What causes cold sensitivity in teeth?

Rita Medwid

Teeth can become sensitive to cold liquids, foods, or even cold air which can become really annoying. At times, the dentist, will have to play detective to find out which tooth and why. You may point to a bottom tooth, and then it turns out to be a top tooth. The causes may be decay, or a leaky filling, a hairline crack, or a tooth that is being clenched or ground down by bruxism. This type of problem is caused by stress and keeping your teeth clenched, or by grinding day or night. Another cause of sensitive teeth is root recession, which can happen again by grinding or by too vigorous brushing with a tooth brush. Gum disease will also cause sensitive teeth. The best thing to do is first try a good fluoride toothpaste, rub it on the tooth that bothers you and leave it on overnight. Then talk with your dentist.

Cold sensitivity can have a variety of causes: receded gums, cracked teeth, defective older fillings or crowns, and bruxism (grinding your teeth) are a few. A check up with your dentist can determine what the cause and appropriate treatment should be. 
There are many possible causes for cold sensitivity. 

If you've recently had dental work such as a filling, it may be a normal reaction as your tooth adjusts to the new material. This type of cold sensitivity usually does not linger for very long once your tooth is no longer in contact with the cold item. But if the way your teeth come together (your bite) is not correct, this can also cause cold sensitivity. This is usually easily corrected by your dentist.

Other causes of cold sensitivity are
  • bruxism (grinding your teeth), which puts extra stress on your teeth and can wear teeth down leaving some spots hitting harder than others.
  • recession: the gum moves down and exposes some root surface. The root surface does not have as thick a covering as the top part of your tooth and so cold is noticed more as it passes over the root surface.
Jonathan B. Levine, DMD
Cold sensitivity is when anything cold goes in your mouth, there's an immediate pain response.
  • THE CAUSES: The decay is either starting to progress a bit further along, or the root exposure has become more significant. If you have old dental work in your mouth ("old" meaning ten years or older), decay could be lurking under an old restoration making the tooth more sensitive as it edges closer to the nerve. When the nerve gets inflamed, the pulp of the tooth is inflamed as well, and the condition is called reversible pulpitis.
  • WORRY LEVEL: These conditions aren't past repair. With the reversible pulpitis condition, the operative word here is reversible. The nerve is still alive. The tooth can be reinsulated again.
  • TREATMENT: Reversible pulpitis can be fixed with some type of restoration, like a bonded filling, inlay/onlay or crown that seals the tooth well.
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When the dentin (middle layer) of the tooth is exposed, you may experience cold sensitivity. Normally, the dentin is covered by enamel (above the gum line) or by cementum (below the gum line). When tubules (tiny openings in the tooth that house nerve branches) are exposed, pain or discomfort from hot and cold temperatures can occur. Dentin exposure can be caused by brushing your teeth too hard, poor oral hygiene, untreated cavities, and other factors.

Cold sensitivity can also be caused by a reaction from a single tooth’s pulp. This is called pulpal sensitivity. The pulp is a mass of blood vessels and nerves in the center of the tooth. Sensitivity in one single tooth to hot and cold temperatures can be an indication of decay or infection. See your dentist to find out what's causing your sensitivity to cold and to get treatment.

If you have cold sensitivity, report this to your dentist. But, what is abnormal cold sensitivity? Most people cannot bite into ice cream, whereas drinking ice tea should not cause a problem.

  • Generalized sensitivity on the Upper and Lower front teeth is often caused by your tooth paste. We recommend patients reporting this switch to Crest or Colgate original with fluoride with none of the other additives-Whitening, total care, tartar control, etc. These additives often cause cold sensitivity.
  • Enamel wearing away on the tooth prematurely due to clinching or grinding is often a problem that occurs at night during sleep. Of course you don't realize this unless you are one of the extreme cases. Your dentist will be able to clinically determine if this is occurring. If this is the case, you will need a small, comfortable night appliance to prevent bruxing during sleep.
  • Abfractions are notches that can occur at the gum line in the dentin of the tooth. This also occurs from night grinding. They can be as sensitive as a cavity. The same appliance recommended in #2 above will resolve your problem here.
  • New cavities and cavities reoccurring under existing restorations [fillings or caps] should be checked by your dentist at each checkup to prevent this as a problem.
  • Root canal problems can occur under existing restorations after they have been placed. I wish we could always prevent this when we place the restoration; however that is not how Mother Nature works sometimes. This can be corrected by your dentist.
  • Trauma can be a deceptive problem to isolate. I call them eating accidents when we by chance bite on something hard unexpectedly. This can cause micro fractures inside the tooth leading to sensitivity.

My best recommendation, see your dentist regularly and fully discuss any issues that you know about at each visit.

The cause of cold sensitivity should be diagnosed by a dentist. A broken or decayed tooth can be sensitive to cold. Exposed roots of teeth can be sensitive to cold. Worn areas of enamel can be sensitive to cold. A tooth with a large deep filling can be sensitive to cold. Once your dentist has determined the cause of your sensitivity, he can offer you solutions to treat the problem.

Dan Jenkins
Cold sensitivity is experienced from various degrees of nerve exposure. This may be from a loss of the enamel, (due to decay or wear), covering the dentin, (which has nerves in it), or loss of gum which covers the roots.

Prevention of this happening comes through regular check-ups to see what is causing it ahead of time. While preventing the sensitivity is important once it is there you want to prevent further problems necessitating crowns, root canals, or removal of a tooth.

It would be best for you to have this checked by your dentist as soon as possible.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.