Why Does Cold Make Your Teeth Hurt?

And When It Is Worth Worrying About

By Dr. Joshua Parry, DMD

How many cookouts and picnics have you been to this summer? Did this happen: you took a long drink of iced tea and a sharp jolt shot through one tooth. It went away quickly. But that ice cream cone, it took a few minutes for that cold twinge to calm down. Now, you’re worrying about it.

If that sounds familiar, you are in the right place. Sensitive teeth are one of the most common complaints we hear, and the cause isn’t a big mystery. Here is what that twinge means, and when it is worth an appointment.

Why do my teeth hurt when I drink something cold?

Under your enamel is a softer layer of material called dentin, and it’s filled with microscopic channels that run straight to the nerve at the center of the tooth.

When your enamel wears thin over time, or your gums pull back with age, that dentin is exposed. Cold, sweetness, even a rush of air can travel down those channels and reach the nerve. The result is the sharp pain you felt, which usually fades within seconds. The American Dental Association just calls it heat and cold sensitivity.

What causes tooth sensitivity?

Sensitivity is a symptom, not a diagnosis. So, the right fix you need depends on what is actually happening. The Cleveland Clinic gives us a long list of possible causes.

• Enamel worn thin by acidic foods and drinks: citrus, soda, wine, tea
• Brushing too hard, which wears enamel and pushes gums back
• Recent whitening or a recent dental procedure
• Receding gums that expose the root, often tied to gum disease
• Grinding or clenching, which thins enamel over time
• A cracked tooth or a leaking filling, which may need a crown
• A cavity working its way toward the nerve

The first few are gradual and manageable. As the list goes on, there are some real problems to deal with, and the conditions can get worse and expensive to deal with, especially if you wait too long.

How can you tell a twinge from a real problem?

Pain that stops within seconds of the cold leaving your mouth is usually ordinary sensitivity. Pain that lingers, throbs, or builds suggests the nerve may be involved. Here are three things to pay attention to:

• Several teeth or one tooth. Widespread sensitivity points to worn enamel or receding gums. One tooth points to something local: a crack, a failing filling, or decay.
• Cold only, or pain when you bite. Pain on biting suggests a crack rather than simple sensitivity.
• Brief or lingering. Pain that outlasts the trigger by 30 seconds deserves a prompt look.

Call right away for pain that wakes you at night, throbbing, swelling, or a bad taste near the tooth. Those cross into dental emergency territory.

Amy Hutchinson, a patient at our practice, shared: “I love this place! They are the friendliest dental staff you will ever meet. They are also wonderful dentists who care and do superior work. So gentle, yet so effective.”

Is it normal for teeth to be sensitive after whitening or a cleaning?

Yes, and usually temporary. Whitening, a deep cleaning, or a new filling can leave a tooth reactive to cold for a few days up to a couple of weeks. If it is getting worse instead of better, or still there a month later, call us. Temporary discomfort is normal, ongoing pain needs attention.

What can you do at home in the meantime?

None of this replaces an exam, but it can take the edge off while you wait:

• Switch to a desensitizing toothpaste, twice daily. Give it a few weeks; these work gradually.
• Use a soft-bristled brush and ease up on the pressure.
• Wait about 30 minutes after acidic foods before brushing, since enamel is softened afterward.
• Hold off on whitening products until you know what is causing the sensitivity.

How do we find the cause, and what actually fixes it?

The appointment is diagnostic, not a sales pitch. We ask when the pain happens, examine the tooth and gumline, take digital X-rays, and gently test individual teeth to isolate the source.

Treatments follow a better understanding of what’s happening in your case.

• Exposed dentin: a professional fluoride or desensitizing treatment
• Decay or a worn notch at the gumline: a filling or bonding
• A cracked or heavily worn tooth: a ceramic crown
• Gum disease and recession: periodontal therapy
• Grinding: a custom night guard
• Nerve involvement: root canal therapy, far more comfortable than its reputation

All of these are handled in our offices. Where receding gums need surgical grafting, we evaluate it here and coordinate your care with a trusted specialist.