Question

I always suffer from toothache in cold weather. When I come in from the cold into the warm room, the pain starts. This mainly affects the molars, some of which have fillings. My teeth also react sensitively to hot and cold food. What are the causes and what can be done about it? S. W. in L. 

Short answer

Healthy teeth are living parts of the body, they are supplied with blood and nerves. The rapid change from cold to warm or vice versa can be perceived as unpleasant, especially when the gums recede. Protective varnish, special toothpastes or rinsing solutions can reduce the toothache caused by temperature fluctuations 

Natural, healthy teeth are living parts of the body, they are supplied with blood and nerves. Teeth are often not indifferent to cold air or hot and cold food. Tooth enamel and gums protect. An intact tooth enamel is a perfect protective layer against all external stimuli. The inner tooth substance (the dentin), i.e. the layer directly under the enamel, as well as the root of the tooth, which begins directly under the gum line, are interspersed with many small canals that contain small extensions of the dental nerve. If external stimuli reach these nerve processes, especially when there is a rapid change from cold to warm or vice versa, we usually perceive this as an unpleasant sensation. Gum recession or loss of tooth enamel result in parts of the tooth root or the dentine coming to the surface, exposing the nerve processes to the stimuli in the oral cavity. 

To a lesser extent, gum recession is a normal ageing process, but to a greater extent it can be a sign of gum and bone inflammation (periodontitis) or incorrect tooth brushing. The loss of enamel to a greater extent is caused by teeth grinding, the consumption of acidic foods or drinks, repeated vomiting or frequent acid regurgitation and tooth decay. Typically, during the cold season, repeated eating of acidic fruits (oranges, mandarins, etc.) can lead to increased attack on the tooth surface. 

Therapy options 

If exposed tooth roots are the cause, these can be covered with a protective varnish to make them less sensitive. Special toothpastes or rinsing solutions can also help. If the loss of tooth substance is too great or caries is present, a filling is necessary. A correct cleaning method with a soft toothbrush and a gentle fluoride toothpaste protects against excessive and rapid loss of gum and tooth substance. Newer sonic toothbrushes can also do a good job here. Professional advice from a dental hygienist or dentist is advisable. It is also important to rinse your mouth immediately with water or even better with milk after consuming acidic foods or drinks in order to neutralize the harmful acid immediately. Under no circumstances should teeth be cleaned within the first hour after eating acidic foods, as otherwise the top layer of teeth, which has been weakened by the acid, would be virtually rubbed off with a brush. People who regularly and severely grind their teeth can have a protective splint made that can be worn at night and protects the teeth from excessive loss of substance. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on February 04, 2013