Teeth reaction to cold and hot food - causes, treatment, recommendations

Increased sensitivity of teeth (hyperesthesia) is a short-term occurrence of pain under the influence of temperature, chemical or mechanical irritating factors. Usually occurs when drinking cold water, sour, sweet, salty, or touching with a toothbrush. The intensity of pain varies from mild to unbearable.

According to WHO, every second person in the world suffers from hypersensitivity. In Russia it is about the same: 45–65% of adults aged 20–55 years. More often women make complaints.

A little anatomy

A tooth consists of a crown and root part, connected by a neck. The coronal part is covered with enamel, the root part is covered with cement. Beneath the enamel and cement there is dentin, a hard tissue. Inside there is soft tissue - the pulp; blood vessels and nerves pass through it.

Dentin is not sensitive, but consists of many tubules in which fluid circulates. The irritant causes fluid movement, which is detected by the nerve endings of the pulp. A person feels their reaction as pain.

How might the nerve react?

Often teeth due to deep caries and pulpitis. And such “ache” will very soon turn into more serious, excruciating pain, not only when cleaning and eating hot or cold food, but also in a calm state, both day and night.

With pulpitis, a cavity develops in the coronal part and root canals of the teeth, where the nerve fibers are located, which over time fills with pus and blood. And although the epicenter of inflammation in this case is the nerve, the patient may initially complain that the whole row of teeth is “aching.” The sensations are localized in one tooth a little later, the pain becomes unbearable and requires the intervention of a dentist.

Tooth sensitivity: causes

• Demineralization of enamel. It becomes more loose due to the leaching of calcium, phosphorus, and other trace elements.
• Thinning of enamel. As a result of increased abrasion due to malocclusion and the occurrence of wedge-shaped defects.
• Untreated caries or violation of the marginal seal of the filling.
• Exposure of roots as a result of injury, metabolic-dystrophic process or inflammation of the gums.
• Changes in the pH of saliva due to the consumption of certain drinks, foods, and medications. A pH of less than 5.5 is considered dangerous.
• Some diseases accompanied by gastroesophageal reflux and endocrine disorders.
• Vitamin deficiency, exposure to radiation, work in hazardous industries, living in a region with an unfavorable environmental situation.
• Smoking.

More often than not, several reasons are discovered at once. The enamel becomes thinner, loses strength, and cannot protect dentin from irritants. The result is pain.

Causes of toothache

As we have already said, the main reason for such painful sensations is the thinning of the enamel. Hyperesthesia can also develop due to:

• dentin reactions;
• allergies to dental medications;
• periodontal diseases;
• mechanical damage to enamel;
• hereditary predisposition.

Let's look at each cause of the problem in more detail.

Provoking factors

Hyperesthesia does not appear immediately. There are several factors that you need to pay attention to in order to eliminate them in time. Don't wait for discomfort to appear. It is better to initially develop healthy habits that will help you maintain your health so that you never experience acute dental pain. Sensitivity increases when any of the factors listed below are present.

1. Insufficient oral hygiene. Soft plaque is an accumulation of microbes that eat food microparticles stuck in crevices, releasing organic acids that dissolve enamel minerals. Externally, the dental unit looks intact, but the density of the enamel is significantly reduced. Its demineralization occurs. The first alarm bell is increased sensitivity, then caries develops.
2. Consumption of certain foods. Juices, wine, sweet soda, fruits, candies, and other sweets contain phosphoric and other acids that negatively affect the strength of enamel.
3. Constant use of aggressive whitening pastes containing abrasive and chemical components.
4. Ultrasonic cleaning. Under a dense coating, the enamel becomes thinner and becomes loose. After professional cleaning, it is exposed, its sensitivity increases sharply. Usually, dentists, taking this point into account, use strengthening pastes at the end of the procedure for the preventive treatment of tooth sensitivity.

What complications may arise?

The main thing to remember is that tooth sensitivity does not go away on its own. If you do not fight it, the disease will progress quickly. Unpleasant sensations will soon be replaced by outbreaks of pain when the enamel is irritated by hot and cold drinks. Then you will not be able to eat sweet and sour, salty and spicy. And at the last stage, short-term pain transforms into constant pain, and its intensity will be such that just touching the tooth will seem unbearable.

At the last stage of the disease, fluoridation will no longer help. It will be lucky if the dentist agrees to cover the patient’s own enamel with composite materials. But in most cases, the doctor will insist on the removal of diseased teeth and subsequent prosthetics.

Types of hypersensitivity

If sensitivity is increased on one or more teeth, it is called limited. If for everyone - generalized.

Table 1. Types of hyperesthesia

№	View	Reaction
1.	Light	for cold, hot
2.	Average	as with 1st degree plus for sour, sweet, salty
3.	Expressed	as in grade 2 plus mechanical irritants (when brushing teeth, eating)

Thinning enamel

Tooth enamel can become thinner for a variety of reasons, such as:

• improper bleaching or poor-quality professional cleaning;
• using brushes that are too hard;
• using pastes with abrasives that expose the enamel to chemical and mechanical stress;
• vitamin deficiency (the pain in this case is characterized by an aching, twitching character and manifests itself during cleaning, rinsing the mouth, eating and drinking).

Sensitivity of teeth. Stages of treatment

1. Eliminate the cause of hyperesthesia: get rid of plaque, deposits, stones, caries, wedge-shaped defects.
2. Carry out professional oral hygiene.
3. Strengthen the enamel with calcium and fluoride.
4. Teach the patient how to use a toothbrush and floss correctly.
5. Choose suitable dental care products: toothpaste, mouthwash.

Table 2. Tooth sensitivity: causes and how to treat

№	Cause	What to do
1.	Soft coating.	Careful hygiene with home remedies.
2.	Hard coating.	Professional hygiene in dentistry.
3.	Caries in the white spot stage.	Deep fluoridation, remineralization.
4.	Caries, pulpitis, periodontitis.	Dental treatment.
5.	Exposure of the cervical part, wedge-shaped defect.
6.	Malocclusion.	Orthodontic therapy.

Dentin reaction

Dentin is the hard tissue of the tooth underneath the enamel. This is a layer that, after damage, can allow irritants to pass into the nerve zones. Dentin is destroyed during advanced stages of caries, and can also occur with inadequate dental treatment if an infection develops under a filling.

If teeth ache for this reason, the patient feels a drilling, sharp pain, similar to the sensations of purulent pulpitis.

In very rare cases, teeth ache due to the patient’s individual intolerance to certain dental medications, after visiting a doctor. In this case, the pain is accompanied by itching in the gums and palate.

Elimination of tooth sensitivity

Using ultrasound, the doctor removes soft and hard deposits from the teeth. After removing plaque, teeth become more sensitive for a short time, so remineralization or deep fluoridation is immediately carried out. During remineralization, the enamel is treated with active compounds of calcium and phosphates. Deep fluoridation – coating with sodium fluoride. Both procedures significantly strengthen the enamel's resistance to irritants.

The doctor uses agents that reduce the movement of fluid in the dentinal tubules. It “seals” them using desensitizers or reduces their volume through remineralization. Protecting exposed dentin reduces the force of transmission of the irritant impulse from the enamel to the nerve.

Why does a tooth without a nerve hurt from cold and hot?

It is generally accepted that after the nerve is removed, the tooth will no longer be able to hurt. In fact, the reaction of a dead tooth to temperature is rather normal, and there is no need to worry. Over time, the pain will subside on its own, because most often the cause lies in microtraumas to the enamel of neighboring teeth that were received during treatment.

If after a few days the reaction to hot or cold does not decrease, but intensifies, you should not hesitate! It is likely that the dentist did not completely remove the nerve, and the inflammatory process was not stopped. Such mistakes are extremely rarely made by dentists with extensive experience, but among beginners it is not at all uncommon.

There is no point in blaming the aesculapians: what we are accustomed to calling a nerve is, in fact, a branched system of tiny hairs, spreading in all directions of the tooth. It is sometimes impossible to see all the “tentacles” even on an x-ray. And only with experience comes an intuitive feeling of how the “labyrinth” of nerves is located in a particular patient.

In the practice of Western dentistry, a separate specialty has long been distinguished: an endodontist, a specialist in root canal treatment. In Russia, only large, well-equipped clinics can afford specialists of such a narrow profile.

Basic points of proper hygiene

Use a synthetic, medium-hard or soft brush. Change it every three months.

The toothpaste should be suitable for very sensitive teeth. Typically, such products contain hydroxyapatite, strontium chloride, fluorides, potassium nitrate, or a combination of calcium carbonate and arginine.

Take enough paste. For children under 3 years old - the size of a grain of rice, from 3 to 14 years old - the size of a pea, for adults you need to squeeze out about one centimeter.

Brush your teeth for 2 minutes: 30 seconds on each surface, top and bottom. Monitor time using an hourglass or mobile phone timer. Electric toothbrushes emit a short beep every 30 seconds and a long beep every 2 minutes from the start of brushing.

Diagnostics

When diagnosing dentin hypersensitivity, it should be borne in mind that it is often a symptom of a disease. Therefore, when a patient approaches, the dentist begins treatment with a survey, during which he receives answers to the following questions:

• duration and nature of the pain syndrome;
• number of units with dentin sensitivity;
• localization of increased susceptibility;
• characteristics of stimuli that cause pain.

After the examination, the patient is required to undergo probing of sensitive areas and other diagnostic tests (thermal, electrical, osmotic, evaporative), as well as percussion (tapping on individual areas of the tooth). At the same time, they find out whether the element is sensitive when biting, identify microcracks in the enamel, damage inside and around the filling, malocclusion, and signs of bruxism.

In addition, diagnostics are carried out using hardware methods and “hidden” carious lesions and periapical changes are identified if they are present.

Much attention is paid to determining the level of pain and the degree of tooth sensitivity:

• no pain;
• mild discomfort;
• medium intensity;
• severe pain or unbearable.

The patient's pain reaction may occur to a greater extent to thermal stimuli (cold, heat), tactile (tactile), evaporative (air), electrical or osmotic (solutions of weak acids).

Dentists note that the reaction most often occurs to cold, brushing teeth, heat and sweets.

The more dentin is exposed due to dental diseases and other factors contributing to enamel loss, the higher the degree of hyperesthesia. This is explained by the fact that in completely exposed dentin there are more dilated tubules with open holes.

Cleaning sequence

1. Using sweeping movements, clean the outer and then the inner surfaces of the bottom row. Move from molars to incisors. Then do the same on the top row. Hold the brush at a 45-degree angle and do not use a sawing motion. This leads to damage to the enamel.
2. Brush chewing surfaces with small circular movements.
3. Close your jaws and walk along your gums in a circular motion.
4. Brush your tongue using a leisurely four to five strokes from root to tip.
5. Treat the interdental spaces with dental floss.
6. Rinse your mouth.

It is more effective to clean with an electric brush or irrigator. The quality of hygiene increases 3–4 times. Hyperesthesia can be dealt with faster.

Is it possible to strengthen sensitive teeth at home?

Yes. If you can’t get to the dentist, you can try to help yourself. There are several remedies that can solve the problem of hyperesthesia at home.

Table 3. Popular products for home use

№	Name	Mechanism of action	Age category
1.	ROCS Medical Minerals, GC Tooth Mousse	Remineralizing gels	Adults and children
2.	Colgate Duraphat 2800 ppm	Fluoridating paste	10–15 years
3.	Colgate Duraphat 5000 ppm		From 16 years old
4.	ELMEX junior	Fluoridating paste	6–12 years
5.	ELMEX		From 13 years old
6.	LACALUT Extra Sensitive	Paste that reduces tooth sensitivity	For adults
7.	Colgate Sensitive Pro-Relief
8.	PRESIDENT Sensitive
9.	LACALUT Sensitive, 300 ml	Rinse for sensitive enamel	From 15 years old

Why do my teeth hurt so much?

Not every toothache is highly intense, but with pulpitis it is truly one of the most severe in the body.
Pain is one of the five main manifestations of inflammation. Another sign of an inflammatory reaction is tissue swelling. A peculiarity of dental nerve endings is their location inside hard tissue (dentin), which cannot expand when the pulp is inflamed. Elsewhere in the body, swelling slightly reduces pain by reducing pressure on nerve endings due to the cushioning effect of the increased volume. In a closed pulp chamber, swelling leads to even greater pressure on the nerves - which is why the intensity of toothache is the highest. However, there is a large category of people who do not feel pain at all from caries - they may not notice pulpitis (or there is sensitivity, but it is weak). This is due to the body’s hypoergic reaction to inflammation and the high rate of production of replacement dentin. Due to obliteration of the tooth cavity, the blood supply deteriorates, the pulp becomes ischemic and gradually dies quietly.

Algorithm of actions for hyperesthesia

1. Adjust your diet. Avoid completely or significantly reduce the consumption of foods and drinks containing acids and sugar. Especially fruit and berry juices, wine, candies. Eat more green vegetables, fiber-rich foods, and whole grains.
2. Change your toothpaste. Never use bleach. Choose from those labeled "Sensitive".
3. Check if you are practicing proper oral hygiene. If it's wrong, correct it.
4. Make an appointment with your dentist to find out the type of tooth sensitivity, find out the cause and get treatment.
5. Visit the dentist twice a year, even if nothing hurts.

How to protect teeth from hyperesthesia?

Many people believe that it is enough to brush their teeth twice or thrice a day, and they will always be fine. However, this is a common misconception! If you brush your teeth incorrectly, they will not only not become stronger, but, on the contrary, they can be seriously harmed. For example, a high abrasive content in toothpaste will cause the enamel to become thinner.

The best solution would be to buy a fluoride-containing paste that has a medium level of abrasiveness. During the research, it was possible to identify why this disease occurs less often in men. The fact is that due to stress, the functioning of the gastrointestinal tract is seriously deteriorated. Because of this, the acidity of the oral cavity changes. Due to frequent exposure to acid, they become highly sensitive to irritants, which results in severe pain that causes a lot of discomfort.

To avoid hyperesthesia, you need to brush your teeth every day and try as much as possible to protect yourself from stress.

Treatment of hyperesthesia in the “Family Doctor”

If hyperesthesia occurs, make an appointment with a dentist by calling the contact center in Moscow +7 (495) 775 75 66 or using the online appointment form. Our clinic has been operating for more than 26 years. Experienced doctors help patients cope with pressing problems, including hypersensitivity.

The doctor will find out the cause of tooth sensitivity and provide effective treatment. In most cases, it is enough to select suitable oral care products and carry out proper hygiene procedures. In more complex situations, full treatment is used, and if necessary, surgical treatment.

The clinic takes a gentle approach to patients. All procedures are accompanied by adequate pain relief, which eliminates the occurrence of discomfort and pain. Increased sensitivity of teeth is not just a feature of them. This is the beginning of a disease that must be cured. And it's better to do it as quickly as possible.

Professional treatment

Hyperesthesia is a reason for medical intervention.
You should not try to cope with the problem yourself, otherwise complications will not be avoided. High-quality therapy should first of all be aimed at eliminating provoking factors. What to do if your tooth hurts and reacts to cold and hot water, food, air:

• It is necessary to go through remineralization and fluoridation. The enamel layer is additionally fed with fluoride and calcium. A special composition with a high concentration of these components is applied to the surface. The procedures are carried out for preventive purposes to prevent caries.
• Iontophoresis involves the introduction of a special drug into hard tissues using galvanic current.
• Installation of prostheses, implantation. If the rows are very damaged, they can only be restored in this way. The doctor determines which method is optimal in a particular case: restoration with veneers, the use of composites, artificial crowns.

What to do if your teeth are afraid of cold and hot, first of all? Dentists adhere to a clear algorithm:

1. initial examination and diagnosis of possible dental diseases, inflammations;
2. development of a plan for further action;
3. sanitation of the oral cavity and elimination of pathological foci;
4. elimination of plaque and stone;
5. treatment with remineralizing compounds.

Initial measures to eliminate signs of hyperesthesia

To eliminate unpleasant sensations, the doctor primarily gives the patient the following recommendations:

• exclude predisposing factors;
• do not consume food acids, that is, refuse those products that contain them;
• Carry out hygienic teeth cleaning long before or after meals;
• Reduce the time you spend brushing your mouth to one minute and use a soft-bristle brush.

The patient's teeth are treated with desensitizers. They reduce the sensitivity of teeth of various etiologies by sealing the dentinal tubules. The use of special toothpastes is prescribed.

When the root and neck of a tooth are exposed, mucogingival surgery (vestibuloplasty, etc.) is used to correct gum recession. During surgery, the soft structures of the oral cavity are moved to those areas that require restoration.

For pulpitis, the doctor resorts to pulpotomy. During a dental operation, the pulp is partially amputated using a vital method. At the same time, that part of it that is located in the root canal remains viable.

If sensitivity to irritants persists, additional diagnostics are carried out to exclude chronic pain syndrome, and a more effective treatment plan is drawn up.

Localization and nature of toothache

It's hard to go wrong with a sore mouth. A person can easily describe where and what hurts. Painful sensations can differ both in intensity (sharp and strong or weak and aching) and frequency (for example, at night - that’s another test). Toothache can affect one tooth or several in a row, on one or both jaws. The pain can radiate to the temple, affecting not only the eye and ear, but also causing migraines. Moreover, the trigger (trigger mechanism) for such sensations is not necessarily hot tea or cold ice cream. Sometimes a person describes their occurrence as “out of the blue.”

Let's try to summarize the types of toothache:

• Aching, sensations are dull and not intense.
• Shooting, sharp, in the form of sharp impulses, causing suffering.
• Sharp, unexpected, independent of the time of day.
• Long-lasting, “background”, tolerable, so the patient puts off seeing a doctor.

Each of the above types of pain indicates a particular pathology. With a timely visit to the dentist, there is every chance of maintaining a beautiful smile and healthy teeth. Otherwise, unpleasant consequences will not keep you waiting.