When a tooth aches specifically when you bite down, it can be an unsettling experience. This sensation often signals an underlying issue within the tooth structure or surrounding tissues. Understanding this pain helps individuals recognize potential problems and seek appropriate care.
Why Your Tooth Hurts When Biting
Tooth decay, a cavity, can cause pain when biting. As bacteria produce acids, they erode the hard outer enamel and the softer dentin layer beneath. Biting pressure can stimulate nerve endings within exposed dentin, leading to discomfort. Deeper decay increases this pain.
Cracked tooth syndrome involves tiny fractures, often invisible during examination. When you bite down, the crack can flex or spread open, momentarily stimulating the pulp. Releasing the bite can cause a sharp, fleeting pain as the crack snaps back into place. Discomfort can be inconsistent and hard to pinpoint.
Dental abscesses or infections at the tooth’s root or within the surrounding gum tissue cause throbbing pain that intensifies with biting. Infection causes inflammation and pus, creating pressure within the bone or tooth. Biting directly presses on this inflamed area, increasing discomfort. Pain feels localized and constant, even without biting.
Gum disease, specifically periodontitis, contributes to biting pain. As gum tissue recedes due to inflammation, sensitive root surfaces become exposed. Lacking enamel, these root surfaces are vulnerable to biting pressure. Inflammation in supporting bone and ligaments can also make the tooth feel loose or sore under chewing forces.
Compromised dental fillings and restorations can cause biting pain. A filling that has worn down or cracked can expose underlying dentin, irritating the tooth’s interior. A poorly sealed filling can allow new decay underneath, creating a void that collapses under pressure. An uneven or high filling can also create premature contact, placing excessive force on a tooth during biting.
Bruxism, the habitual grinding or clenching of teeth, exerts excessive force on dental structures. This chronic stress can lead to microfractures in the enamel and dentin, making teeth more sensitive to biting. The continuous pressure can also inflame the ligaments that hold the tooth in its socket, causing soreness and pain that worsens with chewing. Jaw muscles can also become fatigued and tender, radiating pain to the teeth.
Pulpitis, inflammation of the tooth’s pulp, can cause pain when biting. The pulp contains nerves and blood vessels. When this tissue becomes inflamed, due to deep decay, trauma, or repeated dental procedures, pressure applied to the tooth can compress the swollen pulp. This irritates nerve endings, leading to a dull ache or sharp pain when biting.
When to See a Dentist
Persistent or worsening tooth pain when biting requires professional evaluation. Ignoring such symptoms can allow underlying issues to progress, leading to more complex problems. Immediate attention is advisable if the pain becomes constant or interferes with daily activities.
Symptoms like visible swelling in the face or gums, fever, or pus around the tooth indicate possible infection. These signs suggest a severe issue requiring prompt dental intervention. Delaying treatment for an infection can lead to its spread to other areas of the body.
If you notice visible damage to the tooth, such as a chip or a crack, consult a dentist. Even small fractures can deepen over time, compromising the tooth’s integrity. Lingering sensitivity to hot or cold temperatures, especially after the stimulus has been removed, can also signal a deeper problem needing professional assessment.
How Dentists Diagnose and Treat
Diagnosing the cause of biting pain begins with a visual examination of the affected tooth and surrounding gums. The dentist will look for signs of decay, cracks, or swelling. Dental X-rays, such as bitewing or periapical images, are taken to visualize the tooth’s internal structure and root areas, identifying cavities, abscesses, or bone loss.
Diagnostic tests help pinpoint the specific tooth and problem. A percussion test involves gently tapping the tooth to assess sensitivity, while biting tests use a special instrument to identify pain upon biting down or releasing pressure. Temperature sensitivity tests with cold or hot stimuli can also reveal pulp inflammation. These steps provide a comprehensive picture of the tooth’s condition.
Treatment options vary depending on the diagnosed cause. For cavities, the decayed portion of the tooth is removed and replaced with a dental filling, restoring its structure and function. Teeth with significant cracks or extensive damage may require a dental crown, which encases the tooth to provide strength and protection from biting forces.
Root canal therapy is performed when pulp is infected or severely inflamed. This procedure involves removing the damaged pulp, cleaning and sealing it to prevent further infection. If a tooth is irreparable due to severe decay or fracture, extraction may be the only viable option. Gum disease is treated with scaling and root planing, deep cleaning procedures that remove plaque and tartar below the gumline. For bruxism, a custom-fitted night guard can protect teeth from grinding forces during sleep, alleviating related pain.