If you’ve experienced it, you remember it. It’s winter and you’re running, skiing, or shoveling show. You’re panting slightly and take a deep breath in through your mouth. Suddenly, one or more of your teeth scream back at you with a surprising and striking pain. Instances of tooth sensitivity amongst my patients, like in the previous example, happen significantly more often during the winter than they do in the summer. To help us understand why, let’s first take a look at the main causes of tooth sensitivity.
Exposed Dentin
Our teeth have an enamel layer covering the majority of the tooth sticking out of the gums. However, that enamel tapers off and ends where the crown portion of the tooth transitions into the root. The root of the tooth is made up of the same dentin that’s under the enamel layer. This dentin has millions of tiny pores that can quickly communicate hot, cold, and sweet sensations to the underlying nerve in the center of the tooth. The primary way in which tooth roots become exposed is through gum recession due to clenching, grinding, heavy brushing, genetics, trauma, periodontal disease, or one of many other factors.
Traumatic Occlusion
I have about 2mm of gum recession on most of my molars and premolars and I’m convinced that it is due to two causes. When I was in junior high and high school, I regularly used a low-quality, firm-bristled battery-powered toothbrush. But more importantly, all of my posterior teeth were severely slanted inward. It was so bad that when I smiled, you barely saw any of my teeth behind my canines. Like a nail getting pounded into a wooden board, our teeth are well-designed to receive force right down the center of their axis. However, if your teeth are leaning, like mine were, the vertical force of biting and chewing causes the tooth to move in a non-ideal direction. Something similar happens if a person frequently grinds their teeth from side to side. In both cases, traumatic occlusion — how the upper and lower teeth interact — often results in the teeth becoming hyper-sensitive to cold air and other things.
Contraction and Expansion
When transitioning from a hot cup of coffee to freezing air, your mouth and teeth can experience a temperature swing of as much as 120 degrees. These dramatic shifts in temperature can cause our teeth to rapidly expand or contract, which can result in the development of small cracks called craze lines in the enamel. This can be a contributing factor in tooth sensitivity while living in a cold climate. If you stand in front of a mirror and move a flashlight from left to right, you can see some of these craze lines.Metal Fillings or Crowns
Metal contracts and expands much faster than a natural tooth. This means that if our mouth experiences a dramatic swing in temperature, the metal fillings in our teeth can either shrink and pull away from the tooth or expand, creating extra pressure on the surrounding tooth structure. During the winter, this contraction and expansion happens often enough that the affected teeth can become hypersensitive.
Now that we have reviewed the most common causes of tooth sensitivity in winter, let’s talk about the things that can be done to lessen its severity and inconvenience. The first thing that I recommend to my patients is to swap their toothpaste out for a sensitivity toothpaste like Sensodyne or Colgate Sensitive. These kinds of toothpaste have all the promised benefits of your usual toothpaste with an added ingredient that can plug up the millions of pores in your exposed roots. It usually takes a few weeks for the full effect to be noticeable, so be sure to stick with it. Next, if you have teeth that are in traumatic occlusion, the best thing to do would be to have a consultation with an orthodontist to see what could be done to move your teeth into a healthier position. If braces aren’t in the cards, at least speak with your dentist about getting a nightguard which can give your teeth (and the ligaments that support your teeth) an eight-hour break every night. While you’re at it, you can speak to your dentist about two other things. Ask them whether you have any metal fillings that would be wise to replace and if they have a medicament that could be applied to your sensitive tooth roots. There are certain products, like Seal and Protect, that can be bonded to the teeth and provide a few months of sensitivity protection.
As always, our goal at Slate is to help you improve your oral health. In this instance, that means being proactive in protecting and repairing your teeth this winter. Let us know if you have any homemade tricks that have helped with your cold-weather tooth sensitivity!