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Advanced cosmetic and general dentistry

My First Premolar Tooth Is Sensitive to Cold

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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.

Jaw swelling is worse after a tooth extraction

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My bottom right second molar was hurting on and off for a few months. My jaw started swelling, so I finally went to a dentist. And a little over a week ago, the dentist extracted my bottom right second molar. Before I left the dental office, my doctor gave me an amoxicillin prescription. I’ve been taking the medicine, but the infection and pain are worse. The swelling in my jaw is large and hard. Do I need to ask for a stronger dose of amoxicillin before Io lose the tooth? Thank you. Reuben

Reuben,

Although amoxicillin often works well for tooth infections, your infection is not improving. It’s getting worse. Many infections have a bacterial strain with amoxicillin resistance. That is likely the case with your infection.

Infections in the jaw can become severe, spread elsewhere in your body, and become life-threatening.

Signs and symptoms that the infection is spreading:

  • Diarrhea
  • Dizziness
  • Fatigue
  • Fever, including sweating or chills
  • Headache
  • Nausea
  • Rapid heart rate
  • Stomach pains
  • Swelling that makes it difficult to open your mouth, swallow, or breathe
  • Vomiting
Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Treating a severe jaw infection is the priority. A dental implant can replace a lost tooth.

Call your dentist immediately and request a different antibiotic that will help your body fight the infection. Don’t delay getting the prescription filled and taking the new medicine right away. If your symptoms get worse, go to an emergency room.

The effects on your overall health are at risk. If you lose the tooth, you can visit an implant dentist to replace it. But for now, it is essential to get the infection under control.

Michael Szarek, DMD, of Lowell, MA, sponsors this post.