Now that we've got tooth whitening covered, I'm going to begin a series of posts on the causes of tooth pain and sensitivity. It's important to understand these posts are meant to be informational only and are not substitutes for a formal dental exam and diagnosis. That being said, lets kick it off with mild cold sensitivity! Woo Hoo!
There are various reasons a tooth can become sensitive to cold temperature, but when you understand the basics of how a tooth is put together, you'll see they are all manifestations of the same underlying mechanism. Basically, in the center of everybody's tooth there is a soft bundle of nerves and blood vessels called the pulp. The majority (but by no means all) of dental pain comes from this pulp, and it can be very, very testy. If anything irritates these nerves in the pulp their only response is to signal pain. Hot, cold, trauma...all are interpreted as pain. They are pretty one sided in this regard. Furthermore, when something irritates the pulp, it can cause the blood vessels that compose it to become inflamed which, in turn, bothers these nerves and causes them to interpret even mild irritants as disproportionately painful. So, the pulp nerves signal pain, and the pulp blood vessels determine the tooth's threshold for pain.
Mild cold sensitivity is defined as sensitivity to cold that lasts only few seconds. If a tooth aches for a minute or longer after being exposed to something cold, something different is going on, and I'll discuss that in my next post. With that in mind, lets explore what causes mild cold sensitivity:
1) Decay - If a tooth has some decay, the proximity of the bacteria causing the decay to the center of the tooth irritates the blood vessels of the pulp which, in turn, lowers the tooth's threshold for pain.
2) Exposed root - If a tooth's root is exposed because of gum recession, the nerves of the pulp in this area are closer to the surface of the tooth and not protected by a layer of hard, insulating enamel. For this reason cold signals have a much easier time making their way to the pulp. Consequently, their effects will be exaggerated and the tooth will be sensitive. Often this sensitivity is transitory and will go away on its own -- desensitizing toothpaste can help here.
3) After a dental filling is placed - If the filling is deep and placed relatively close to the pulp, the trauma to the tooth from cleaning out all the decay can irritate the blood vessels of the pulp and consequently lower the tooth's threshold to pain. At some point in the near future (a few days to a few weeks) this sensitivity will subside.
4) Tooth has been fractured from biting on something wrong- If part of a tooth has broken off, the insulating enamel has been removed and cold sensations have a shorter distance to travel to the pulp. From there it's the the same mechanism as described in number 2 above.
5) Trauma to the tooth - If your tooth experiences blunt force trauma (through a fall, blow to the face, etc.), the blood vessels in the pulp will become irritated and lower a tooth's threshold for pain. This effect SHOULD be transitory, but tooth trauma is more complicated than this and will get its own post later.
6) Tooth is cracked - This reason is so complicated it merits its own post.
Those are the main reasons your tooth can be mildly cold sensitive. Please understand that all of these reasons require a dental consult to determine if any treatment is necessary. Think of this pain as an early warning signal that something is wrong. Often, a dentist can intervene at this stage with minor treatment. If the pain is ignored, future pain and the consequent treatment of it could be more involved. So - listen to your body and see your dentist!
Next post...strong cold sensitivity will be explained. Have a good one!
-DRS
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