Hey DrJeff

[Geoff]

A professional opinion since my retired Oral Surgeon father is in an altzheimers lockdown and is no longer available for dental issues....

Today on the hill, I was getting some tooth pain on one of my lower central incisors that felt thermal. It was single digits and I was smiling because the skiing is good. When I used to have an amalgam in the only reconstructed tooth in my mouth, I'd get the same kind of tingle when I put a fork on it. Since I've basically had zero dental problems for my entire life, I don't know if this is a normal part of turning 50 and wearing down enamel or whatever. Is this a "go to a dentist immediately" thing or should I wait and see if I have more issues?

 

[drjeff]

A professional opinion since my retired Oral Surgeon father is in an altzheimers lockdown and is no longer available for dental issues....

Today on the hill, I was getting some tooth pain on one of my lower central incisors that felt thermal. It was single digits and I was smiling because the skiing is good. When I used to have an amalgam in the only reconstructed tooth in my mouth, I'd get the same kind of tingle when I put a fork on it. Since I've basically had zero dental problems for my entire life, I don't know if this is a normal part of turning 50 and wearing down enamel or whatever. Is this a "go to a dentist immediately" thing or should I wait and see if I have more issues?

Geoff, if it's a "go to the dentist immediately" thing most likely depends on the time duration of the pain. Generally speaking when the pain is brought on by cold exposure, and I'll go out on a limb and assume that it wasn't drastically warmer at K today than it was at Mount Snow , if we're talking a short duration (maybe 15-20 seconds tops) pain that tends to be more sharp in it's sensation, the VAST majority of the time it's not a big deal. What that tends to be is whats called root surface sensitivity (this is something where age, unfortunately can be a factor where changes, even very slight ones in the height of one's gumline can essentially expose a now "uninsulated" layer of one's tooth. This part of the tooth, which normally has a layer of gum to act as an insulator, is microscopically very porous(think piece of swiss cheese), and these pores terminate in the center of the tooth where the nerves and blood vessels that supply the tooth reside. What will cause sensation in a tooth is movement of fluid through these tubes to the nerve, and when fluid reaches the nerve, it kicks off the pathway to our brain that lets us know something is going on in our mouths. If the gumline changes and more of this usually gum covered surface is exposed, then more fluid can get to the nerve, and you get what tends to be a short duration, sharp(almost like an electrical shock) pain. Cold tends to bring this type of pain on more than hot, since generally speaking compared to normal mouth temperature, we'll expose ourselves to cold temps that may be 60 to 90 degrees colder than normal mouth temps verses hot wise we usually won't see temps more than 30 to 40 degrees above normal, and the larger the temperature difference, the greater the response. If this is the case, a few days of brushing with a toothpaste such as "Sensodyne" will essentially deposit a chemical insulation layer over the tooth and get things back to normal. In my book, the only time that this type of pain is a true, see your dentist soon emergency, is if it prevents one from being able to consume cold beer Short of one's face being grossly swollen due to infection there is no greater dental emergency in my book than the in ability to consume a cold beer!

Now Geoff, if the pain was much longer lasting(10-15 minutes), and more of an achy sensation than a sharp sensation, then we're starting to get into the "see your dentist soon" situation. Longerlasting, constant, achy pain is much more likely to be associated with a pathological problem with the nerve itself, and tends NOT to be something that will go away on its own. The good thing though, is that usually the type of pain that's due to nerve problems tend to be brought on my heat much more than cold.

My guess would be that this is a no big deal problem. If it really concerns you, probably later this week when the temps looks like they might be ridiculously cold, go get an x-ray and dental exam of that tooth. Otherwise, enjoy the great conditions!

 

[Geoff]

My guess would be that this is a no big deal problem. If it really concerns you, probably later this week when the temps looks like they might be ridiculously cold, go get an x-ray and dental exam of that tooth. Otherwise, enjoy the great conditions!

It's brief. It's thermal. It hasn't happened since. I have a little bit of a head cold so I was breathing out of my mouth more than normal up on the hill. On closer inspection, my gums are a little inflamed at the spot so it's likely as you have described where my gum line receded a little. I haven't been to the hygenist in 7 months and I had full X-Rays done then since my dental/vision flex spending account was about to vaporize. I guess I need to get my ass into the chair to get scraped.

Thanks muchly.

 

[drjeff]

It's brief. It's thermal. It hasn't happened since. I have a little bit of a head cold so I was breathing out of my mouth more than normal up on the hill. On closer inspection, my gums are a little inflamed at the spot so it's likely as you have described where my gum line receded a little. I haven't been to the hygenist in 7 months and I had full X-Rays done then since my dental/vision flex spending account was about to vaporize. I guess I need to get my ass into the chair to get scraped.

Thanks muchly.

Not a problem. Hopefully todays powder helped a bit too!