Tooth neck is exposed - what to do?
introduction
When chewing hot or cold food, drinking a delicious sweet soft drink or eating acidic fruit, the pain suddenly begins to be intense and pulsating. You put your hand to your cheek and grimace with discomfort.
If you try again, the same thing happens again and you lose the desire to continue consuming it. Exposed tooth necks can be to blame for this misery and require rapid treatment by a dentist, because deeper problems can be to blame for this condition.
treatment
If up to now there has only been pain and if there is no periodontitis or caries on the neck of the tooth, a fluoride varnish or a plastic is usually applied that closes the exposed tubules so that the hypersensitivity subsides. Fluoride varnishes usually do not last that long, so that the plastics in the form of dentin adhesives show a longer effectiveness.
Read more on the topic: Cervical caries
A new method are special dental lasers that briefly soften the tissue so that the tubules are then closed. However, if the tooth neck damage is already at an advanced stage, the dentist can remove the caries and insert a tooth neck filling, or depending on the case, a crown is necessary. The worst that can happen is removal (extraction of the tooth), but only if, despite the root canal treatment, the tooth decay has made the tooth irreparable and unstable.
Afterwards, however, you should ensure that you continue to use the correct toothbrush and toothpaste at home, so that the gums can regenerate and no new tooth necks are exposed.
Which toothpaste will help with an exposed tooth neck?
The most important thing in treating exposed tooth necks is gently brushing the affected areas. The gums must not be further irritated there, otherwise there is a risk that they will retreat further. In such cases, it is generally advisable to rub the affected areas with toothpaste (e.g. elmex jelly) that contains a lot of fluoride or to brush them very gently and carefully.
Home remedies
As a first step at home, gentle rubbing with fluoride-containing jelly (e.g. elmex Gelee®) and careful cleaning are very helpful. The jelly closes the small tubules in the dentine (tooth bone) and prevents tooth decay. Home remedies also include gentle rinsing with saline solution (dissolve 1/2 teaspoon salt in warm water). Furthermore, oils that are applied to the affected areas can also lead to a reduction in sensitivity.
Read more on the topic: Home remedies for toothache
homeopathy
As with any treatment of ailments, it is also very important when using homeopathic medicines to know the cause of the pain. ’Schüßlersalz’ is a homeopathic medicine that is often used for pain or inflammation. There is also Hypericum, a homeopathic remedy made from St. John's wort, or aconite, made from blue monkshood.
If the pain persists, this is a sign of tooth decay or inflammation in the gums. These cannot be combated with homeopathy, but must be treated by the dentist.
Read more on the topic: Homeopathy for toothache
Symptoms
Depending on the degree of severity, exposed tooth necks are manifested by:
- unpleasant / painful "pulling" when consuming sweet, sour, hot, cold foods
- Pain in the tooth draw in on bare air
- receding gums (tooth looks longer)
Read more on the topic: Pain in the neck of the tooth
The gums recede
When the gums recede, the necks of the teeth are exposed. This means that a piece of dentin is no longer protected by the gums. Reasons for receding gums can include excessive brushing, inflammation of the gums, old age or teeth grinding.
Read more on the topic: Inflammation of the gums
It is important to find out the cause. It is best to see a dentist. If the cause is an inflammation of the teeth holding apparatus (periodontitis), this must be treated immediately. It is important to treat the affected areas in the mouth very gently. If, for example, teeth grinding is the cause of the retraction of the gums, the dentist can create a splint.
Read more on the topic: Receding gums
Pain
The gums may have retreated for a variety of reasons. The so-called dentin of the tooth is now partly no longer under the protection of the gums and is exposed. There are many small tubules in the dentin that ultimately flow into the pulp, the pulp. This is where nerves and blood vessels are located. For this reason, contact with, for example, cold, hot or sour foods is perceived as painful. The stimuli pull through the small canals up to the tooth nerves and a stabbing, sharp pain arises.
Causes - an overview
Exposed tooth necks can have various causes:
- Caries / cervical caries
- untreated inflammation of the gums (gingivitis)
- Inflammation of the teeth supporting structures (periodontitis)
- Crunching (bruxism)
- wrong technique when brushing teeth (too much pressure)
- wedge-shaped defects
Causes in detail
The main cause of exposed tooth necks is a disease of the tooth supporting apparatus. This is called periodontal disease, colloquially known as periodontal disease.
The tooth-holding apparatus includes the root cement, the gingiva, the alveolar bone and the periodontal membrane (Periodontal disease).
Read more on the topic: Periodontal disease
Also pure gingivitis (Gingivitis) can cause. Periodontitis is an inflammation caused by bacteria that triggers the systematic destruction of the teeth supporting structures. Like gingivitis, it is triggered by plaque (Dental plaque) that is not removed and forms an adhesive biofilm over the tooth.
The resulting bacteria begin to attack and destroy the tooth first, then the surrounding tissue. Untreated gingivitis can turn into periodontitis. The course of the inflammation causes the gums to withdraw further and further and the pain-sensitive tooth necks become more and more accessible. Another reason can be crunching and clenching caused by stress or misalignment of the TMJ. This type of dysfunction is called bruxism and occurs temporarily at night. Large, sustained loads are placed on the tooth.
Read more on the topic: Grinding teeth
Another reason, which often does not immediately seem logical, can be too vigorous brushing. It is wrong to assume that if you press more with the toothbrush, you remove more and better plaque and thus do something good for your teeth. Pressing too hard damages the gums, causing them to injure and begin to retreat over time. The connective tissue fibers that allow it to adhere to the tooth tear and the gums separate from the tooth neck. The premolars and molars, i.e. the posterior teeth, are usually affected. A toothbrush that is too firm or too strong an abrasive body in the toothpaste can also cause this.
consequences
Exposed tooth necks are not only aesthetically unpleasant to look at, they can also have serious consequences, or point to an existing problem as a clear warning signal. The gums are like a kind of protective cover, which is supposed to protect the tooth and the tooth-supporting structure from harmful influences.
If the tooth necks are exposed, the dentin on the tooth can be directly attacked by external bacteria. The many small tubules that are present in the dentin now come into direct contact with the outside world and transmit any chemical or thermal stimulus to the inside of the tooth, causing pain.
Another problem is that exposed tooth necks are a perfect place for bacteria to settle, which cause tooth decay and thus start to break down the tooth substance. Neck caries can spread quickly because the lack of a protective enamel layer makes it easier for bacteria to penetrate quickly and reach the medullary cavity. Patients usually only come to the dentist when a lot of substance has already been lost and the bacteria have reached the pulp. Because the caries can spread so well and the pulp is easily reached, the subsequent root caries is a further consequence of the exposed tooth necks.
You might also be interested in this article: How do I recognize a tooth neck infection?
prophylaxis
The best protection against exposed tooth necks is to prevent their formation. On the one hand, it is important to use the correct toothbrushing technique and toothbrush materials. The teeth should be cleaned on all sides at least twice a day with a toothbrush that is not too hard, applying gentle pressure. Dental floss, tongue scrapers and mouthwashes should be used as a supplement to prevent tooth decay, which can lead to periodontal disease.
Electric toothbrushes are very suitable for cleaning, as they are easy to use and usually have a control lamp that shows you when you are pressing too hard. With the normal manual toothbrush, circular movements are preferred, which should be made at an angle of 45 ° away from the gums to the tooth crown. Regularly changing the brush when there is visible wear or at the latest after 4 weeks should also be observed, as otherwise the full cleaning service is no longer available. Furthermore, protective agents can be purchased, such as remineralizing gels, which are usually applied once a week.
Read more on the topic: dental care
Definition of tooth neck
The tooth is divided into three sections, starting with the tooth crown, then the tooth neck and finally the tooth root.
The tooth neck is the transition between crown and root. In healthy teeth, the visible parts of the tooth are covered by a layer of enamel, the root part is protected under the gums (Gingiva). In the tooth neck area, the enamel runs out towards the tooth root and the cement layer begins. However, in terms of strength and resistance, dental cement is not comparable to enamel and is much more sensitive.
Summary
Exposed tooth necks are a common ailment in dentistry, as they can sometimes be caused unconsciously by patients who brush their teeth regularly but are a little too rough. In addition, every gum reacts differently to external stimuli. With the above tips, however, they can be avoided and even if a visit to the dentist is necessary due to severe pain, the worst cannot be assumed straight away, as this is a very sensitive area. In the event of major problems or underlying causes, a dentist should always be consulted, who will then initiate the correct treatment.
