Sensitive teeth most often come down to one thing: the dentine beneath your enamel has become exposed. Not always — decay, a crack or a failing filling can feel similar, which is covered below. The pattern that points to exposed dentine is short, sharp pain triggered by something cold, hot, sweet or acidic, and the usual reasons dentine becomes exposed are gum recession, acid erosion and tooth wear. Pain that lingers, throbs, or wakes you at night is a different problem, and it needs looking at promptly rather than managed with a toothpaste.

What dentists mean by “sensitive teeth”

The clinical term is dentine hypersensitivity. The definition used in the research literature is short, sharp pain arising from exposed dentine in response to a stimulus — thermal, evaporative, tactile, osmotic or chemical — that cannot be attributed to any other dental defect or disease (Splieth and Tachou, Clinical Oral Investigations 2013;17(Suppl 1):S3-S8).

Two things have to be true at the same time for it to happen. The dentine has to be exposed, and the microscopic tubules running through it have to be open to the mouth. Splieth and Tachou describe this combination — exposed cervical dentine with open dentine tubules — as arising from erosion, gingival recession and abfraction.

That explains something patients often find confusing: sensitivity is usually felt along the gum line on the cheek-facing surfaces of teeth, not on the biting surfaces. The same review found those buccal surfaces show clearly the highest prevalence, with premolars, first molars and canines affected at broadly similar rates.

How common is it?

The honest answer is that the published figures vary enormously, and any article quoting a single confident percentage is overselling the evidence.

A 2019 systematic review and meta-analysis in the Journal of Dentistry pooled 65 papers reporting 77 studies and found prevalence estimates ranging from 1.3% to 92.1%. Its best estimate was 11.5% (95% CI 11.3-11.7%), while the average across all studies was 33.5% (95% CI 30.2-36.7%) — Favaro Zeola, Soares and Cunha-Cruz, J Dent 2019;81:1-6.

A European population-based study of 3,187 adults aged 18 to 35 across seven countries found 41.9% reported pain when a tooth was stimulated, but only 26.8% described themselves as having sensitive teeth when asked by questionnaire (West et al., J Dent 2013;41(10):841-51).

Two things follow from that gap. Sensitivity is common, and the gap between the two figures suggests it is under-reported when patients are asked to describe it themselves.

The main causes of tooth sensitivity

Gum recession

When the gum margin moves back, it exposes root surface. Splieth and Tachou note that root surface exposure through periodontal disease is a common route to exposed dentine in older patients, and found that the presence of gingival recession significantly increased the probability of tooth sensitivity. West et al. identified gingival recession as one of two clinical factors most strongly associated with it.

Recession has several causes, and gum disease is a significant one. The NHS lists “your gums shrinking” among the consequences of untreated gum disease, alongside bleeding when brushing, and swollen, red or sore gums. If your gums bleed when you brush or eat hard foods, sensitivity is a symptom of something upstream — read more about gum disease treatment.

Acid erosion

West et al. found a strong, progressive relationship between sensitivity and erosive tooth wear. The same study associated sensitivity with heartburn and acid reflux, vomiting, energy drink consumption, an acidic diet and smoking.

Erosion is easy to overlook, because there is no single dramatic event — just a slow thinning of enamel where it is already at its thinnest, near the gum line.

Tooth wear and grinding

The NHS notes that teeth grinding causes “worn-down or broken teeth, which can cause increased sensitivity, and loss of teeth and fillings”, and that stress and anxiety are the most common cause. Where grinding is the driver, a dentist may recommend a mouth guard or splint worn at night to protect the teeth from further wear.

Decay, cracks and failing fillings

The NHS lists “sharp pain in your tooth when eating or drinking hot, cold or sweet things” as a symptom of tooth decay, and includes cracked or damaged teeth and loose fillings among the causes of toothache. This matters because decay and dentine hypersensitivity can feel similar at the start, and they need different treatment — which is why persistent sensitivity is worth having examined rather than self-managing.

After dental treatment, including whitening

Sensitivity following treatment is recognised. The NHS lists “teeth becoming sensitive to cold or sweet food and drink” among the possible side effects of teeth whitening.

If you are considering tooth whitening, the NHS position is worth knowing. It states that the chemicals used “should only be used or sold by dental professionals who know how use them safely and protect your teeth and gums”, and warns that whitening from beauty salons, or kits bought from a pharmacy or online, “does not work as well and may harm your teeth and gums”. You can check whether someone is a registered dental professional on the General Dental Council register.

How you brush — a more nuanced picture than you will usually read

Plenty of dental articles state flatly that hard brushing causes recession. The evidence is weaker than that. A 2015 systematic review in the Journal of Clinical Periodontology concluded that “the data to support or refute the association between toothbrushing and gingival recession and NCCLs remain largely inconclusive” (Heasman et al., 2015;42(Suppl 16):S237-S255), although its meta-analysis of 159 subjects did find greater recession at 12 months with manual brushes than with powered ones.

So brushing technique is worth reviewing — but if you have recession, do not assume it is simply your brushing and stop there. Gum disease and erosion are the causes that carry real consequences if missed.

When sensitivity is not just sensitivity

Short, sharp, stimulus-triggered pain that stops when the stimulus is removed is the pattern of dentine hypersensitivity. A different pattern points elsewhere.

The NHS advises seeing a dentist if you have toothache that lasts more than two days, does not go away when you take painkillers, or comes with a high temperature, pain when you bite, red gums or a bad taste in your mouth — and to go to A&E if the area around your eye or your neck is swollen, or if swelling in your mouth or neck is making it difficult to breathe, swallow or speak. The NHS adds: “Do not drive to A&E. Ask someone to drive you or call 999 and ask for an ambulance.”

Pain that lingers after the trigger has gone, that is spontaneous, or that keeps you awake, can indicate that the pulp inside the tooth is inflamed or infected. The NHS notes that pulp can become infected through tooth decay, gum disease, chips or cracks, and that where an infected tooth is not treated with root canal treatment, the tooth may need to be taken out instead.

What helps at home

Desensitising toothpaste — what the evidence actually says

This is where most articles overclaim. The Cochrane review on potassium-containing toothpastes concluded that “no clear evidence is available for the support of potassium containing toothpastes for dentine hypersensitivity” (Poulsen, Errboe, Lescay Mevil and Glenny, Cochrane Database of Systematic Reviews 2006, Issue 3, CD001476.pub2). Objective measures showed a benefit at six to eight weeks; patients’ own subjective assessments did not.

That review is now dated and covers one active ingredient rather than the whole category, so it is not a reason to avoid desensitising toothpaste. It is a reason to treat it as symptom relief rather than a diagnosis, and to get the underlying cause identified if the sensitivity persists.

Everyday care

NHS guidance is to brush twice a day for about two minutes with a toothpaste containing at least 1,350ppm fluoride, to spit out excess toothpaste rather than rinsing — rinsing washes away the concentrated fluoride — and to clean between the teeth with floss or interdental brushes.

Reducing how often you have acidic food and drink is worth doing on the evidence above, and if you have reflux or heartburn, that is worth raising with your GP as well as your dentist.

What a dentist can do

An examination is aimed at working out which of the causes above applies, because the treatments diverge sharply. Recession from gum disease needs the gum disease treated. Erosion needs the acid source identified. Grinding may call for a splint. Decay, a crack or a failing filling needs restoring. Depending on the cause, a dentist can discuss options for protecting exposed root surfaces.

A new patient consultation at Horsforth Smile Clinic is from £55 (price correct as of July 2026), subject to clinical assessment. Our full price list sets out treatment costs.

When to book an appointment

Book if sensitivity has lasted more than a few weeks, is getting worse, is confined to one tooth, or comes with bleeding or receding gums. Book promptly — or seek urgent care — if the pain lingers after the trigger has gone, wakes you at night, or comes with swelling, a bad taste or fever.

Suitability for treatment depends on a clinical assessment. This treatment may not be appropriate for every patient.

Sources

Splieth CH, Tachou A. Epidemiology of dentin hypersensitivity. Clinical Oral Investigations 2013;17(Suppl 1):S3-S8. PMID 23224064.
Favaro Zeola L, Soares PV, Cunha-Cruz J. Prevalence of dentin hypersensitivity: systematic review and meta-analysis. Journal of Dentistry 2019;81:1-6. PMID 30639724. DOI 10.1016/j.jdent.2018.12.015.
West NX, Sanz M, Lussi A, Bartlett D, Bouchard P, Bourgeois D. Prevalence of dentine hypersensitivity and study of associated factors: a European population-based cross-sectional study. Journal of Dentistry 2013;41(10):841-51. PMID 23911597.
Heasman PA, Holliday R, Bryant A, Preshaw PM. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing. Journal of Clinical Periodontology 2015;42(Suppl 16):S237-S255. PMID 25495508.
Poulsen S, Errboe M, Lescay Mevil Y, Glenny A-M. Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001476. DOI 10.1002/14651858.CD001476.pub2.
NHS. Gum disease. https://www.nhs.uk/conditions/gum-disease/
NHS. Tooth decay. https://www.nhs.uk/conditions/tooth-decay/
NHS. Toothache. https://www.nhs.uk/symptoms/toothache/
NHS. Teeth grinding. https://www.nhs.uk/symptoms/teeth-grinding/
NHS. Teeth whitening. https://www.nhs.uk/conditions/teeth-whitening/
NHS. Root canal treatment. https://www.nhs.uk/conditions/root-canal-treatment/
NHS. How to keep your teeth clean. https://www.nhs.uk/live-well/healthy-teeth-and-gums/how-to-keep-your-teeth-clean/