My upper left first premolar tooth is sensitive to cold and air. My dentist’s diagnosis with the air test was too fast. She did not tell me what had been causing the sensitivity. I fear an infection will affect the porcelain veneer tooth in front of it. Addison from Tacoma, WA

 

Addison,

Sensitivity in a tooth can be easy to diagnose, and an air test is the primary way to assess it. At other times, it is more complicated

Air Test for Tooth Sensitivity

An air test helps a dentist identify unprotected and sensitive areas. A dentist may apply a desensitizing bonding agent to coat the tooth and minimize sensitivity.

What Causes Tooth Sensitivity to Cold?

The cause of tooth sensitivity depends on several factors, including the type of pain and the tooth’s condition.

Type of pain

1. Brief pain – Irritated tooth pulp or nerves can cause brief pain. The irritation will heal.
2. Lingering pain – A tooth infection causes lingering pain. Your dentist may recommend root canal treatment.
3. Pain around a tooth filling – Bacteria can leak in any space between a tooth and the filling, causing sensitivity.

Tooth condition

1. New filling – It is normal to feel sensitivity after a new tooth filling. But if bacteria from tooth decay is left behind during the filling process, the tooth can become infected. Root canal treatment will remove the infection.
2. Tooth decay – Decay or infection can cause sensitivity to heat or cold. It will not spread and infect your porcelain veneer tooth if a dentist catches the decay and treats it.
3. Fracture – A fracture from trauma or wear can irritate tooth nerves and cause sensitivity. Untreated pulp damage can require root canal treatment and a dental crown.
4. Gum recession – If your gums pull away from a tooth, it can be sensitive to cold or heat. You can use desensitizing toothpaste, or a dentist may recommend a gum graft or another technique to restore gum tissue.
5. Worn tooth enamel – Worn tooth enamel exposes dentin (the layer beneath the enamel). Dentin contains small tubes that lead to tooth nerves that can become sensitive.

Dr. Michael Szarek, an accredited cosmetic dentist in Lowell, Massachusetts, sponsors this post.