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Sensitivity to temperature – usually cold but also heat – is a classic symptom of the pulp of the tooth being inflamed. If your tooth is sensitive to heat, we have a page that addresses that issue. Here are some possible causes if your tooth is sensitive to cold:
- Deep decay. See your dentist right away. When a tooth is just mildly irritated by to cold, the problem can usually (but not always) be fixed with a restoration such as a filling or a crown. Once the pain in response to cold has progressed to a certain point, you will have a tooth infection and endodontic therapy (root canal treatment) is required to save the tooth. See our toothache page for more explicit information about how to tell if the tooth has a chance to get better, and when you absolutely need to see your dentist.
- Recent dental treatment. Any dental treatment is irritating to the tooth. Sensitivity after a new filling or crown is nothing to be concerned about as long as it comes immediately after the dental treatment and it gradually gets better. If you had the treatment a week or more ago and your tooth is now beginning to react to the cold, or if the sensitivity gets worse over time, this is a warning sign and you should go back to your dentist to have your tooth checked. It is possible that your tooth already had some pathology and now, with the added irritation of being worked on, the condition is aggravated and requires further treatment. Click here to learn about sensitivity from new fillings.
- Exposed roots. If your gum has receded or if the enamel or cementum of your tooth has worn to where the sensitive part of the tooth is exposed, it can make your tooth experience pain from cold. A filling or protective coating can keep your tooth from becoming too irritated. If this is the case, your tooth will also be sensitive to air. A special toothpaste for sensitive teeth can help with this type of problem.
- Mild or moderate trauma can cause a temporary sensitivity to cold—if a tooth is bumped.
When a tooth has pain from cold, there is a question that needs to be addressed: Will the tooth get better on its own, or will endodontic treatment (root canal treatment) be necessary? Here are the keys for making that determination:
- If the cause (deep decay, exposed root) can be determined, address that cause. Remove the decay and fill the tooth, or cover the exposed root. If that works, then further treatment is obviously not necessary.
- Does the tooth hurt only when it is irritated by cold or air or some other stimulus, or does it hurt spontaneously? If the tooth has a sharp pain that occurs all on its own, without being provoked by cold or air, this indicates an irreversible pulpitis and you need a root canal treatment.
- When the tooth is irritated, does it hurt only briefly or does the pain linger? If the pain lingers for more than a couple of seconds (which is the time required for the tooth to warm up) it also indicates an irreversible pulpitis, and endodontic treatment will be required.
Read about a difficult case of pain in the jaw that the specialists couldn’t figure out.
Other sensitivities and related subjects:
Sensitive to air
Sensitive to cold
Sensitive to heat
Sensitive to sweets
Senstive to biting
My tooth is missing!
Tooth pain after filling
— By Dr. David Hall