“Why are my teeth so sensitive to cold?” 

It’s a rather ubiquitous problem shared by millions of people, as evidenced by the plethora of dental products on the market for sensitive teeth. The pain you experience when your teeth are sensitive to cold can run the spectrum from a mild inconvenience to an intense “stops me in my tracks” kind of pain.

Having teeth that are sensitive to cold is not necessarily the sign of a serious looming dental problem. But the noxious feeling brought on by something cold can be startling and severe because the only sensation the nerve of a tooth can register is…pain. When a nerve becomes agitated, it hurts.

The purpose of this soliloquy on cold sensitivity is to explain the most common causes and offer some practical solutions for you:

8 Reasons Your Teeth Are Sensitive To Cold

1. Plaque Build-Up & Gum Inflammation
   A build-up of bacterial plaque is not only potentially destructive to your gums and bone (they support your teeth), it is also an irritant. Plaque can cause gum inflammation and actually lower the threshold at which you perceive pain. In other words, the presence of plaque build-up can make your teeth more sensitive.I have had more than a few patients with healthy mouths complain that their teeth are sensitive to cold and they are very worried that something’s wrong. Thankfully, most of the time, all they need to resolve the issue is a gentle and thorough cleaning. (Usually, they are overdue for their periodic visit, anyway!)
2. Receding or Receded Gums
   Receding or receded gums can make your teeth sensitive to cold, as well. If your gums are not firmly attached to your teeth, as in the case of gum disease, they can actually pull away and creep down (or up if it’s an upper tooth) and leave the root surface exposed. Unlike the part of your tooth that is normally exposed, the root does not have enamel protection and, therefore, is more reactive to temperature, especially cold.Gum recession can be caused by aggressive brushing with a hard-bristled toothbrush or excessive pressure when you use an electric toothbrush. Brushing your teeth should be a gentle process that is confined to the tooth structure. Don’t scrub your gums, either – you are not scouring bathroom tile! For more tips on tooth brushing, link here: The Dos and Don’ts of Brushing Your Teeth. If you’ve had periodontal surgery or orthodontic treatment you may also have gum recession. Try using proper brushing techniques, fluoride rinses (over-the-counter or by prescription), and toothpaste for sensitive teeth.
3. Bruxism & Clenching
   Bruxing (grinding) and clenching your teeth are potentially destructive patterns of behavior in which tremendous forces are placed on your teeth – upwards of 500 lbs. per square inch of force. This can result in a loss of tooth structure on the biting surfaces of your teeth (dentists call it occlusal wear) or near the gum line. As they wear down, sensitive dentin is exposed, and the result is that teeth become sensitive to cold.Aside from temperature sensitivity, bruxism and clenching can cause premature tooth loss, muscle tenderness, and TMJ symptoms. Many people who clench or grind their teeth benefit from an occlusal nightguard, which protects the teeth from wear during sleep.
4. Cavities
   If one of your teeth is sensitive to cold, you could actually have a cavity. Unlike the conditions above, cold sensitivity due to a cavity is more localized and restricted to the involved tooth. See your dentist!
5. Broken or Cracked Teeth & Lost Fillings
   A frequent cause of cold sensitivity is when you have a broken or cracked tooth or when all or part of a filling has been lost. The heightened sensitivity is due to part of the tooth’s structure becoming exposed. Clearly, in all of these situations, a visit to the dentist is warranted. Go!
6. Acidic Food & Beverages
   Beware of the many beverages on the market promoted by their manufacturers as healthy alternatives to other drinks, such as soda pop. Many of the so-called “vitamin waters”, energy drinks, and sports drinks are highly acidic. If you consume them in large quantities, they can actually cause the structure of your teeth to break down. They dissolve tooth structure much the same way acids from bacterial plaque cause cavities!The problem lies in how frequently you consume the offending drinks and the amount of time they are allowed to linger in your mouth. It’s best not to swish while consuming them because it prolongs the acid attack on your teeth. And, do not brush your teeth for at least 30 minutes after drinking one of these beverages because your “softened” tooth enamel or dentin at that point is very susceptible to abrasion.The same problem can also be caused by citrus fruits, pickles, and vinegar.  For more on this issue: Is your Favorite Beverage Eroding your Tooth Enamel?
7. Recent Dental Treatment
   The recent placement of large restorations, fillings or crowns is another reason why teeth can be sensitive to cold. While restorative dentistry is a kind of bloodless surgery – it’s surgery nonetheless. During these procedures, the nerve of a tooth can be traumatized and sensitized. It is not uncommon for a recently restored tooth to be sensitive to cold for several days.If you’ve had recent dental treatment and your teeth are sensitive to cold for longer than several days, contact your dentist. Often a simple bite adjustment can resolve the issue, especially if the filling was a bit too high. But don’t wait. If you delay needed refinement, it can prolong your recovery time.Sometimes, a cleaning or scaling can make your teeth sensitive to cold afterward. Try to be patient. The build-up of plaque may have been “protecting” your teeth from the elements – after a cleaning, those surfaces can be exposed.
8. Acute Pulpitis
   Acute pulpitis is an inflammation of the dental nerve. Generally, the symptoms of this condition are more severe than just a slight cold sensitivity. Not only are the teeth especially sensitive to cold, but the pain lingers even after whatever caused the inflammation has been removed. The intensity of this condition often necessitates root canal therapy. If you are experiencing this problem…go to your dentist – right now.

Conclusion
When your teeth are sensitive to cold, it’s usually more of a quality-of-life issue than a progressive pathological process that is going to worsen over time. Normally there is nothing seriously wrong with your teeth.

For my patients who have this problem, I use various treatment approaches, including conservative over-the-counter remedies, fluoride prescriptions, desensitizing treatments, as well as more definitive dental procedures such as bonding and gum-grafting, to name just two. The proper management of cold sensitivity depends on the cause, the severity, and the duration.

If your teeth are sensitive to cold, ask your dentist for some advice when you go in for your regular check-up and cleaning. However, if you develop sudden or severe cold sensitivity, make an appointment as soon as possible.

Dr. Michael Sinkin is an NYC dentist that has been in practice for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.