My second patient of the day was complaining of tooth sensitivity. “It’s up there, up there on the left top, some place. When I drink cold water, it bothers me”, as she pointed upward towards my ceiling with vague clarity.
During my clinical exam with my trusty explorer instrument, I ticked off my mental checklist. Exam revealed nothing out of the ordinary for this 40 year old individual. Existing fillings looked good and sealed, no cracks in the enamel of the teeth. No obvious decay. Some wear of cusps. Recession of the gums on the molar was noted. The radiograph showed nothing obvious, otherwise boring.
The Subsequent Questions I asked of my patient and my Silent Mental Response (S.M.R.) was as follows:
Q: First of all, does it hurt when you chew,,,,, just straight up and down?
S.M.R. : Good. Hence, no dying nerve requiring a root canal procedure. When a tooth’s nerve is in the early stage of dying, it swells within the pulp chamber. As a result, the tooth “pushes” itself out of the tooth’s socket only the slightest bit. Consequently, when one bites straight down on the tooth, the bruised pulp nerve with its surrounding supporting tissues get compressed. This is interpreted as, “pain on chew”. Combine chewing pain with cold sensitivity that means root canal.
Q: Similarly, Does it hurt when you chew side to side?
S.M.R. : Good. Not a fractured tooth or a fractured restoration. Either fracture would illicit the same cold sensitivity. A fractured anything, most noteworthy, allows a wicking of cold liquid within the seam of the fracture. The cold liquid gets intimately close to the sensing nerve when it is drawn thru the crack. As a result, one can feel the cold temps..
Q: Does the cold linger or does it shoot away very quickly?
S.M.R. : Very Good. A healthy nerve will respond quickly and rapidly dissipate in response when the stimuli is removed ( in this case- cold water is swallowed).
I said, “Hmmm , X-ray looks good. No decay noted radiographically. The nerve is healthy. No cracks anywhere. Some recession of the gum line of those teeth. I’m not a mind reader and it’s difficult for you to pin down which tooth……It seems like recession of the gums sensitivity. Go with the over the counter for sensitive teeth stuff and go easy on the brushing!”
A tooth’s root is poros. Within these microscopic pores, lie extended from the pulp core, tiny nerve fibers suspended in a gelatinous sea. These fibers reach out to the surface of the root and are in a direct communication with the outside world. Toothpaste for Sensitive Teeth formulas essentially are toothpastes containing microscopic boulder elements that are sized exactly to plug perfectly into the dentin pores. These microscopic pores thereby, in effect, are closed “off” isolating the nerve fiber denticles from the outside world. Subsequently, you and I interpret that effect as— O.M.G, no more pain when we drink cold water. In effect, a mechanical barrier is created (sort of like Trump’s proposed border wall). Application of this toothpaste over time creates layer upon layer of pore closings with the desired effect of less and less cold sensitivity.
Other Causes Of Cold Sensitivity :
As mentioned previously above
Aggressive brushing, decay, cracked tooth and/or a cracked dental restoration
Tooth Whitening Toothpaste
Recent dental work
Dr. Emilio & Associates, Always Accepts New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.
His goal is to keep his patients’ Teeth and Gums Healthy For Life.
Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week
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