Sensitive Teeth in Children: Why Cold and Sweet Foods Hurt

"She loves ice cream, but now she pulls a face after every bite." Many parents notice their child flinching at cold water, ice lollies or sweets. A twinge can have several causes, and in children it is often an early signal of a problem that is simpler to treat when caught in time.

What does sensitivity feel like?

Children often describe it as a sudden "zing" or sharp pain that lasts a few seconds. Younger children may not have the words, so watch for clues:

• Chewing only on one side, or avoiding cold drinks they used to enjoy.
• Holding a hand to the cheek after eating or drinking.
• Complaining when you brush a particular area.

Common causes in children

1. A cavity. This is the most important cause to rule out. When decay breaks through the outer enamel, the softer layer underneath reacts to cold and sugar. Pain with sweet foods in particular often points to a cavity.

2. New adult teeth. Freshly erupted adult teeth, especially the first molars around age 6 and the front teeth from age 6 to 8, can be a little sensitive for a while. Their enamel is still maturing and the gum may not fully cover the area yet. Mild sensitivity usually settles, but new molars are also prone to decay in their grooves, so a check is worthwhile.

3. Molar incisor hypomineralisation (MIH). Some children's first permanent molars, and sometimes front teeth, come in with weaker, chalky enamel that may look creamy, yellow or brown in patches. These teeth can be very sensitive, sometimes even to brushing or air, and the weak enamel can chip and decay easily. MIH is not caused by anything parents did, and early dental care, often protective coatings or coverings, helps keep these teeth comfortable.

4. Enamel wear from acidic drinks. Frequent fizzy drinks, sports drinks, juices, flavoured waters and even lots of citrus fruit can slowly soften and wear enamel. This is called erosion. Sipping these drinks over long periods, or brushing straight after them, makes the effect worse.

5. Grinding. Children who grind their teeth at night can wear down the biting surfaces, which sometimes leads to sensitivity.

6. Whitening products. Whitening can cause sensitivity, and whitening products are generally not recommended for children. Please avoid adult whitening strips, gels or powders. If you are worried about the colour of your child's teeth, ask your dentist first.

Other causes include a chipped tooth after a fall or a worn filling.

What about sensitivity toothpaste?

Desensitising toothpastes are made for adults. For children, use one only if your dentist recommends it and tells you how much to use. Using it without a check can hide the warning sign of a cavity. For most children the best everyday toothpaste is a regular fluoride toothpaste in the right amount for their age.

What you can do at home

1. Keep brushing twice a day with fluoride toothpaste, using a soft brush and gentle circles. Avoid hard scrubbing.
2. Water between meals. Keep juice and fizzy drinks to mealtimes, or skip them.
3. Wait before brushing after acidic foods or drinks. Rinse with water first and brush a little later.
4. Offer cheese or milk at the end of a meal, which can help neutralise acids.
5. Note what triggers the pain (cold, sweet, chewing, brushing) and which side, to tell your dentist.

When to book a visit

Book a dental check if sensitivity:

• Lasts more than a few days or keeps coming back.
• Happens with sweet foods.
• Wakes your child at night or lingers after the cold is gone.
• Comes with a visible spot, hole, chip or discoloured patch.
• Started after a fall or knock to the mouth.

Swelling of the gum or face, or pain with fever, needs prompt attention.