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Sensitive Teeth During Pregnancy: Causes

Updated: May 16

Your body may go through a lot of changes during pregnancy due to altered hormone levels but sensitive teeth isn't one of them. Based on our current understanding of how dentinal hypersensitivity works, it is unlikely for pregnancy to have a direct effect.


However we can postulate secondary reasons as to why your teeth may indirectly feel sensitive during pregnancy. Nonetheless, it still doesn't change the fact that you may be feeling sensitive as of this moment. That is why we'll leave you with some tips on how to manage teeth sensitivity at home.


Pregnancy does not directly make your teeth sensitive

Currently the most widely accepted theory on dentinal sensitivity is the Hydrodynamic Theory by Brannstorm. According to the theory, our teeth feel sensitive because receptors are able to sense fluid movement changes in the dentinal tubules.


hydrodynamic theory schematic diagram
Credit: Ji won Kim and Joo-Cheol Park

What causes dentinal fluid movements:

  • Thermal changes - exposure to hot or cold.

  • Physical changes - brushing or flossing your teeth.

  • Osmotic gradients - eating foods that may be acidic, spicy, sour, or sweet.


Direction of the fluid movements in the tubule:

  • Away from the nerve - Cooling, drying, evaporation, and hypertonic chemical stimuli

  • Towards the nerve - Heat and probing


Essentially there is no mention of hormones nor pregnancy and how they may affect fluid movements. In other words, the pregnancy hormones have no effect on tooth sensitivity.


As further evidence, we could find no mention of "teeth" nor "sensitivity" when we looked for research studies about estrogen and progesterone. Those are two hormones which are elevated during pregnancy.


Alleged claims that hormones increase blood flow and gum disease

There appears to be a lot of claims that the hormones will increase blood flow and make your gums more prone to pregnancy gingivitis. Those claims are in fact true and they are verified by the American College of Obstetricians and Gynecologists (ACOG).


However that does not have anything to do with having sensitive teeth. The list of oral health conditions during pregnancy by the ACOG are as such:

  • Pregnancy gingivitis - an increased inflammatory response to dental plaque.

  • Pyogenic granuloma - also known as a pregnancy tumor where the gums swell up in about 5% of patients. Excision is rarely necessary but may be performed.

  • Tooth mobility - ligaments and bone that support the teeth may temporarily loosen. Potentially due to the hormone relaxin, which also makes your TMJ disorder better.

  • Tooth erosion - vomiting secondary to morning sickness may erode your tooth enamel from the gastric acids coming up.

  • Dental caries - pregnancy does not increase tooth decay but due to increased frequency of eating, the risk therefore increases.

  • Periodontitis - untreated gingivitis may progress to periodontitis. This is why it is important to seek dental care while you're pregnant.


Tooth sensitivity is NOT a listed oral condition for when you're pregnant.


 

Sensitive teeth may be secondarily caused by pregnancy

Pregnancy may not directly cause your teeth to become more sensitive but some of its effects may secondarily lead to sensitivity. In other words, it may indirectly cause them to feel more sensitive.

  • Vomiting secondary to morning sickness

  • Cravings for acidic, sweet, sour, and spicy foods


According to the NHS, those are valid signs of pregnancy. What they both have in common is that they lead to tooth erosion. The enamel is being subjected to acid erosion, gastric acids from the vomiting and low pH food consumption.


Candy chemistry pH
Credit: ScienceWorld

The photo above shows some pH values for various foods. We're sure that you've experienced random cravings for certain foods. If you happen to be craving foods with a low pH, it may cause the enamel to erode if you eat a lot of it.


Enamel erosion leads to sensitivity

Acid attacks on your enamel can make your teeth more sensitive.

  • Acids will dissolve the smear plugs that are blocking the dentinal tubules.

  • They can also complete demineralize and erode the entire enamel layer.


Dissolve and dislodge smear plugs

Under normal circumstances, there are smear plugs which block off the entrances to the dentinal tubules. As we've discussed above, according to the hydrodynamic theory our teeth become sensitive due to fluid movements in the tubules.


The smear plugs prevent stimuli from interacting with the tubules. However if you eat a lot of acidic foods, it can dislodge or even dissolve the smear plugs. It will leave them wide open to various stimuli and that may be why your teeth are sensitive.


What makes it even worse is that if you eat acidic foods for an extended period of time, the tubules not only open but also become widened. That means even more stimuli can get into them! You'll definitely have an exaggerated hypersensitivity response if that is the case.


Erode enamel via demineralization

Acidic foods have a low pH and what that means is it has a high concentration of H+ ions. Essentially acids have a lot of hydrogen ions and what they do is pull phosphates out of the enamel.


demineralization remineralization of teeth
Credit: Sangi Co

Since phosphates are minerals, we call the process demineralization. Basically what happens when the enamel demineralizes is that it dissolves.


The phosphates (PO4) get pulled out of the tooth because they combine with hydrogen (H+) to buffer the mouth. It actually makes the oral environment become less acidic. It's a protective mechanism for your mouth to de-acidify itself.


Phosphate buffering system in saliva
Credit: Crest

Unfortunately, if enough minerals get pulled out of the tooth it can leave a hole in the enamel layer. If this process repeats itself for the entire enamel layer, all of the enamel will have eroded away and what you'll be left with is dentin.


Having no enamel will definitely leave your teeth more sensitive since the dentinal tubules will be unprotected. Normally the enamel protects and covers the dentin but if they eroded away, there will be no protection.


The most likely cause for this to happen during pregnancy is if you vomit a lot from morning sickness. The gastric acid is highly acidic and will melt away your enamel. This is why the ADA and ACOG recommends that you rinse with baking soda water to neutralize the acids.


baking soda

How to neutralize stomach acids with a baking soda rinse

  1. Pour about 4 oz of water into a cup.

  2. Add 1 teaspoon of baking soda.

  3. Stir lightly.

  4. Rinse for about 2 minutes.

  5. Spit out.


 

How to treat sensitive teeth during pregnancy

Regardless of why your teeth are sensitive while you're pregnant, there are ways to desensitize them both at home and at the dentist. Although you shouldn't forget that you still need to keep up with your oral hygiene in order to keep your teeth healthy.


Desensitize your teeth at the dentist

If your teeth are feeling sensitive, you should ask your dentist for a treatment with fluoride varnish. This is basically a 5% solution of sodium fluoride which is about 20x more concentrated than your toothpaste.


How the fluoride varnish desensitizes your teeth is by occluding the dentinal tubules by forming a calcium fluoride-like layer over the tooth.

  • It plugs up all of the open orifices of the tubules, thus effectively preventing stimuli.

  • The additional layer that covers the tooth also protects it from the elements.


Desensitizing teeth at home

For desensitizing the teeth at home, you have three options and that is with potassium nitrate, nano-hydroxyapatite toothpastes or stannous fluoride. They either work by directly prevent the nerve from firing or by occluding the open tubules.


sensitive toothpaste
sensitive toothpaste

They will all work so feel free to give them a try and see what works. However, if you were looking for the best toothpaste for sensitive teeth we do have a recommendation. It is a Japanese brand but we do have an alternative in our article.


  • Sensodyne pronamel

  • Colgate sensitive

  • David's toothpaste

  • Risewell mineral toothpaste


 

Verdict

Pregnancy does not directly cause teeth sensitivity because it isn't a stated symptom. However it may indirectly cause sensitivity via secondary effects. The most notable has to do with morning sickness and dietary changes.


All of them lead to acid attacks on the enamel which may lead to dentinal hypersensitivity or enamel erosion. Hearing it already makes our teeth sensitive! If you have any questions, definitely schedule a consultation with your dentist or one of our dentists in Long Island City. It is perfectly safe to get dental care while you're pregnant.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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