Teeth pain when biting down is a common and often concerning symptom. This discomfort can range from a dull ache to a sharp, intense sensation, indicating various underlying issues within the oral cavity. Understanding the potential causes of this pain is the initial step toward finding appropriate relief and preventing further complications.
Common Causes of Pain When Biting
One frequent reason for pain when biting is Cracked Tooth Syndrome. This occurs when a tooth develops a fracture or crack, often too small to be easily seen, extending into the dentin or pulp. When biting, the crack flexes, causing sudden, sharp pain as fluid stimulates the nerve.
Dental cavities, or tooth decay, also commonly cause pain when biting. As decay progresses through the enamel into the softer dentin, it exposes microscopic tubules leading to the sensitive pulp. Pressure from biting can push food or liquid into these areas, triggering a painful nerve response.
Gum disease, specifically periodontitis, can lead to biting pain by compromising the tooth’s support system. Inflammation and infection damage the ligaments and bone holding the tooth in place, making it feel loose or sensitive to pressure. Biting then stresses these weakened structures, resulting in discomfort.
A dental abscess, an infection at the root tip or in the gum, creates a collection of pus that exerts pressure on surrounding nerves and bone. This pressure intensifies when biting, leading to throbbing, persistent pain that sharpens with direct force.
Bruxism, or habitual teeth grinding or clenching, places excessive forces on teeth. This constant pressure can lead to tooth sensitivity, microfractures, and jaw muscle soreness, all manifesting as pain when biting.
Temporomandibular Joint (TMJ) disorders involve dysfunction in the jaw joints and surrounding muscles. While not directly tooth-related, TMJ disorders can cause referred pain that feels like it originates in the teeth, especially during chewing or biting. Misalignment or inflammation in the joint can transmit discomfort to the dental arches.
Sinus infections can also present as tooth pain, particularly in the upper back teeth. The roots of these teeth are often close to the maxillary sinuses. When sinuses become inflamed and filled with fluid, pressure can press on tooth root nerve endings, leading to a generalized ache that worsens with biting or head movements.
Finally, worn or faulty dental work, such as old fillings or crowns, can contribute to biting pain. Over time, fillings can wear down, crack, or develop gaps, allowing bacteria and food particles to reach sensitive tooth structures. A high or improperly seated crown can also create uneven bite forces, leading to localized pain or discomfort.
Immediate Steps and When to See a Dentist
When experiencing pain upon biting, several immediate steps can offer temporary relief. Rinsing your mouth with warm salt water can help reduce inflammation and clean the area, potentially easing discomfort. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can also help manage the pain temporarily. Avoiding hard, chewy, or extremely hot or cold foods can prevent further irritation to the affected tooth. Applying a cold compress to the outside of your cheek near the painful area may also help reduce swelling and numb the sensation.
It is important to recognize when professional dental attention is necessary. If the pain is severe, persistent, or lasts for more than a day or two, a dental visit is warranted. Other warning signs include visible swelling in the gums or face, a fever, difficulty opening your mouth fully, or a visible crack or chip in a tooth. Ignoring persistent pain can lead to more serious complications requiring dental intervention.
How Dentists Diagnose the Cause
Dentists follow a systematic process to pinpoint the exact cause of pain when biting. The diagnostic journey often begins with a detailed discussion of the patient’s symptoms, including the type of pain (sharp, dull, throbbing), its duration, and what triggers or alleviates it. This initial conversation provides valuable clues about the underlying issue.
A thorough clinical examination follows, involving visual inspection of the teeth and gums for signs of decay, cracks, or swelling. The dentist may use a small instrument to gently tap on individual teeth or ask the patient to bite down on a cotton roll or specific biting tool to isolate the painful tooth. Palpation of the jaw muscles and gums can also reveal areas of tenderness or swelling.
Imaging techniques are employed to provide a deeper view. Dental X-rays, such as periapical or bitewing radiographs, can reveal cavities, bone loss around the roots, or signs of infection like an abscess. In complex cases, a cone-beam computed tomography (CBCT) scan might provide a detailed 3D view of the teeth and surrounding structures. Pulp vitality tests, using cold or heat, assess the health and responsiveness of the tooth’s nerve. If the source of pain remains elusive, the dentist might use selective anesthesia, numbing one tooth at a time to narrow down the origin of the discomfort.
Effective Treatment Approaches
Once the cause of biting pain is diagnosed, various treatment approaches are available, tailored to the specific condition. For dental cavities or minor cracks, a simple filling can restore the tooth’s structure and eliminate sensitivity. If the damage is more extensive, a crown may be placed to encase and protect the tooth from further fracture.
When deep decay, an abscess, or a severe crack has reached the tooth’s pulp, root canal therapy often becomes necessary. This procedure involves removing the infected or inflamed pulp tissue from inside the tooth, cleaning and shaping the root canals, and then filling and sealing them to prevent further infection. For teeth that are severely damaged or infected beyond repair, extraction may be the only viable option to alleviate pain and prevent the spread of infection.
Gum disease treatment involves professional cleaning procedures like scaling and root planing, which remove plaque and tartar deposits from above and below the gum line. Antibiotics may also be prescribed to combat bacterial infections in the gums.
For individuals experiencing pain due to bruxism or certain TMJ disorders, a custom-fitted nightguard or splint can be fabricated. These devices protect the teeth from grinding forces and help reposition the jaw, reducing strain on the joint and muscles.
In cases of acute infection, such as a dental abscess, oral antibiotics may be prescribed to reduce the bacterial load before definitive dental treatment. Sometimes, a referral to a specialist, such as an endodontist for complex root canals, a periodontist for advanced gum disease, or an oral surgeon for difficult extractions, becomes necessary for optimal care.