing your teeth and applying the fluoride toothpaste to your gums.....don't drink, or eat for at least 30 minutes in order to give the fluoride a chance to work.  I don't think I would put my night guard in my mouth either for at least 30 minutes.

Hope you are feeling better soon.

Best regards,
Jonathan
Patient Point of View



---------- FOLLOW-UP ----------

QUESTION: Thank you for taking the time to reply. FYI: I got the Dr. Collins Restore Toothpaste (Novamin) online on my own, but I see that it is currently out of stock as they reformulate. They say it will be available soon.

Regarding your TMJ issues, could the new crown have changed my bite so that I now have more sensitivity? I never had this before. How long does your sensitivity take to go away? And when would it be worth getting a second opinion?

Thanks again.

Answer
Hi Diane,

Yes, I have TMJ issues, but never had to deal with teeth sensitivity problems.

If you have crowns on your lower molars, would it not be easier to simply were your night guard on your upper teeth?  Does your night guard effect your sensitivity?

As far as a second opinion, I say, why wait??  You have nothing to lose, and it will either provide confirmation as to what your current dentist is doing....or provide a new opinion that could be helpful.

Best regards,
Jonathan
Patient Point of View

Dentistry

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Jonathan at PatientBabble

Expertise

My area of expertise from the patients point of view would be Dentistry/TMJ plus the speech challenges that these jaw and bite problems sometimes represent. Over the years I have seen a multitude of dentists, orthodontists, oral surgeons, speech therapists, neurologists and other health professionals who all had an opinion about my TMJ/bite problem. I AM NOT A DOCTOR...but would purely be a patients point of view type person. I "get it" when people say they tried to explain to their dentist what their TMJ/bite problem is and that they are misunderstood. I can listen to people's trials and tribulations and there is a good chance I have been down that road before. I can make suggestions as to what people can do at home, or what questions to ask their doctor or dentist when they visit. I will try and recall information or experiences that may be helpful to you.

Experience

About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." For whatever reason, the first sensation I remember was not that my bite was off.....but rather that my normal tongue and speech patterns had been impeded. I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. The majority of dentists believe they can treat TMJ, but only those whose primary focus is TMJ treatment, are really any good at it. Any dentist, can take an impression of your teeth, send that impression off to the lab and have them make a night guard. That is the easy part. The tricky part is what the dentist does with the night guard, once receiving it from the lab. The dentist has to do a "fitting" where they tailor the night guard to be evenly balanced and comfortable in your mouth. Sometimes it can take a few visits, because further adjustments need to be made to the night guard appliance, to get it just right. I have found that dentists, who have had the most practice, do a better job at fitting your appliance. It's almost like an art form.

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Jonathan's Blog is: https://patientbabble.squarespace.com/jonathans-blog

Education/Credentials
College Graduate with Bachelor of Arts Degree

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