What the pattern usually means

Sharp, brief pain when you bite or release: often a crack. The tooth flexes under load and the crack opens.

Cold sensitivity that fades in seconds: often exposed root or a leaking filling. Usually treatable without a crown or nerve work.

Cold or hot that lingers for minutes, or aching that comes on by itself: the nerve may be inflamed or dying. This is the one I do not watch.

Soreness that moves around or comes with headaches: often grinding or a high spot in your bite.

What I check at the visit

Most of these take a minute each. Together they usually point to one cause.

• Cold test on the tooth and its neighbors, to see how the nerve responds
• Bite test on each cusp, which finds cracks that X-rays miss
• Percussion, tapping the tooth, which points to inflammation at the root
• X-rays, and a 3D scan when the picture is unclear
• Gum measurements around the tooth, since a gum pocket can mimic a toothache

When we watch, and when we do not

I watch when the tooth responds normally to cold, there is no crack on the bite test, the X-ray is clean, and the pain is mild and explained, often by a high filling we can adjust or a gum pocket we can clean. Watching means a recheck date and clear instructions on what should bring you back sooner.

I do not watch lingering pain, pain that wakes you, swelling, or a crack I can reproduce. Those get treated, because they only move in one direction.

Call today if

We hold same-day time on weekdays. Most emergency exams and X-rays are covered by PPO plans.

• Pain wakes you at night or lingers for minutes after hot or cold
• Any swelling in the gum, cheek or jaw
• A bad taste or a bump on the gum
• Pain on biting that is getting sharper