Teeth reacting to cold: what is behind it

A short, sharp pain from cold water or air is not a disease of its own but a symptom. It has a few typical causes, and they are treated differently.

Sensitivity appears when dentine — the layer beneath the enamel — loses its cover and its tubules are left open. They contain fluid, and any sharp temperature change makes it move, which the nerve ending reads as pain.

Common causes

• gum recession that exposes the neck of the tooth
• enamel wear from a hard brush and too much pressure
• erosion from acidic drinks and citrus
• cracks and chips, including from clenching
• decay and leaking old fillings

What to do

Toothpaste for sensitive teeth helps, but it covers the symptom rather than the cause. If the reaction lasts more than two weeks, does not go away after changing paste, or the pain becomes prolonged and aching, it is worth coming in for an examination.

At the appointment the point is to tell whether this is an exposed neck, a crack, or already inflammation of the pulp: that determines whether remineralisation and better brushing will be enough or treatment is needed.