Sensitivity to temperature—usually cold but also heat—is a classic symptom that the pulp of the tooth is inflamed and probably needs treatment.
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.
The final stage before the pulp of the tooth dies is that the tooth becomes sensitive to heat and cold actually relieves the pain. This is a 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.
The patient would come into the office sipping a cup of ice water to keep the tooth from hurting. That’s all I would need to know to make a diagnosis. The tooth is infected and the pulp tissue inside is almost dead. Once root canal treatment is begun, the pain would go away and the patient would be comfortable. Often all it would take would be opening the tooth because that would relieve the pressure inside.
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.
This content was written by Dr. David Hall.
Other related topics:
- Sometimes pain in the jaw can be difficult to pinpoint. Read about a difficult diagnostic case.
- With a tooth infection, it will progress to become a tooth abscess unless it is treated.
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