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Dentistry/Teeth Whitening for Sensitive Teeth

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Question
Hello,

For many years, I've had very sensitive teeth when it come to cold and very sweet foods. My dentist told me that my gums were receding, though I rarely ever had bleeding or swelling in my gums.

I have been to the dentist recently, and he says everything looks healthy. However, whenever I try to whiten my teeth, whether it be with Listerine Whitening, or a homemade rinse of hydrogen peroxide, it feels like knives are stabbing into the roots of my teeth while I'm swishing. It's an excruciating pain.

My questions are, is this something that can be treated/cured? To have such sensitivity is very alarming. And, on a cosmetic level, are there any teeth whitening procedures available that are safe for sensitive teeth/gums? Thanks!

Answer
Hi Ashley and thanks for your question.

Your dilemma is not uncommon and shared by many patients during the course of their life.  Gum recession has a multitude reasons for developing, from periodontal disease to localized infection to ageing and incorrect brushing habits, but the overwhelming symptom in common is an increase in tooth sensitivity due to the exposure of the very sensitive root neck of the tooth.  This area is usually covered by the gum tissue which protects the area which doesn't have any enamel protecting it.  Depending on the extent of the recession and the size of the exposed neck, it is possible to protect the tooth and seal off this area with a white filling material such as composite or glass-ionomer, but one does need a certain degree of tooth surface to bond onto to ensure longevity.

Sadly, as most of the good whitening products contain an acid-based ingredient to etch the tooth during whitening, these agents would increase tooth sensitivity - but this effect does vary from person to person and product to product.  You might get more effective whitening with fewer symptoms from in-chair whitening procedures done by your dentist under controlled conditions rather than a general, over the counter one.

The other thing I can advise you to consider, is the daily use of a fluoride mouth wash, a high fluoride containing toothpaste such as Elmex or a toothpaste containing triclosan, such as Sensodyne.  Triclosan takes about 2-3 weeks to reduce symptoms so don't expect immediate relief, but the effects are worthwhile giving it a try. The higher fluoride content of Elmex hardens up any sensitive or newly exposed dentine and reduces its reaction to temperature changes - with the added benefit of preventing decay at the same time.

I hope this helps and wish you all the very best in resolving this problem, take care.

Kind regards
Dr Craig Peck

Dentistry

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.

Experience

I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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