Wednesday, January 16, 2013

Cold Sensitive Teeth





One of the most frequent questions I get is about sensitive teeth. There are many potential reasons for sensitivity. Sometimes this could be a minor nuisance, whereas in other cases, this could be much more serious.

Here are a few reasons for cold sensitivity:
  • Metal restorations: Many people have fillings, crowns, bridges and other metallic restorations. The reason why there is often cold sensitivity with these types of restorations is that metal conducts temperature rather well. So any temperature change is readily noted.
  • Gum recession: When gums recede, the root surfaces of the teeth become exposed. These exposed root surfaces can be very sensitive to cold because there is no enamel covering the surface.
  • Decay: A surface that has decay is often cavitated. The break in the continuity of the enamel makes the tooth much more sensitive to cold.
  • Teeth with enlarged pulps: There are nerves and blood vessels inside every tooth. The space within the tooth that they occupy are called the pulp. Younger people have larger pulps. As we age, the space gets smaller. This means that the pulp of younger teeth are closer to the surface of the tooth. In other words, there is less tooth structure insulating the tooth. So in the absence of other issues, younger teeth are more likely to be sensitive to cold.
  • Temporary restorations: Temporary restorations simply do not fit as well as permanent restorations and are very likely to be cold sensitive. Click here to see a previous blog on temporaries.
  • "High" restorations: When you bite down, if there is a spot on a tooth or restoration that makes premature contact, it will cause more force to be applied to the tooth repetitively. The extra force on a single tooth will make it become sensitive to biting pressure. In addition, the tooth will also become more sensitive to cold. Fortunately, this can be fixed easily. A small amount of restorative material may just need to be polished away to decrease the biting pressure.
  • Defective restorations with open margins: If there is a gap in the interface between the restoration and a tooth, cold sensitivity is likely to become an issue. This is because of two things. The first is that there is simply a gap and the exposed tooth structure is quite sensitive. The second reason is that bacteria migrate into the spaces and infect the tooth structure. The decay that occurs is very toxic to the pulp. When the pulp becomes infected, the nerves become hypersensitive.
  • Trauma: When there is trauma to a tooth, the nerves and blood vessels within a tooth become inflamed. Since they are in a confined space with no room to expand, the pulp becomes incredibly hypersensitive.
  • Infected pulp: When this occurs, the pain will be incredibly intense. The pain may also linger for some time after the source of cold is removed. In addition, the tooth may experience a throbbing sensation.
If you are suffering from cold sensitivity get the advice of your dentist. Do not ignore the problem because it may lead to more complications and expense.


Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit www.advanced-smiles.com

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