Exposed Tooth Nerves: Causes, Instant Relief, & Treatment Options

In healthy conditions, the dental nerves are safely tucked away in the center of the tooth, protected by robust layers of enamel and dentin.

However, when the protective layers break down due to various dental conditions, the nerves become exposed to the outside environment. The result? Discomfort and challenges in daily activities like eating, brushing, and sleeping.

In fact, tooth sensitivity is a common occurrence that leads many patients to seek professional help. According to some studies, it affects up to 85% of the adult population.

In this blog post, we delve into the conditions that can lead to exposed tooth nerves, explore immediate pain relief techniques, and uncover the different treatment approaches to manage these dental issues effectively.

What does it mean to have an exposed tooth nerve?

Understanding what nerve exposure means and how it happens is crucial in determining the appropriate course of action. To achieve this, let's take a closer look at the tooth's inner structure.



Picture your tooth like a two-story building. The top floor is the crown—the part you see and use for chewing. It's covered with a strong, whitish protective layer called enamel. It is known as the hardest tissue in our bodies.

Now, the bottom floor represents the roots. These are hidden beneath the gums and bone, providing hold for our teeth. The roots are protected by a tissue called cementum, a thin mineralized layer.

Beneath these protective structures is another tissue called dentin. Dentin is also a protective layer. But when it comes to isolating nerves, it doesn't do a good job.



Unlike enamel, dentin contains thousands of tiny holes called dentinal tubules that lead directly to the nerves.

So, if anything happens that breaks down the tooth's protective layers—like cavities, gum recession, or tooth fractures—it can expose the dentin and, consequently, the nerves.

As a result, when you eat or drink something hot, cold, or sweet, those stimuli can travel through the dentinal tubules and reach the pulp, causing that sharp, short pain you feel.

In more extreme cases, the pulp itself is directly exposed to the outside environment. This happens when a deep cavity or fracture extends deep into the tooth.

Picture showing exposed dental pulp following trauma

Dental Conditions that Can Lead to Exposed Tooth Nerve

Exposed tooth nerves can be the result of various dental conditions. The most common ones include:

1. Receding Gums

Receding gums occur when the gum tissue gradually pulls away from the teeth, exposing the roots. This can make your teeth appear longer than before.

As we discussed earlier, the roots of our teeth are protected by a thin and less robust layer called cementum. Since cementum isn't meant to withstand the pressures of chewing, when the gums recede, it wears away rapidly, leaving the dentin and nerves vulnerable.

That's why receding gums and sensitivity issues often go hand in hand.

The two main culprits behind this gum condition are plaque buildup and trauma.

• Plaque buildup: It's a soft, sticky film packed with harmful bacteria. When you neglect oral hygiene, this plaque accumulates on your teeth and irritates your gums, leading to inflammation. Over time, this can cause your gums to shrink and recede.
• Trauma: Aggressive tooth brushing or any kind of injury to the gums can also cause them to recede.

2. Tooth Wear

Tooth wear is another dental condition that affects the protective teeth layers. But the main target here is enamel.

Like cavities, tooth wear involves the progressive breakdown of the hard tissue covering the tooth. However, what's unique about it is that it does not involve bacteria.

Rather, tooth wear results from the interaction between external irritants and our teeth. These factors can be divided into two categories:

1. Mechanical factors: These include actions like brushing too hard, and teeth grinding (bruxism), which exert excessive pressure on the enamel, leading to its gradual degradation.
2. Chemical factors: Tooth wear can also be caused by exposure to acidic substances. Whether due to our diet or acid reflux, this will erode the enamel over time and weaken it.

As the enamel wears away, the underlying dentin becomes exposed. This will potentially lead to various issues, including sensitivities.

Tooth wear caused by brushing too hard

3. Tooth Decay

Tooth decay occurs when certain bacteria in our mouth break down sugars from our meals and release acids. While enamel, the hardest tissue in our body, is quite resilient, it has its weaknesses. When it comes into contact with acid, the minerals in the enamel start to dissolve, leading to its progressive breakdown.

Without proper treatment, the decay continues to advance and can reach the deeper layers of the tooth. The result? The nerves become exposed.

As the dentin gets affected, you may experience increased tooth sensitivity to cold, hot, and sweet foods.

At advanced stages, if the decay reaches the pulp (nerves), the pain gets worse and may prevent you from sleeping.

Detecting tooth decay on the visible tooth surface is relatively easy. But it becomes trickier when it's hidden between the teeth.

One way to detect cavities between teeth is by using the flossing technique. If the floss tears or you feel roughness between your teeth during flossing, it could indicate the presence of a cavity.

4. Tooth Fracture

Tooth fractures can happen when a tooth loses a fragment, affecting its appearance and making it more vulnerable. They often occur due to blows, accidents, or trauma.

The tooth's response to the fracture depends on its severity and the depth of the damage.

If only the enamel is injured, you may not feel anything. However, if the fracture is deep enough, it may expose the dentin or even the pulp.

Emergency In-Office Treatment to Relieve Pain Due to Exposed Tooth Nerve

If you experience severe pain involving multiple teeth and home remedies fail to bring relief, it's time to visit your dentist for professional treatment.

These options are more effective and can often provide immediate relief. Here are the different approaches your dentist may use to manage pain caused by exposed tooth nerves:

1. Numbing Agent: Your dentist may apply a numbing agent to block the nerve pathway.


2. Fluoride Varnish: It's a highly concentrated fluoride product (about 20 times more than toothpaste) that helps seal exposed dentinal tubules, thus reducing sensitivity.


3. Dental Bonding: Dental bonding involves using a tooth-colored resin to cover and protect the exposed area, alleviating pain.


4. Laser Therapy: Laser treatment is another approach that helps seal exposed dentinal tubules, reducing sensitivity and pain.


5. Gum Grafting: If the nerve has been exposed following gum recession, your dentist may suggest a gum graft to cover the exposed root and protect the roots.


6. Root Canal Treatment: If the nerve exposure is significant and causes intense pain, or if all previous measures have failed, a root canal may be necessary to remove the damaged nerve and provide lasting relief.

Tips to Strengthen Teeth and Prevent Further Dental Issues

1. Oral Hygiene:

• Brush your teeth at least twice a day with fluoride toothpaste, using a soft-bristled toothbrush and gentle, circular motions.


• Floss daily to clean between teeth and remove plaque from areas that your toothbrush cannot reach.


• Visit your dentist regularly for professional cleanings and check-ups to detect and address any dental issues early on.

2. Diet:

• Limit sugary and acidic foods and beverages, as they can contribute to tooth decay and enamel erosion.


• Consume a balanced diet rich in calcium, phosphorus, and vitamins, as these nutrients are essential for strong teeth and gums.


• Drink plenty of water throughout the day to offset acidity and prevent dry mouth.

3. Promote Your Saliva:

Saliva is a natural mouth cleanser that plays a vital role in eliminating bacteria and food debris while naturally remineralizing our teeth. To promote healthy saliva production, consider the following tips:

• Chewing sugar-free gum between meals: This stimulates saliva flow, which helps neutralize acids and protect your teeth from decay.
• Avoid snacking between meals: Saliva's primary role occurs during meal breaks. So try to limit snacking to let it do its job more effectively.
• Stay hydrated and maintain a balanced diet: Maintaining proper hydration and a balanced diet further supports the beneficial effects of saliva in protecting your teeth and gums.

4. Consider Remineralizing Treatments:

• Your dentist may recommend fluoride supplements, such as dental gels or mouthwash.


• Hydroxyapatite, Novamine, and Recaldent are other effective alternatives with a proven ability to remineralize and strengthen teeth.