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Exposed Dentin: Causes, Treatment, & Prevention

Normally, dentin is the layer underneath the enamel of the tooth but if the enamel gets worn away then the dentin becomes exposed. Once exposed, the tooth can become extremely sensitive to hot, cold, sweet, and acidic foods because the dentin is not meant to receive any external stimulation. Our long island city dentists will go over all of the causes, treatment, and prevention for this sensitive tooth condition.



What does exposed dentin look like?

The dentin layer has a yellow appearance and it is what gives the tooth it's color because the enamel is translucent. The yellow color shows through the translucency of the enamel. Below is a photo of what it looks like.


Exposed dentin
Exposed dentin

You normally can't see the dentin layer because the enamel is covering over it but if the enamel gets worn away, then it will expose the layer underneath. Your enamel is the hardest substance in the body but it is not impenetrable. There are a variety of situations that can cause your enamel to be worn away.



Causes of exposed dentin

There are many different causes of exposed dentin but they are all a result of the enamel layer being worn away or eroded. These are some of the common causes:


Teeth grinding

Teeth grinding with exposed dentin
Teeth grinding with exposed dentin

Grinding your teeth at night will slowly wear away the enamel and expose the dentin. The constant grinding motion is unhealthy for your teeth. The cause for grinding is usually due to stress. Treatment for this condition involves making a night guard to wear and also lifestyle changes such as de-stressing.



Aggressive brushing

Overzealous brushing especially with a hard tooth brush can cause major damage to your enamel. If you couple that with an abrasive toothpaste, your dentin will be exposed in no time. Treatment would be to switch to a soft bristle brush along with a non-abrasive toothpaste but most importantly to be more gentle while brushing.



Gum recession

The gums can recede because you are genetically predisposed to it or it could be from aggressive brushing as well. Once the gums recede, it will expose the layer of dentin underneath, which is very sensitive. Even if your tooth has a crown on it, the gums can still recede below where the crown margin ends. Below is a photo of a crown with receding gums.

In order to not make this condition worse, you should not brush so aggressively. Be gentle around the areas that have already receded.



Tooth decay

Bacteria cause cavities by secreting acid onto the tooth, which eats through the layer of enamel. Once the enamel is completely gone, the dentin will become exposed. Below is a photo of tooth decay that has gone through the enamel and into the dentin layer.


Treatment for tooth decay would require a tooth filling to repair the exposed dentin. There is no other way to replace the missing tooth structure.



Lemon water or preference for acidic foods

Drinking a lot of lemon water or consuming very acidic foods will erode your enamel, leaving the dentin exposed. The reason is because the low pH or acids will eat through your tooth. It is not that you can't have acidic foods but if you do, make sure you rinse your mouth out really well with water to wash away any residual acids. Below is a photo of a habitual lemon eater with eroded enamel.


Eroded enamel
Eroded enamel

The only way to treat this would be to get fillings or dental veneers. Both are costly options even though lemons are relatively inexpensive in comparison. Stay away from all those lemons!



GERD - Gastroesophageal reflux disease

Individuals with GERD are at risk for exposed dentin because when the acids come back up their throat, it bathes the enamel in acid. The constant exposure to acid will wear through all of the enamel and expose the layer underneath of it. The best way to prevent this from happening is to make sure you take your GERD medication and also to rinse your mouth out with water every time acid comes back up!



Bulimia


Bulimia enamel erosion

Individuals with this eating disorder will experience a lot of exposed dentin because the habitual vomiting is full of acids. When the acids are coming back up, it comes into contact with your teeth and erodes it. Typically, the erosion is seen on the tongue side of all of the teeth.


Treatment for bulimia consists of a multidisciplinary team of psychotherapists, nutrition counselors, and dentists.



Missing tooth filling

One of the most common causes of having exposed dentin is if you lose a filling. A tooth filling is meant to replace the missing enamel and dentin so if the filling comes loose, everything underneath will become exposed. Below is a photo of a missing tooth filling showing the dentin underneath.


Missing filling
Missing filling

Treatment for a missing filling would be to replace the filling with a new one. It is a simple process but you do need to make an appointment with your dentist. Our dentists in long island city will be more than happy to help you with that!



Missing dental crown

If your crown falls off, it can reveal the exposed dentin underneath. The purpose of the crown is to cover and protect the sensitive dentin. Once in awhile the crown may fall off because the glue gets loose or you eat something sticky that pulls it off.

Missing dental crown


The photo above shows a tooth that is missing half of a dental crown. The patient was eating chicken bones and broke half of it. The exposed dentin in the photo is yellow in color and very sensitive to cold air. Treatment for this would be to replace the broken crown with a new one.



 


Common symptoms of dentin being exposed

You may experience a couple of symptoms when the dentin gets exposed. The reason why you get these symptoms is because biologically the dentin is meant to be covered and protected by the enamel.

  • Sensitivity - the dentin has a lot of tubules that lead to nerve endings in the pulp. Any type of stimulation such as hot, cold, sweet, or acidic will trigger a reaction causing you to feel sensitivity.

  • Discoloration - the natural color of dentin is yellow, which is not as pretty as the translucent enamel that covers over it. Once it is exposed, you see more of the yellow, which is not quite as aesthetic.

  • Chipped teeth - if you have exposed dentin, you will become more prone to your teeth chipping because the dentin isn't as sturdy as enamel. Dentin has a 3 on the Mohs scale of mineral hardness while enamel has a 5 in Mohs.



How to treat exposed dentin

There are many types of treatment available but they all achieve the same effect of covering up the exposed dentin. All of the treatment can only be performed by a dentist because home remedies only offer a temporary solution.

  • Tooth filling - either a white filling or a silver filling will both cover up the exposed dentin because they add an additional layer over it. This way, all of the external stimuli will affect the filling and not the dentin underneath of it.

  • Dental crown - alternatively you can cover the entire tooth with a crown so that no dentin will remain exposed. This option is less conservative than a tooth filling because because you have to drill and prepare around the entire tooth.

  • Dental veneer - a more conservative option than the dental crown because you only drill away the front part of the tooth in order to make a veneer. The only caveat is that a veneer will only cover up dentin that is exposed on the cheek side of your mouth. If you have exposure on the tongue side, you should go with a full coverage crown instead.

All of these treatments share one trait in common and that is they all cover up the exposed dentin. These restorations basically act as a replacement for the enamel layer, which is meant to protect the dentin.


How to seal exposed dentin

Alternatively if you don't want to permanently treat the exposed dentin, you can also seal it off. How dentin sealing works is by clogging or blocking the dentinal tubules so that the tooth no longer feels any sensitivity.


Sealed exposed dentin

The sensitivity comes from the dentinal tubules being unsealed so all you have to do is to reseal it and there are three ways to seal it.

  • Use a sensitivity toothpaste - the anti-sensitivity ingredient in these toothpastes are Potassium Nitrate and how they work is by sealing off the tubules. This prevents external stimuli such as cold, hot, sweet, and acidic from reaching the nerves. The effects will last as long as you keep using the toothpaste. Unfortunately the anti-sensitivity subsides once you stop using it.t

  • Use a professional desensitizer - in office desensitizers such as KoR desensitizer and Gluma both work in sealing off the exposed dentin. These products work for a longer duration of time compared to the sensitivity toothpastes but they still eventually wear off after a few months.

  • Place a thin layer of bonding - instead of having your dentist put a complete bonding on your tooth, they can also put a very thin layer of bonding just to cover up the exposed dentin. This is the longest lasting temporary solution but it will still wear away over time from brushing your teeth.



How to prevent dentin from being exposed

You won't need to have the exposed dentin treated if you just prevent it from happening to begin with. There are certain actions and habits that we do, which contribute to the dentin being exposed. If we simply stop these actions then the condition shouldn't progress.

  • Wear a night guard - wearing a guard at night will prevent you from grinding away your tooth enamel, which will cause dentin exposure. You will grind on the plastic night guard instead of your enamel.

  • Avoid or minimize acidic foods - the acid from the foods that you eat can erode the enamel, thereby causing an exposure. The less of these types of foods that you eat, the less likely you'll end up with dentin sensitivity.

  • Use a soft bristle toothbrush - overzealous brushing of your teeth will wear away the enamel so please remember to be gentle when brushing. Don't forget that plaque is very soft and only requires light pressure to remove it.

  • Use a low abrasive toothpaste - some toothpastes are very gritty and abrasive. Those toothpastes can erode the enamel when combined with aggressive brushing. In order to counteract that, please switch to a low abrasive toothpaste.

  • Repair all exposed dentin - if you already have exposed dentin, you should have them all treated and repaired. If you leave them exposed, your teeth will be more prone to chipping and wear because the dentin is softer than enamel. The dentin isn't really meant to sustain chewing forces.

These are all the tips from our LIC dentists on how to prevent your dentin from being exposed and from getting worse! If you have any questions, please feel free to contact our office!

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