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Almost every day, I see patients that are concerned because their teeth are sensitive to cold foods and drinks. Sometimes the problem is obvious – like a large cavity that has caused the tooth’s nerve to be nearly exposed. Other times, the pain may be from a cracked tooth.

But, many times, I will see patients who have great, cavity-free teeth that are still struggling with cold sensitivity! Usually, it is younger patients, ranging from 16-40 years old, who have good oral hygiene habits and no decay. Often, these people can not figure out what tooth is bothering them. I will hear, “My teeth are very sensitive to cold”, rather than a specific tooth that hurts.
When I hear a patient relay that many of their teeth are sensitive, I often suspect they are either clenching or grinding their teeth. In dentistry, we call this “bruxism” and it can happen at night while we are asleep or during the day. Mostly, this is a subconscious manifestation of stress, and a habit we develop that we have very little control over.
The pressure from bruxism can cause many problems including: worn, flattened enamel surfaces, broken fillings or crowns, fractured teeth, headaches, facial muscle pain, TMJ symptoms and more.  The cold sensitivity I see is often caused by microfractures of the enamel right near the gumline. Small indentations can be seen on the front of the teeth, often accompanied by gum recession. Even small lesions can cause rather intense hypersensitivity.
I know from experience that this can lead to sensitivity to cold water or air, cold fruits (grapes/watermelon) or foods like ice cream. A patient may also have sensitivity to sweets, especially chocolate and sticky candies like Starburst or Sour Patch Kids. Many people have these symptoms and assume they have a cavity on their teeth, but there is no decay. Instead, I see the early signs of bruxism.
So, what can you do if you may be grinding or clenching? Wearing a nighttime guard can help prevent the damage caused by bruxism. You may also find relief from the symptoms by using a toothpaste like Sensodyne. Desensitizing toothpastes include potassium ions which decrease the tooth nerve’s ability to fire off a pain signal to your brain. Sometimes, fillings are necessary to cover areas where the tooth has fractured due to stress and pressure. The best thing to do if you suspect you are grinding/clenching, is to get a good evaluation by your dentist and make a plan together to treat the cause and symptoms.