Why is My Tooth Sensitive to Cold or Hot?

Posted on:

August 25, 2021

If you have a sensitive tooth, then ordinary things seem like a struggle. If you have a tooth sensitive to hot and cold, then everyday tasks like brushing your teeth with cold water become tedious. If you have a tooth sensitive to heat, then having a cup of hot coffee is a struggle or if you have tooth sensitivity to cold, then the mere thought of having ice cream is upsetting! Having a sensitive tooth or a tooth sensitive to hot and cold food and beverages is not an ordinary struggle as neither cold nor hot temperatures are your friends.

Why is My Tooth Sensitive to Cold or Hot?

What Is A Sensitive Tooth?  

Let’s get to know why you have a sensitive tooth, why your tooth is sensitive to hot food and beverages, why you have tooth sensitivity to cold drinks and food, and what exactly sensitive teeth mean in this section. 

The outermost layer present on teeth is called enamel. This enamel protects your teeth and crowns of your teeth (the part above the gum line.) In healthy teeth, the enamel is the densest substance in your body. 

However, the enamel is not the only substance protecting your teeth. The cementum layer is also present on the root of the teeth to protect them. The root of a tooth can be found below the gum line. The cementum, the outer layer of the root, protects the roots of the teeth. However, this cementum is softer (or less dense) than enamel. So, when the cementum layer is exposed due to gingival/gum recession, extreme cold and hot temperatures can irritate the nerve and trigger pain which makes the tooth sensitive to hot and cold temperatures and is called a sensitive tooth.

Why Is My Tooth Sensitive?

If you feel like you have tooth sensitivity to cold or a tooth sensitive to heat, then you can check or identify the causes in this section.

Sensitive Teeth: Causes -

  • Tooth decay: Issues like tooth decay can be the reason for sensitive tooth as it leaves a protective layer as well as dentin (tissue underneath the enamel) exposed. When teeth are left unprotected, extreme temperatures can trigger nerve pain, making tooth sensitive to hot and cold temperatures.
  • Exposed Root Surface: Gum recession, which is normal with increasing age, can affect cementum (layer protecting roots of teeth) and leave the roots of the teeth unprotected and exposed, making tooth sensitive to heat, causing tooth sensitivity to cold, and triggering pain.
  • Broken Down Fillings: Sensitive tooth is common after going through treatments like fillings, bleaching, crowns etc. If you feel you have a sensitive tooth after crown or your tooth is sensitive after filling, then that is also normal. This sensitivity is common, feels like sudden shocks of extreme cold or heat in the mouth, and will subside after a few days. You just need to be observant and careful of triggers during such days to minimize sensitive tooth. However, if your tooth gets exposed in cases of broken dental fillings or fractured fillings, then it is advisable to get immediate professional help to prevent further damage.
  • Gum Disease: Along with gum recession, a buildup of plaque or tartar can affect the gums and lead to gum diseases, leaving protective layers of your teeth broken and roots of teeth exposed, unprotected. In such cases, if not treated, a sensitive tooth may lead to tooth decay and other such serious problems.
  • Worn Tooth Enamel: Underneath both the enamel and the cementum is dentin. The dentin is the inner tooth layer which is less dense than enamel and cementum. The dentinal layer contains microscopic tubules (small hollow tubes). When dentin loses its protective covering of enamel or cementum these tubules allow heat and cold to reach the nerves and cells inside the tooth. The result can be hypersensitivity.
  • Fractured Tooth Structure: If there is a fracture line within the tooth, the nerve can be irritated when you bite down on the area that has the fracture. This is due to the movement of the fractured tooth structure. If a tooth has a portion missing due to it fracturing off, the nerve is not as protected and can be aggravated.
  • Brushing Too Hard: If you are brushing your teeth with force, using too much mouthwash too many times to achieve pearly teeth, a brighter smile, then be careful because these things may affect the enamel and other protective layerings of the teeth, leaving them exposed which may lead to sensitive tooth or worse, some serious damage.
  • Grinding Your Teeth: Grinding teeth, clenching your teeth may wear down the enamel of your teeth over time which will expose and affect other protective layers like dentin, causing nerve pain and sensitive tooth. It is advisable to wear mouth guards and address deeper issues leading to grinding and clenching teeth to protect your teeth from tooth sensitivity and other issues accompanying it.

Triggers For Sensitive Tooth:

If you have a sensitive tooth, then the following things may irritate the roots, nerves of the teeth and trigger pain. The triggers for tooth sensitivity to cold, signs that you have a tooth sensitive to heat are as follows:

  • Hot and cold foods, beverages
  • Sweets, sugary food and beverages
  • Eating sour food
  • Acidic foods and beverages
  • Cold air
  • Brushing teeth
  • Using mouthwash

Sensitive Teeth Symptoms:

In this section, let’s take a look at the sensitive teeth symptoms to check whether you have tooth sensitivity to cold or have a tooth sensitive to heat or hot temperature. The following are the sensitive teeth symptoms:

  • Bad breath
  • No taste or changes in taste
  • Redness, Pus
  • Receding, swelling of gums
  • Noises when opening or closing the mouth or inability to open the mouth
  • Jaw pain or muscle pain in the face
  • Sinus pain

How To Get Rid Of Sensitive Tooth?

A sensitive tooth can be diagnosed during regular checkups or dental cleanings. If you are experiencing severe symptoms and the pain is being triggered often, then the test for other potential problems/ causes like broken fillings, gum diseases, cavities will also be done. If you’re concerned with how to get rid of a sensitive tooth, then we’ll discuss a variety of treatment options in this section. Depending on the causes, type, symptoms, the right tooth sensitivity treatment will be suggested to you. The following are the tooth sensitivity treatments:

  • Desensitizing/ Sensitive Toothpaste: Desensitizing toothpaste or sensitive toothpaste contains compounds that help block the transmission of sensation from the tooth surface to the nerve. However, it is not an overnight treatment. If you’re using sensitive toothpaste with a doctor's recommendation as a treatment, then it will require consistent use of 3-4 weeks before you start noticing a reduction in the sensitivity. Also, you will be advised to use alcohol-free mouthwash as it is better suitable for sensitive tooth. 
  • Fluoride Gel: The application of fluoride gel or prescription-grade desensitizing agents is another easy and safe way to treat the sensitive tooth. The application of fluoride gel is a professional treatment and an in-office technique that strengthens tooth enamel, reduces the transmission of sensations, and protects the teeth. 
  • A Dental Crown: A crown is used when a large portion of the tooth is missing due to decay or fracture.  Also, a dental crown is placed on a tooth with an asymptomatic fracture line to immobilize the fractured segment.
  • Root Canal: If sensitivity is severe and persistent and is diagnosed to be irreversible, root canal therapy may be recommended to treat the problem.

Poor oral hygiene contributes to many of the causative factors behind a sensitive tooth. If plaque is not removed properly and consistently, it can lead to tooth decay and/or gum recession. It is important that you maintain good oral hygiene habits and visit your dentist regularly.

This blog was first posted on December 10, 2019, and updated on August 25, 2021.

About the author

Dr. George Orfaly

Dr. George Orfaly, D.M.D.

Dr. George Orfaly is a Doctor of Medicine in Dentistry and has been practicing as a dentist in Salem, MA since 2005. He has consistently improved the lives of his patients by providing them relief, confidence, and healthy smiles. He believes that oral health is directly related to overall health and well-being. Dr. Orfaly has also been an active member of the American Dental Association, Massachusetts Dental Society, and North Shore District Dental Society.

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