<s>[INST] Hello doctor, My front upper right tooth spontaneously became extremely sensitive to heat yesterday while drinking hot liquid in the middle of the day. Shortly after, it became painful, primarily when touched or biting. I can also feel some throbbing from the root or gum. Today it is still painful. I am not sure what I could have done, I always brush the area twice a day so I would be surprised if there were decay. I have minor gum recession above the tooth in question. I also had panoramic and 3D X-rays taken a couple of weeks ago for my wisdom teeth, and the images did not display anything unusual going on in the front teeth. I have not bitten anything hard or consciously done any damage to it. What could be going on? Is this just temporary pain or sensitivity? [/INST] Hi. The sensitivity could be due to tooth abrasion. But pain indicates a pulpal or a periodontal pathology (pain due to decay tooth or problem with the gums involving the tooth). An X-ray could probably be of good help in such a situation. Maybe, you had a hit to the tooth previously (even a few years back) it could suddenly cause pain. Or it could be gum recession or any food stuck between the tooth and the gum. It could be trauma from occlusion (a condition in which the affected tooth is damaged due to continuing hard contact with the opposing tooth of the lower jaw when clenching the teeth). So the cause of the pain must be diagnosed to come up with a treatment plan. If it is due to the hard bite, occlusal correction should be enough. If it is sensitivity and gum recession, a deep scaling and/or a local flap surgery procedure should be done. If it is pain due to tooth decay or X-ray suggests a periapical problem, root canal therapy (RCT) should be done. Management depends on the cause of the problem. Visit your dentist for the proper treatment plan. For more information consult a dentist online --> </s>