Osmotic Pressure

“Dear doctor,

I have a tooth that hurts only when I eat or drink something with high sugar content. It otherwise does not hurt from eating carbs, or from anything, and as I regularly got to the dentist, it puzzles me that the dentist keeps telling me there is nothing wrong with it. As this only happens with sugar, I naturally thought that bacteria must be involved. Am I right in thinking this? Could there be some other explanation?

Thank you in advance,

Helen”

Dear Helen,

The pain you are experiencing does not have anything to do directly with bacteria, but bacteria can rightly be involved. What is happening is due to a little thing called osmotic pressure. It is a little bit difficult to explain, but I will try.

The tensile strength and viscosity of your spit makes the pressures that you are experiencing. When you eat sugar, your spit becomes heavier, more viscous, and as such has more pressure. When you have teeth that are sensitive and your saliva changes like this, the osmotic pressure that is a result of osmosis of your spit will cause the weaker teeth to hurt.

This is almost always a sign of tooth decay, or at the very least some kind of problem with the tooth enamel. If the tooth enamel is as strong as it needs to be, you will not feel this kind of problem at all, as the pressure will be lost on the enamel coating, and nothing will even feel the pressure that your saliva is exerting. This means that the tooth or teeth that are reacting this way are experiencing dentine hypersensitivity, which means that they have lost some amount of tooth enamel; enough to make this a problem, quite obviously.

What disturbs me most is the way that your dentist is treating this issue, as the problem itseéf is common enough, although may seem mysterious to the layperson. Sure, this is not an issue of cavitation, and no serious treatments can be administered, but a little dab of composite gradia on the tooth that is causing the problem will cause this problem to go away. If your dentist is not doing that, he is neglecting your needs. You may want to look after getting a new dentist, and one that is more patient oriented than this guy is. The enamel may be worn out very thinly, and maybe difficult to spot, but if a patient complains of osmotic pressure, upon checking the tooth, there should be no problems in identifying where that dab of gradia needs to go.