My tooth hurts when I eat hot or cold food or drinks

Question:

My tooth hurts whenever I eat hot or cold food or drinks.  If feels like a sharp pain, then it goes away.  What does this mean?

Answer:

This is a sure sign of a condition called reversible pulpitis.

What is Reversible Pulpitis

Reversible pulpitis essentially means that the nerve is starting to feel irritated, however it’s still fairly early and the sensation can easily be reversed by a dentist.

Exposed Dentin Causes Pain

The feeling that you are experiencing is caused by exposed dentin.  Remember that dentin is normally covered by enamel (see article on tooth anatomy), if for some reason a portion of dentin is left uncovered, you will usually feel sensations of short, sharp pain when exposed to hot or cold substances.  Exposed dentin can be caused by a cavity, a defective filling/restoration, or recent dental work.

Reversible Pulpitis Solution

The good news is that this problem can be fixed easily, the dentin just needs to be covered.  Your dentist will be able to give you a filling, simply fix your existing filling, or a pulp cap if necessary.  However, don’t wait too long.  Reversible pulpitis, if left untreated, can turn into irreversible pulpitis.  Unfortunately, irreversible pulpitis can only be treated with root canal therapy, which costs a lot more in the end.  So be sure to act now by visiting your dentist.

Good luck!

Tooth Crown Pain

Question:

Help!!  The tooth under my crown is hurting.  What does this mean and what should I do?  I’ve only had this crown for one year!!

Answer:

Sorry to hear that your tooth is in pain.  This can mean a number of things.  Let’s take a look at the many reasons for pain under a tooth crown:

Carious lesion/cavity under your crown

Sometimes, bacteria are able to find its way under the margins of crowns if not cleaned properly (see article on brushing).  If this happens, it could result in a painful situation, especially if the tooth nerve still remains in the tooth.

Bacteria not completely removed while preparing tooth for crown

In order to prepare a tooth for a crown, alot of tooth structure must be removed.  However, sometimes bacteria may still remain on the tooth structure that cannot be visibly seen by the dentist.  If this occurs, pain will occur at a later time.

Crown not being correctly adjusted in mouth

It could be “too high”, which means your bite could be off, and may need to be reduced by the dentist.  It could also mean that the crown isn’t adjusted to tightly “hug” the tooth and seal off the margins.  If the margins aren’t tight and snug, bacteria could easily creep in and eventually cause tooth crown pain.

Be sure to visit the Dentist to fix the problem

Your best bet is to go to the dentist to evaluate your options.  First, make sure the dentist runs a couple of tests to ensure that the pain is indeed coming from that tooth.  Sometimes, pain in one area is projected to a nearby area, this phenomena is called referred pain and occurs quite frequently.  If the dentist identifies this tooth as the source of the pain, then you’ll have a couple of options.  The crown may just have to be readjusted, which will only take a few moments, or it may have to be removed and the situation assessed from there.  Depending on the extent of bacterial invasion, you may just need the crown re-prepped, a root canal, or even an extraction.  Also, depending on your dentist’s office polices, he/she may offer to re-do your crown for free.

Good luck!

Teeth Grinding

Bruxism, or grinding of the teeth, is a fairly common condition that affects a majority of the adult population (estimates range up to 85%).  It usually occurs while sleeping and the individual is completely unaware that he or she is grinding his teeth.  Unfortunately, this bad habit can lead to a host of other dental problems.

How would I know if I grind my teeth?

• Teeth appear worn down or damaged
• Enamel has been worn down exposing a yellow layer (dentin)
• Experience headaches or migraines in the morning or right after waking up
• Frequent earaches
• Ringing in the ears, especially in the morning
• Sensitive teeth
• Have a loved one observe you in your sleep, grinding of the teeth will occur quite frequently throughout the night
• Facial Pain

What causes teeth grinding [bruxism]?

Causes of bruxism are still under investigation.  However, the most common causes are as follows:

• Stress
• Anxiety
• Alcohol
• Sleep disorders
• Malocclusion

How can I treat bruxism?

Effective treatment is still in the research phase.  The best way to prevent and control grinding of the teeth is to wear a nightguard.  This can be purchased over the counter or provided by your dentist.  Also, try to find ways to reduce the amount of stress in your life.  Activities such as deep breathing and yoga have found to be successful in reducing one’s stress level.

Please do not hesitate to visit the dentist if you suspect brusixm.  Grinding of the teeth can lead to several other dental problems including TMJ issues, the need for fillings, crowns, root canals, bridges, and even extractions.  Eventually, once the grinding becomes bad, the teeth can loosen and will need to be removed.  This is definitely not an issue to take lightly.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

Toothache Got Cha Down?

Tooth pain is definitely a sign of bad things to come if not treated properly.  Please do not ignore these signs!!  It’s best to find out a cause early on then wait until it’s too late to be saved.  The first question to ask yourself is, what type of pain is it?  The type of pain can tell you a tremendous amount of information as to the next step in treatment.

Type of pain

• Brief, short pain
• Pain when eating or drinking cold food/liquids or exposed to air
• Long lasting pulsating pain
• No sensation/tooth discoloration

Brief short pain:

If the pain only occurs occasionally, such as when drinking cold liquids, this is a sure sign of reversible pulpitis.  Depending on the extent of bacterial invasion and condition of tooth structure, this condition can usually be treated with pulp cap.  The good news is that the pulp of the tooth can likely be saved.

Long lasting pulsating pain:

Long lasting lingering pain is usually indicative of irreversible pulpitis.  This means the bacteria has invaded the tooth’s pulp and, depending on the extent of invasion, the entire pulp or portion of the pulp may have to be removed.  If the amount of bacterial invasion is extensive, or if a substantial amount of tooth structure has been destroyed, the tooth may have to be extracted.  The treatment options for irreversible pulpitis include:

• Extraction
• Pulpotomy/Pulpectomy
• Root Canal Therapy

No sensation/tooth discoloration:

If you noticed a major discoloration of the tooth in question, necrotic pulp is probably the culprit.  This means the pulp of the tooth is dead.  If the pulp is dead, the tooth is dead and it needs to be removed.  If substantial tooth structure remains, the dentist may be able to retain the tooth by performing root canal therapy.  The only treatment for necrotic pulp is extraction or root canal therapy.

Keep in mind that a series of tests must be performed by the dentist before a diagnosis can be reached.  Tooth pain can also indicate a fractured root, impacted tooth, gum disease, or even problems with the temporomandibular joint.  So, if you experience any type of pain with a tooth or any structure in your mouth, be sure to contact your dentist as soon as possible for the best possible treatment options.

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