Sensitivity to temperature – usually cold but also heat – is a classic symptom of the pulp of the tooth being so inflamed that it is almost dead.
Click here if your tooth is sensitive to cold. Sensitivity to cold is less alarming than sensitivity to heat. Some teeth will go through stages of sensitivity in reaction to deep decay. At first it is mildly sensitive to cold. Then it becomes progressively more sensitive to cold. It may become so that the toothache pain is even spontaneous. After that, the tooth can become sensitive to heat and cold will actually relieve the pain.
If this is the case, you have a typical case of acute pulpitis. The pulp of the tooth is nearly dead, and will need a root canal. Click here to read more about root canal treatment.
As bacteria enter the pulp from deep decay, the tooth tries to fight the infection. White blood cells accumulate at the site of the infection and the tooth becomes sensitive because the tissue is irritated. The problem with fighting this infection inside your tooth is that there is no room for the tissue to swell to make room for the extra white blood cells. As the pulp tissue tries to swell, it essentially strangulates itself and begins to die and decompose and produce gases. This creates pressure in the tooth and pain. At this point, if you apply cold to the tooth, the cold causes the gases to contract, giving you some relief.
In the dental office, when we see a patient come in with a glass of ice water that she has to sip every few minutes in order to keep the tooth comfortable, it is a sure sign of an infected tooth. Once root canal treatment is begun, the pain will go away and the patient will be comfortable.
This sensitivity to heat from severe pulpitis comes from deep decay. It can be new decay, or it can be decay under an old, leaky filling. It’s the bacteria in the decay that get into the pulp that produce the sensitivity to cold followed by the sensitivity to heat.
However, if your tooth is mildly sensitive to heat, and it hasn’t gone through the stages of sensitivity to cold listed above, that is a different situation, and your tooth may only be irritated and not infected.
Other related topics:
- Sometimes pain in the jaw can be difficult to pinpoint. Read about a difficult diagnostic case.
- With a tooth infection, it can progress to become a tooth abscess.
Other sensitivities and related subjects: