During the cold snap this winter, my husband kept complaining that his teeth “hurt.” He’d just been to the dentist, who found no problems. Can cold temperatures cause tooth pain?
Yes, cold temperatures irritating nerves in the teeth could be at the “root” of your husband’s pain. Tooth sensitivity to cold, or what dentists call “dentin hypersensitivity,” is a relatively common phenomenon. In dental practices in the U.S., about 12 percent of patients have dentin hypersensitivity affecting an average of three teeth. They feel a quick, sharp pain when their teeth are exposed to cold—usually when consuming chilly foods such as ice cream or refrigerated beverages. Exposure to cold temperatures outdoors is another dental pain trigger.
Dentin hypersensitivity most often happens when the protective tooth enamel wears away or the gums recede, exposing the more sensitive inner part of the tooth, called the dentin, to air. Dentin is filled with tiny tubules that connect directly to nerve fibers. When cold air rushes through those tubules, it stimulates the nerve fibers and causes pain. Even if your teeth and gums are healthy, any thinning enamel, tiny cracks, or broken fillings can create pain. Teeth also expand and contract in response to temperature changes. When they expand, cracks or openings expose the sensitive nerves inside.
Another cause of tooth pain that may be triggered by temperature is thermal allodynia (from the Greek allo, meaning other, and -dynia, meaning pain). It’s a symptom of nervous system pain disorders such as postherpetic neuralgia, diabetic neuropathy, nerve injury, and central pain syndromes. People with thermal allodynia feel pain after a temperature change—for example, when they move from the cold outdoors to the warmth indoors. It’s not the cold itself, but the transition from cold to warm that causes pain. Unsurprisingly, thermal allodynia most often occurs during the fall and winter months (in regions that have pronounced seasonal temperature changes).
Pain from thermal allodynia is different than pain from typical dentin hypersensitivity. It’s dull and throbbing and spread out over several teeth, rather than being sharp and focused in one tooth. Allodynia pain is also longer-lasting, sometimes continuing for several hours.
Another possible cause of tooth pain is sinusitis, which affects an estimated 29 million Americans and increases in prevalence during the winter months. When the maxillary sinuses, located behind the cheekbones and above the teeth, become inflamed, they can cause the teeth to ache.
What to do. To avoid cold air discomfort, try to breathe through your nose when outdoors in wintertime to prevent cold air from hitting your teeth. Use a toothpaste made for sensitive teeth, and brush with a soft-bristled toothbrush so you don’t further irritate receding gums and wear away more tooth enamel.
If these interventions don’t relieve the pain, see your dentist, who can look for problems like enamel cracks and gum recession and treat any exposed roots or weakened enamel.
Tooth pain from sinusitis is treatable with nasal saline rinses, decongestants, and over-the-counter cold and allergy medicines. Saline rinses, along with steroid nasal sprays and allergen avoidance, are also helpful for avoiding sinusitis in the first place.
