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Dentistry/Sensitivity in #18 and #31


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 I’m 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,
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.

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,
Patient Point of View


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Jonathan at PatientBabble


My area of expertise from the patients point of view would be 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 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 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 come from a family of dentists. My first house growing up was one of those residential/dentist combination homes and I was around the dental practice all the time. My teeth had always been perfect, and in many respects they still are. I have never had a cavity and my teeth are straight. About 25 years ago, I had my wisdom teeth out and since then my bite has never felt "normal." I have learned a lot over the years as I tried to figure out my problem from the Dentists, Speech Pathologists and assorted doctors that I have visited. I will try and recall information or experiences that may be helpful to you.


Twenty-Five years ago after my wisdom teeth were removed, my bite did not feel right and then had trouble speaking. 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. The years of searching for proper treatment has underscored the importance of understanding the relationship between dental and speech methodologies.///// To this end, and to further my research, I recently attended the American Speech-Language-Hearing Association Convention (ASHA) in Atlanta. At ASHA I learned about a specialty within Speech Pathology termed “Orofacial Myology”. In laymen's terms Orofacial Myology Disorder (OMD) deals with the establishment of correct functional activities of the tongue, lips and jaw. OMD is a motor speech disorder that impacts the normal flow of speech, chewing or swallowing.///// If you believe that your struggles with your teeth also present speech, chewing or swallowing challenges, you may want to seek out a licensed Speech Language Pathologist.....preferably one that has training with Orofacial Myology Disorder.

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Abridged Version of a Letter I Sent to a Health Care Professional (3/14/13): "..In my early 20's I had my wisdom teeth out. Almost immediately within a few days, something did not feel right in my mouth. I had trouble speaking. When I raised my tongue to try and touch my palate, I felt mostly just teeth. It is very cumbersome to talk and my bite also became a little bit off. If feels almost as if someone put a fork in my mouth and said "now try and speak." Very difficult. My articulation is fine, so to an observer I sound normal. But it takes a monumental effort, so I hate situations like talking on the phone or when somebody asks me to "tell them a story." ..I spent years going to different dentists, who lumped me into their generic version of what they knew about TMJ. They just automatically gravitate to what they have heard about TMJ and assume I am either stressed, or just imagining it. Years later, I look back at all those dentists and doctors and I am amazed at how little they really knew about my condition. I have seen the best dentists, including my dad who is a Orthodontist in New York, to TMJ Dentists in Atlanta and Florida. No one ever suggested that Speech Pathology may be a direction I should explore. ..And I was frustrated by the fact that several MRI's over the years, showed nothing. How could the MRI’s show nothing, and at the same time, I know something does not feel right? I do wear a night guard to sleep in, but it does not fix the trouble that I have when I try to talk. ..I went with a Speech Pathologist friend of mine to the American Speech Language Hearing (ASHA) Convention last October in Atlanta...There was a Speech Pathologist at ASHA who was saying that sometimes when you have your Wisdom Teeth taken out "late" that it could possibly cause damage to the Trigeminal Nerve and surrounding muscles.” POSTSCRIPT: At ASHA, I discovered OROFACIAL MYOLOGY (OMD) which is a specialty in Speech Pathology that addresses Oral Muscular Issues.

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