Experiencing pain when biting down can be an unsettling sensation, signaling an underlying oral health issue. Understanding the potential origins of this pain is the first step toward finding relief and preserving your dental well-being.
Direct Dental and Gum Issues
Cracked tooth syndrome, involving tiny, often invisible cracks in the tooth’s enamel and dentin, is a common cause of pain when biting. These cracks can extend into the pulp chamber, irritating nerve endings. Pain often occurs when pressure is applied and then released, as the crack segments move, causing sharp, fleeting discomfort. This condition commonly affects molars and premolars and can be challenging to diagnose.
Tooth decay, or cavities, can also lead to pain when biting. As bacteria erode the outer enamel and dentin, they expose sensitive inner layers of the tooth. Large cavities may trap food, causing pressure and pain. Advanced decay can irritate the dental pulp, causing pain with biting or chewing.
A dental abscess or infection is another source of pain. This occurs when bacteria invade the tooth’s pulp, typically through a deep cavity, chip, or crack, leading to a pocket of pus at the root tip or in the gums. The accumulation of pus creates pressure, causing severe, throbbing pain that worsens with chewing or biting. If left untreated, such infections can spread to surrounding bone and tissues.
Faulty or “high” fillings and crowns can cause pain when biting. If a newly placed restoration sits slightly higher than the natural bite, it creates uneven pressure points, leading to soreness and pain. This sensation is often most noticeable immediately after the dental procedure once anesthesia wears off. A dental professional can adjust the bite to alleviate this pressure.
Gum disease can expose sensitive tooth roots or destabilize teeth, leading to pain when biting. As gum recession occurs due to inflammation or aggressive brushing, the roots become vulnerable. This exposure makes them sensitive to pressure, temperature changes, and can increase the risk of decay.
Bite-Related Problems and Habits
Bruxism, the habitual grinding or clenching of teeth, puts excessive stress on the teeth, jaw muscles, and temporomandibular joints (TMJ). This chronic force can lead to soreness, pain, and wear on the teeth, often causing pain when biting or chewing. Bruxism can occur unconsciously, particularly during sleep, and is frequently linked to stress and anxiety.
An improper alignment of teeth, known as malocclusion or a “bad bite,” can cause pain when biting. When teeth do not fit together correctly, certain teeth may bear too much force during chewing, leading to uneven pressure distribution. This can result in inflammation within the pulp chamber, wear down enamel, or even cause teeth to chip or crack over time.
Non-Dental and Referred Pain
Sometimes, tooth pain when biting can originate from areas outside the teeth themselves. Sinusitis, an inflammation of the maxillary sinuses, can cause referred pain to the upper back teeth because the roots of these teeth are located very close to or sometimes extend into the sinus cavity. Pressure from inflamed sinuses can mimic a toothache, often affecting several upper teeth rather than just one.
Temporomandibular joint (TMJ) disorders, affecting the jaw joints connecting the jawbone to the skull, can lead to referred pain in the teeth. When the TMJ is irritated or misaligned, pain can radiate to surrounding areas, making it feel like the pain is in the teeth. Pain can occasionally originate from other distant areas, such as the ear or neck, and be perceived as tooth pain due to shared nerve pathways.
When to Seek Professional Care
Persistent tooth pain, especially when biting down, warrants a visit to a dental professional for accurate diagnosis and treatment. Signs to seek professional evaluation include:
Pain that lasts more than a day or two
Pain that does not subside with over-the-counter pain relievers
Swelling in the face or jaw
A fever
Red or swollen gums
A bad taste or smell in the mouth
Difficulty opening your mouth wide
Only a dental professional can accurately diagnose the underlying cause of your pain. During an examination, the dentist will ask about your symptoms, including the pain’s severity, duration, and triggers. They will perform a thorough oral exam, checking for signs of infection, inflammation, or damage. Diagnostic images, such as X-rays, provide detailed views of teeth and bones, helping to pinpoint problems not visible to the naked eye. Treatment options vary depending on the diagnosis and may include fillings for cavities, dental crowns for larger damage, root canal therapy for infections, or bite adjustments for alignment issues. In some cases, a tooth extraction may be necessary as a last resort if a tooth is beyond repair.