Diagnosis of the cause
We map which teeth react, to which stimuli and for how long, look for recession, wear, erosion and cracks, and take X-rays to exclude decay or a failing filling. The pattern usually reveals the cause.
About this treatmentDental condition · Wimpole Street, Marylebone
Tooth sensitivity: why cold, sweet and air make teeth twinge, and what actually helps
A sharp, short jolt when ice cream, cold air or a sweet drink touches a tooth is one of the commonest complaints we hear, and it has a precise mechanism. Beneath the enamel, dentine is riddled with microscopic tubules running inward to the nerve. Fluid inside those tubules shifts when the surface is exposed to cold, sugar or a blast of air, and the movement fires the nerve endings. As long as enamel or gum covers the dentine, nothing happens. When something strips that cover away, the tooth becomes sensitive. Gum recession exposing the root, erosion from acid, wear from grinding or overbrushing, a crack, a leaking filling and early decay can all do it, and each has a different remedy. Sensitivity is also a normal short-lived phase after whitening, a filling or a scale and polish. The job at Wimpole Street is to work out which cause is behind yours, because the toothpaste that helps a receded root will do nothing for a cracked molar.
Recognising it
How it usually feels
Sharp jolt with cold drinks or breathing in cold air
The hallmark of exposed dentine; ends as soon as the stimulus is removed.
Twinge with sweet or acidic food
Sugar and acid change the fluid balance in the tubules and provoke the nerve.
Discomfort when brushing near the gumline
Exposed root surface or a notch worn at the neck of the tooth.
One tooth sensitive to biting or releasing pressure
Points to a crack or a leaking filling rather than generalised exposure.
Sensitivity after a recent filling, whitening or hygiene visit
Expected and usually fades within days to a few weeks.
Ache that lingers a minute or more after cold
Beyond simple sensitivity; the pulp is inflamed and needs assessment.
Behind the symptoms
What's going on
- 01
Gum recession
As the gum pulls back it uncovers root surface, which has no enamel and only a thin, easily lost layer of cementum. Recession follows gum disease, heavy or incorrect brushing, thin gum tissue and orthodontic movement. The exposed root is sensitive to everything until the tubules seal over.
- 02
Acid erosion
Fizzy drinks, fruit juice, wine, vinegar-based foods and stomach acid from reflux or vomiting dissolve enamel over time. Erosion thins the enamel evenly so teeth look flatter, more yellow and glassy, and become sensitive across several teeth at once.
- 03
Wear and overbrushing
Grinding wears enamel from the biting surfaces. Scrubbing hard with a stiff brush, especially with an abrasive paste, wears notches into the neck of the tooth where enamel is thinnest. Both expose dentine.
- 04
Cracks and leaking restorations
A hairline crack or a filling whose seal has failed lets cold and sugar directly into the dentine. The sensitivity is usually confined to one tooth and often includes a sharp pain on biting.
- 05
Early decay
A cavity that has just broken through enamel exposes dentine in a very localised spot. Sweet sensitivity in one particular place, rather than cold across a whole quadrant, raises this possibility.
- 06
After dental treatment
Whitening, a new filling, a crown preparation or thorough root cleaning by a hygienist can all leave teeth reactive for a while as the pulp settles. This resolves on its own in most cases, but sensitivity that worsens rather than eases after a filling is checked.
Before your appointment
What you can do today
- Use a toothpaste for sensitive teeth twice daily for at least a month; rub a little onto the worst spot with a fingertip and leave it there last thing at night.
- Brush with a soft or electric brush using light pressure and small movements, not a horizontal scrub.
- Wait half an hour after anything acidic before brushing, and rinse with water in the meantime.
- Reduce frequent acidic drinks; if you have them, take them with meals and through a straw.
- If you suspect reflux, speak to your GP as well as your dentist; treating the reflux protects the teeth.
- Do not switch to lukewarm-only living and ignore it; sensitivity that has appeared in one tooth needs a diagnosis.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Fluoride varnish and desensitising agents
High-concentration fluoride or a desensitising varnish painted onto exposed root or worn enamel blocks the tubules and reduces sensitivity within days. Repeated every few months if needed.
About this treatmentBonding over exposed dentine
Notches at the gumline and worn edges are covered with a thin layer of composite, sealing the dentine and restoring the shape. From £185 for a small area.
About this treatmentReplacing a leaking filling or protecting a cracked tooth
A filling that has lost its seal is replaced; a cracked molar is protected with an onlay or crown before the crack deepens.
About this treatmentGum treatment and grafting
Where recession is active, gum disease is treated and brushing technique corrected. In selected cases a gum graft covers the exposed root and removes the sensitivity along with the cosmetic concern.
About this treatmentNight splint for wear
When grinding is thinning the enamel, a custom splint protects the teeth while the dentine seals and any repairs are made.
About this treatmentFees
Costs to expect
An examination at Wimpole Street to find the cause of sensitivity, including X-rays, is expected to be £95. Fluoride or desensitising varnish is a small additional fee and is often applied at the same visit. A hygiene appointment is £89, with varnish available at the end of the clean.
Composite bonding over worn notches or exposed roots is from £185 per tooth. Replacing a leaking filling is from £185; an onlay or crown for a cracked tooth is £995. A night splint for grinding is £795. Gum grafting for recession is quoted after a periodontal assessment. Fees are confirmed in writing once the cause is clear.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Sensitivity has developed in a single tooth rather than across several.
- The pain lingers after the cold or sweet trigger has gone.
- You have pain on biting or releasing, as well as with temperature.
- Sensitivity after a filling or crown is getting worse rather than better after two weeks.
- You can see your gums have receded or notches have appeared at the gumline.
- A month of sensitive toothpaste has made no difference.
FAQ
Common questions
They work in two ways. Potassium-based pastes calm the nerve gradually, and stannous fluoride or arginine pastes build a plug in the tubules a little at a time. Both need repeated application to accumulate, so a month of consistent twice-daily use is a fair trial before judging.
Sometimes, particularly when it is sweet-triggered and confined to one spot, but most sensitivity comes from exposed root or worn enamel with no decay at all. An examination distinguishes them; never assume either way.
Not necessarily. Sensitivity during whitening is common and temporary. Using a desensitising paste for two weeks beforehand, whitening on alternate nights, and shorter wear times reduce it markedly. If your teeth are sensitive because of erosion or exposed roots, those should be addressed first.
Yes. The pulp lays down protective dentine and the tubules seal with minerals from saliva over months, which is why sensitivity from recession often fades. It persists when the cause is ongoing, such as continued acid exposure, aggressive brushing or a crack.
Only when the pulp has become irreversibly inflamed, indicated by pain that lingers well after the trigger, spontaneous aching or pain waking you at night. Short, sharp sensitivity that stops immediately is treated by covering the exposed dentine, not by root treatment.
Removing tartar from root surfaces uncovers dentine that had been sheltered under the deposit. The exposure is temporary and settles within a week or two as the surface seals. A fluoride varnish at the end of the appointment shortens this.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
