- When I drink something cold or even inhale cold air I get an immediate and sharp pain, but it goes away quickly. What could cause this?
- I have a tooth that hurts all the time and I feel a throbbing in the area – what can I do?
- When I bite on a tooth it hurts a lot. What could cause this?
- When I drink hot coffee one tooth in particular hurts. How can I fix this?
- When I bite down on a tooth it feels OK, but when I let up the pressure it suddenly hurts. What can I do?
- Why do I get a painful pressure in an area of my mouth after I eat meat, particularly? Its kind of a sore feeling and often goes away after I brush.
- I have an intense pain on the lower right side not necessarily associated with biting down. It’s around the teeth. What can be the problem?
Short Answers with Links:
- When I drink something cold or even inhale cold air I get an immediate and sharp pain, but it goes away quickly. What could cause this? The pain is most likely caused by exposure of the root surfaces of the teeth. When there is recession of the gums (gingival recession), the root of the tooth is no longer covered by the gingiva, and there are nerve endings near the surface of the root that may be sensitive to cold and even touch. When we are young and the roots are covered by the gingiva all the way onto the enamel, there is no root sensitivity possible. With advancing age, which inevitably brings on advancing periodontal disease, which leads to gum recession, this SENSITIVITY is often encountered. There are treatments that are possible to greatly reduce this sensitivity for most people, and there are tooth pastes like Sensodyne, that are designed to reduce this sensitivity as well. It is also possible that a tooth can be cold sensitive when it is subjected to repeated trauma, for example by a high filling. The sensitivity of the nerves in and around the tooth due to this trauma can induce cold sensitivity, but not hot sensitivity. For more on the gum disease that may cause this visit Chapter III.2. For more on diagnosis of periodontal disease and recession, visit Chapter IV.4. For more on periodontal therapies that may prevent this problem, visit Chapter V.12…………………BACK to Questions
- I have a tooth that hurts all the time and I feel a throbbing in the area – what can I do? A throbbing pain is never good. It is very likely that your tooth has had the decay process advance into the pulp chamber and maybe the bacteria of this infection have even gone through the tooth and out the roots apices into the bone. The inflammation that is caused by the body’s immune system is designed to kill off the bacteria, but the chemicals that are produced also cause intense pain in the nerves which lie in the pulp chamber, root canal system and in the bone beyond. It is probable that the only solution for this kind of infection, causing this kind of pain, is to have a root canal. The dentist may prescribe a course of antibiotics to try to kill off the bacteria and reduce the inflammation before doing the procedure, so it will be more comfortable for you. For more on deep infections that require root canals, and their symptoms visit Chapter III.1.……………….BACK to Questions
- When I bite on a tooth it hurts a lot. What could cause this? There are a couple of possible causes. If it hurts in the bone area beyond the tooth, it is likely that the bone has become infected through the tooth. It is possible that the decay in the tooth itself has killed all of the living cells within, so there is no pain from within the tooth, but the inflammatory process in the bone will likely cause pain when the tooth is pushed into the sore area of bone. Biting down will cause this pain. It may be sharp or even a kind of itchy pain, and it may also be triggered simply by tapping on the involved tooth. If there is infection in the bone, a root canal is certainly required and then the infection will clear up and any bone that was resorbed in the area of the root apex will grow back. It is ALSO possible that there is a cracked cusp on the tooth. It may not have broken all the way off, but it may be fractured and moving a little as you bite on it, causing pain as the nerve endings in the dentin in the area are stimulated. This crack may well be seen by the dentist when looking in your mouth, and the cusp can be removed and restored using various filling materials, or in extreme cases by a crown. Also visit Chapter III.1 for symptoms of deep decay, and Chapter IV.1 for a more complete description of PAIN. ……………….. BACK to Questions
- When I drink hot coffee one tooth in particular hurts. How can I fix this? Hot sensitivity is a classic sign of pulpal infection. Whereas cold sensitivity may well not last long, when a tooth is exposed to hot temperatures and the pain lasts for a longer time – called pain of DURATION – it is another sign of pulpal involvement. This tooth also will likely require a root canal to end the infection by removing the infectious bacteria, and remove the nerves that are signaling pain………………… BACK to Questions
- When I bite down on a tooth it feels OK, but when I let up the pressure it suddenly hurts. What can I do? This particular scenario is very typical for a vertical fracture of the tooth. As opposed to a fractured cusp, which is broken rather horizontally, this vertical fracture extends from the biting surface down toward and often onto the root. I don’t know why it is only painful when the pressure is released, but it is a familiar observation to the dentist. There is no way to bind or glue the tooth back together such that this fracture will not propagate further and the pain will lessen. In general such a fracture requires extraction of the tooth………………… BACK to Questions
- Why do I get a painful pressure in an area of my mouth after I eat meat, particularly? Its kind of a sore feeling and often goes away after I brush. The answer to this may be obvious to most people, but I put it in because I am experiencing this exact thing right now. I had an upper third molar extracted, and the lower third molar which was kept in place by the biting relationship between them, has shifted now a little. The lower third molar has moved slightly away from the neighboring second molar, creating a space between them. This space is often packed with food, and meat like chicken is a prime candidate. The food gets packed in and puts sustained pressure on the gingiva below the area. If the gingiva is inflamed due to bacteria in the area, it can be very annoying. I use a little brush, like a baby bottle brush, to push the food out, although flossing can be effective but generally more difficult. In general, where there is a gap between neighboring teeth, food can become impacted and it can be painful until it is dislodged somehow. For more on home care for periodontal conditions, visit Chapter V.12……………….. BACK to Questions
- I have an intense pain on the lower right side not necessarily associated with biting down. It’s around the teeth. What can be the problem? This kind of pain may be difficult to diagnose. It feels like a nerve pain and it can be very painful, but is not associated with common oral infections or issues. When this occurs it is possible that it can be relieved by using topical anesthetic in the area, and I have given some of this to patients with this complaint and it has been found effective. It is likely that the pain does not last more than a week or so. It is not clear what the cause is, but one possible cause would be stress related clenching down on a tooth, subjecting it to trauma. If this traumatic pressure on the tooth is transmitted to surrounding nerves, there can certainly be a painful situation. If something topical is found to work, then stress reduction may be the best thing that can do. Of course, the dentist should rule out any other cause by evaluation of X-rays and checking teeth for hot, cold and percussion sensitivity………………… BACK to Questions