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Tooth Sensitive To Cold: Causes, Treatment & Management

Updated: Jan 2

A tooth sensitive to cold is a type of tooth sensitivity where a tooth or teeth may experience discomfort or pain to cold stimuli. Depending on the severity of the sensitivity, you may be able to manage it at home or it may need professional treatment.


gum recession teeth sensitive to cold
gum recession teeth sensitive to cold

This tooth condition is not always pathological and may not always need to be treated. It really depends on what the cause is and how much it affects your quality of life. Ultimately, a consultation with your dentist is recommended but we will prepare you for what to expect.


Table of contents:


 

Overview


What is a cold sensitive tooth?

A cold sensitive tooth is a tooth/teeth that feels discomfort or pain when it's exposed to cold stimuli. However, when it is not subjected to cold stimulus, the tooth otherwise feels normal.


Signs & symptoms:

  • Pain or discomfort to cold stimuli.

  • Can feel like a mild shock or zing inside the tooth.

  • It can also throb like a heartbeat in severe cases.

  • Sensitivity can linger afterwards.


When it can happen:

  • Drinking cold beverages.

  • Eating cold foods (ice cream).

  • Breathing or sucking in cold air.


Is cold sensitivity normal?

It is normal for teeth to feel cold sensitivity when it is subjected to cold stimuli (ice cold foods or beverages). After all, teeth do have nerves so if they can feel the cold it means that the tooth nerve is still alive, meaning it is not a dead tooth.


hydrodynamic theory schematic diagram
Credit: Ji won Kim and Joo-Cheol Park

However, while it is normal to feel the cold, an exaggerated or extreme reaction to cold is considered pathological. That means if the tooth feels extremely sensitive to cold stimuli, it is an indication that something is wrong or abnormal with it.


Essentially cold sensitivity occurs on a spectrum, very mild sensations is within normal limits but very severe sensations are abnormal.


What it means:

  • Tooth is vital.

  • It may be a healthy tooth.


What it does not mean:

  • Tooth is non-vital.

  • Always need a filling.

  • Always need a root canal.


We wish to emphasize that this condition does NOT always mean that you need a root canal or a filling. It is only when it is extremely severe that you may need it.


Causes

Cold sensitivity is a symptom for many oral conditions so there is a litany of causes.


Causes for teeth to be extra sensitive to cold:

  • Receding gums. Gum recession results in exposed root surface.

  • Tooth decay. Small cavities aren't sensitive but the larger sized ones are.

  • Gum disease. Periodontal disease causes inflamed gums that are very loose and that can leave the sensitive root surfaces exposed at times.

  • Grinding or clenching. Parafunctional habits such as teeth grinding or clenching can wear away enamel which leaves the sensitive dentin exposed.

  • Defective restorations. Broken fillings, damaged crowns, and chipped veneers can contribute to the sensitivity.

  • Cracked tooth. A fractured tooth will leave the pulp exposed which can be painful.

  • Brushing too hard. Aggressive brushing especially with a hard bristled toothbrush can cause gum damage and eventually lead to gum recession.

  • Acidic diet. Consuming a lot of low pH foods is akin to throwing acid on your teeth. Too much of it can cause enamel erosion and lead to sensitivity.


If you have any of the above conditions, they may what is contributing to your symptoms.


Treatment

Depending on the cause, the treatment to eliminate or reduce tooth sensitivity to cold will differ. However, most of these options do require seeing a dentist.


Cold sensitivity treatment:

  • Sensitive toothpaste. Using toothpaste with anti-sensitivity agents (stannous fluoride, hydroxyapatite, potassium nitrate) twice daily can help minimize the amount of discomfort.

  • Fluoride varnish. A dose of professionally applied fluoride can alleviate the sensitivity for a couple of months.

  • Dental bonding. The bonding is most effective for exposed root surfaces and receding gums. It is an alternative to gum grafting.

  • Gum graft. Requires seeing a periodontist who will try to graft and regrow the gums.

  • Veneer. Placing a thin layer of porcelain laminate over the teeth can block sensitivity.

  • Crown. Extremely sensitive teeth may benefit from a full coverage tooth cap.

  • Root canal. Sensitivity stemming from tooth nerve pain may require root canal therapy. This option is typically reserved for the worse case scenarios.


We did not list extractions as an option above because it is only for cracked teeth. Typically cold sensitivity isn't the main symptom for that condition.


Which treatment is best for me?

The best treatment for your cold sensitive tooth will depend on what is causing it and the severity of the discomfort. You should discuss with your dentist to explore the right option for you.


If you do not get treatment for it, the sensitivity can last indefinitely. Yes, it is a temporary condition but it may feel like it is permanent. After all it does require treatment to resolve it.


 

Management

The way you manage teeth sensitive to cold is similar to how general sensitivity for teeth is managed. Most of these are lifestyle modifications and things that you can do at home.


How to reduce cold sensitivity on a daily basis:

  • Brush with sensitive toothpaste.

  • Minimize cold food consumption.

  • Avoid acidic foods.


The above recommendations are what you should be doing regardless of if you had professional treatment for them.


How sensitive toothpaste works

There are three commonly used desensitizing agents in toothpaste that may help with your sensitivity. They will reduce sensitivity either by occluding open dentinal tubules or by depolarizing the tooth nerve.


Tubular occlusion agents:

  • Stannous fluoride

  • Hydroxyapatite


Nerve depolarizers:


One agent isn't necessarily better than the other, they just work in different ways. If you find that your toothpaste isn't quite giving you the results that you want, you may want to give a different desensitizer a try.


Home remedies

Unfortunately there is no viable home remedy for teeth that are sensitive to cold. Although we suppose you could call using sensitive toothpaste as a home remedy since it is something that you do at home.


The toothpaste definitely works because it can usually get rid of mild sensitivity completely but it may only help reduce it for the severe cases.


Prevention

Unfortunately there is no way to prevent the teeth from becoming sensitive to cold. However, if you practice good oral hygiene habits and get routine dental check ups, you may be able to reduce the chances of it happening.


If your condition is really unmanageable you can schedule a consultation with one of our dentists in Long Island City.


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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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