Updated: Apr 19
Normally your teeth shouldn't hurt if you're drinking cold beverages straight out of the fridge or even ice water. Healthy teeth should be resilient enough to not be sensitive nor cause you any pain when you do so.
If you do feel pain or sensitivity from drinking cold water or various other beverages, it could be an indication that your teeth aren't as healthy as you think. There may be something wrong with it and you should consider a consultation with your dentist so that you can get to the bottom of it.
Unfortunately, there are a plethora of possible causes for teeth to be sensitive to cold. However, luckily for you there are an equal amount of possible treatments and solutions for minimizing cold sensitivity!
This article will explore everything that you need to know about why your teeth are sensitive to cold and what you can potentially do to mitigate the discomfort. That way you can get back to drinking the ice cold beverages that you enjoy, especially during the summertime.
Reasons your teeth can hurt when you drink something cold:
Receding gums can certainly cause your teeth to hurt if you drink something cold straight out of the fridge. When the gums recede, it leaves the root surface of the teeth exposed to all of the elements. That can be extremely sensitive to cold stimuli because the root is not used to being so stimulated.
Normally the gums should be covering the surfaces of the root to protect it from cold beverages. However, once it recedes the root will become exposed. The picture above shows gum recession which you can tell because the color of the root looks different from the enamel.
The enamel looks white while the root surface looks more yellow. You can compare it to a tooth with no receding gums where you won't see any of the root surface at all.
An analogy for why receded gums would be sensitive is that the gums are similar to your jacket. If you go outside during the winter time with no jacket on, you will feel cold. However if you wear your jacket and go outside while its cold, you won't really mind it as much. Thus, when the gums recede, it is akin to going outside with no jacket on.
Causes of gum recession
The damage has already been done but you should still understand what may have been the possible cause of the gums to recede. Reason being, if you're still partaking in the offending activity the recession will only get worse. That means your teeth can become even more sensitive to cold drinks than right now.
Therefore, if you are doing one of these activities below you may want to stop it promptly. You really don't want your sensitivity to get worse and be unable to enjoy any drink cooler than room temperature.
Possible causes of gum recession:
Brushing too hard. The gums and your mouth in general are very delicate so you shouldn't be rough housing it. Brush with gentle circular strokes.
Hard toothbrush. If you use a hard body scrub you can damage your skin. The same can happen to your gums if you use a brush with hard bristles.
History of gum disease. Periodontitis can damage the bone and the gums. The receded gums may have been from previously having gum disease.
Teeth grinding. You may be surprised but grinding at night can cause a lot of pressure at the gum lines. They can potentially recede the gums or even worse damage the enamel.
Needless to say, if you wanted to prevent the condition from getting worse, you should avoid all of the above four activities. That means brushing gently and using a soft toothbrush. If you have gum disease you should go get your routine dental cleanings. If you grind your teeth you should have a night guard made.
What you can do about it
Since the cold sensitivity is from the receding gums, we can treat it by covering up the recession or by desensitizing the exposed root surface.
Gum grafting - cover it up with new gum
Dental bonding - cover it up with a filling
Desensitize - block the sensitivity and pain signals
The receded gums can be regrown by doing a gum graft. This specialty procedure is when your dentist harvests a piece of gum tissue from a donor site and grafts it onto the tooth with the recession. Once the exposed root surface gets covered up, the cold sensitivity should subside.
As an alternative to grafting gum, the exposed root surface with the receded gums can be covered up with some dental bonding. This is basically a composite filling that is bonded onto the root surface. That provides a layer of protection that insulates the sensitive root from outside elements.
This procedure is very simple and straight forward and can be done sometimes with no anesthesia at all. However, you should be aware that sometimes these restorations need to be replaced every couple of years.
The most conservative way to treat cold sensitivity due to gum recession is by desensitizing the entire exposed root surface. The simplest way to do this is with potassium nitrate which is the primary desensitizing agent in sensitivity toothpastes such as Sensodyne.
How it works is that as you keep using the toothpaste twice a day for at least two weeks, the potassium nitrate starts to build up at the pulp. Once it reaches a sufficient concentration, it will prevent the nerve from firing pain and sensitivity signals whenever you drink something cold.
Just be aware that it takes at least two weeks for you to see any relief from drinking cold beverages or water. Then once you achieve some relief, you need to keep on using the toothpaste because it wears off. You need to keep reapplying it in order for the concentration to replenish. It is similar to a life sentence of using the toothpaste.
It is not just the root surface which can be sensitive because the dentin layer is equally so. Just like how the gums naturally cover the root of the tooth, the enamel layer normally covers the dentin.
If for whatever reason the enamel layer becomes missing, the dentin layer will become exposed. Uncovered dentin can be a source of pain or sensitivity to when you drink an ice cold beverage. Anything that is exposed is not a good sign.
Exposed dentin is very sensitive because the tissue is alive and filled with nerve endings. The pulp contains the bulk of the tooth nerve but a lot of branches of it extend into the dentin. That makes it a sensitive layer when it becomes exposed to the cold elements.
The enamel on the other hand is not alive and does not contain any nerves. That is why the enamel is not sensitive and serves as a good protective layer for the dentin.
The dentin layer is underneath of the enamel and will not become exposed unless the enamel is missing. Thus, any condition that causes the disappearance of the enamel will result in exposed dentin. Here are some possible causes:
If you happen to pop out a filling while flossing or eating, the dentin layer will become exposed. This exposure will be extremely sensitive to cold fluids whenever it touches the uncovered dentin.
Eroded enamel due to acid erosion
Drinking a lot of acidic beverages that are cold can also lead to enamel erosion. In fact, any type of acid can potentially melt away the enamel. If you think about it, really strong acid can even melt through metal so your teeth aren't immune to it.
The acid eats through the enamel and forms little circles through the enamel. You can tell it is into the dentin layer because the color inside of the circles are yellow which is the color of dentin.
Teeth grinding at night
Grinding your teeth will not only flatten your teeth but wear away the enamel layer. Once the top layer of enamel is gone, only the dentin will be left. That dentinal layer can be extremely sensitive to cold sometimes.
What you can do about it
If the exposed dentin is causing you pain to drinking cold beverages, the solution would be to cover it up. You would definitely need to see your dentist to have that done because in order to cover it, the enamel layer would need to be recreated.
The enamel can be replaced by either dental bonding or an indirect restoration. Both options would take the place of the lost enamel and protect the exposed dentin from cold fluids.
This is basically a composite resin filling that goes over the exposed layer of dentin. Since the composite material is not alive and has no nerves in it, it will not be irritated by changes in temperature.Indirect restoration
Your dentist will most likely use a tooth colored or white filling material. Alternatively they can also use an amalgam filling with is also known as silver fillings. However, due to esthetics it is recommended to go with a tooth colored one.
Options for indirect dental restorations would be either a crown or a veneer. The veneer is more conservative than the crown because it only covers the facial or cheek facing side with porcelain. The crown on the other hand will cover the entire tooth 360 degrees.
The crown is less conservative than the veneer but there are certain situations that may require it. If you're grinding your teeth a lot, a crown would be needed for the structural strength because a veneer is much more delicate. The porcelain laminate would not be able to withstand grinding pressure.
Broken dental restorations such as a cracked crown can leave the underlying tooth exposed. That could very well be a source of cold sensitivity if you drink anything out of the fridge.
The reason why the tooth has a crown on it was to protect it in the first place. That protection includes resistance against the elements such as cold and hot foods
Alternatively, it doesn't have to be as drastic as having half of the crown come off... the crown could also just have a hole through the top of it. Possible cause would be the same, such as if the patient bit into something really hard.
From the photo above you can see a hole in the top of the chewing surface of the molar crown. You can even see food that is stuck inside of that hole. As you can imagine, it can be quite sensitive and painful when that happens. Since the hole is open to the oral environment, ice cold water can get right in and shock your nerve.
What to do about it
If you have a defective crown, the only thing you can do to fix it would be to replace it. That is something only your dentist can do, which means there is no home remedy for it.
What to expect:
Your dentist will have to first numb the tooth so you don't feel anything.
Remove the entire old crown.
Refine the preparation.
Take a new impression.
Send it out to the dental lab to have a new one made.
Leave the office with a temporary crown.
Return about two weeks later to try in the new crown.
Glue it in and you are done.
Just be aware that there IS a limitation to the number of times that you can replace the crown. That means you should be careful in the future so that you don't damage it again. There is only so many times that you can repeat this procedure before there is no tooth left.
Therefore, you should be extra cautious eating foods that are too hard. Ice cubes and crab legs are a definite no. If you do want to eat seafood, you should use the crab leg crackers instead of trying to bite through it with your bare teeth.
It is a lot more expensive to fix a tooth than to use a tool to crack the crab legs. The choice is yours to make but we would recommend that you don't keep breaking your teeth. Although that is good for the dental business... but we have your best interest in mind!
If you have extreme sensitivity when you drink cold fluids, it could potentially mean that the nerve is unhealthy or even infected. That is assuming that there is no cavity on it, exposed root surface, exposed dentin, or a defective restoration. If nothing appears out of the ordinary on the tooth but it reacts with pain whenever cold touches it, it may be an infected nerve.
In fact, a cold test is what your dentist uses to test how healthy the tooth nerve is. What they will do is put something very cold on your tooth and see how it reacts.
Is the pain very sharp?
Does the cold linger for about 30-60 seconds?
If the answer is yes to either of those two above, the nerve may be unhealthy and could potentially require a root canal. That is the only procedure that can fix or cure an unhealthy nerve. That treatment basically separates the nerve from the tooth so that you no longer feel pain when you drink cold water.
The nerve could become infected from a wide array of causes. The most common is a large cavity that has reached the pulp. Other times it could be from trauma.
List of possible causes:
Large cavity into the nerve or close to it
Trauma such as a sports injury
Fractured tooth from biting into hard foods
What to do
Since the tooth nerve needs to be treated and the only way to do it is via a root canal, it means you must see your dentist. There is simply no way around it because you can't do a root canal at home nor is there a home remedy that can separate the nerve from the tooth.
Until you finally get the procedure done, the pain that you feel when drinking cold drinks will not go away. It will persist and bother you until you finally decide to get it done.
Alternatively, your teeth could be sensitive to cold drinks if you've recently finished teeth whitening treatment. A known side effect for bleaching your teeth IS teeth sensitivity. It would not be out of the ordinary if it felt painful to drink a beverage out of the fridge for the next week or so after finishing treatment.
The good news is that it should subside and everything should go back to normal after that 1-2 week period. You just need to be patient and wait it out. In the meantime it may be better for you to avoid the ice cold drinks until you recover.
In case you were curious as to WHY your chompers get so sensitive after whitening them is due to the bleaching gel interacting with the smear plugs. Your teeth has tubules in the dentin which lead directly to the nerve. Normally, there are smear plugs that clog the tubules and prevent stimuli from irritating the nerve.
When you whiten your teeth, the whitening gel will dislodge or dissolve these smear plugs. This permits the acidic bleaching material to travel straight to the nerve of the tooth. As you can imagine that is not a very pleasant experience.
In addition to that, it also permits other stimuli such as hot foods and cold drinks to travel to the nerve as well. The nerve is not supposed to be stimulated in such a way and will send pain signals up to your brain in order to tell you to stop doing that.
What you can do about it
Fortunately this isn't an irreversible condition because the pain that you get from drinking cold water is self inflicted. Namely it was caused by you whitening your teeth.
Thus, it should go away once you stop trying to whiten them. Most bleaching treatment usually only lasts for about two weeks anyway so if you wait it out it should return to normal shortly after.
We know it may be uncomfortable in the meantime, thus we do have a couple of recommendations to help alleviate some of the tooth pain:
Sensitivity toothpaste. Using a toothpaste like Sensodyne can help desensitize the nerve. It contains an ingredient called potassium nitrate which depolarizes the tooth nerve and prevents it from firing signals.
Avoid cold drinks. Since it is ice cold water that is bothering your teeth, it definitely does help if you don't drink it for awhile. Try room temperature or ever so slightly cold until your sensitivity goes away.
Pain medication. You can take some ibuprofen or acetaminophen to help alleviate some of the pain. That should help you last through the sensitivity period until it goes back to normal.
Beverage just too cold
This may be a possibility but maybe whatever you are trying to drink is just TOO cold. It is akin to how you get brain freeze if you eat extremely cold things without letting it warm up prior to doing so.
Even the healthiest of teeth are not immune to extreme cold temperatures. There is a certain threshold where they will feel pain even if they aren't infected or have anything wrong with them.
The solution to this would be to just let whatever food that you are eating or drinking to warm up just a little bit before consuming it. Those extra few minutes just sitting on the counter can do a world of wonder for decreasing the pain/sensitivity you may have if you didn't wait to consume it.
If your teeth were healthy, they shouldn't feel any pain if you drank something cold. That means if it does hurt when you do, it could mean that there is something wrong with it. You should probably schedule a check up with your dentist just to make sure.
If something is wrong, it is better to have it addressed sooner rather than later. A lot of these causes for cold sensitivity can be treated. There is no need for you to avoid cold drinks if you simply fixed whatever it was that was causing it!
We do want you to enjoy your favorite ice cream and iced cold beverages in moderation of course! Just try to minimize the amount of sugar in your cold treats so that they don't end up causing cavities.