Tooth pain is typically a persistent ache that worsens with stimulus. However, a confusing symptom emerges for many people: the severe pain momentarily lessens when they gently bite down or apply steady pressure to the affected tooth. Understanding why this phenomenon occurs involves looking closely at the complex anatomy of the tooth and the surrounding tissues. The relief is not a sign of healing, but rather a deceptive neurological and mechanical response to a serious underlying issue within the tooth structure.
Understanding Pressure Relief
Temporary comfort from pressure is partly due to how the nervous system prioritizes sensory signals. This response relates to a concept where a non-painful sensation can override or block a pain signal from reaching the brain. Applying force to the tooth activates specialized nerve fibers that transmit touch and pressure information much faster than the slower fibers that relay the dull, aching pain signals. By stimulating these faster pathways, the pressure sensation effectively distracts the brain from the original discomfort, providing a brief respite.
The periodontal ligament (PDL), a mechanical structure surrounding the tooth root, is a dense network of fibers and sensory nerve endings that acts as a shock absorber, anchoring the tooth to the jawbone. When the tooth is inflamed, the tissue around the root tip swells, causing the tooth to feel slightly elevated in its socket. Applying pressure momentarily stabilizes the tooth within the socket and compresses the fluid-filled space, temporarily reducing internal pressure.
Underlying Causes of the Symptom
The discomfort temporarily relieved by biting down is most often a sign of advanced internal inflammation within the tooth’s core, known as the dental pulp. The pulp contains the nerves, blood vessels, and connective tissue, encased within the hard dentin walls. When decay or trauma causes irreversible pulpitis, the inflammation and swelling occur in this rigid, confined space. The pressure build-up inside the chamber is the primary source of the intense, spontaneous throbbing pain.
As the inflammation progresses, the pulp tissue begins to die (necrosis), and an infection may spread beyond the root tip into the jawbone. This leads to the formation of a periapical abscess, a pocket of pus that collects at the root end. The pressure from this accumulating fluid causes constant, severe pain. Applying pressure essentially squeezes this inflamed tissue or fluid, momentarily pushing it into surrounding bone marrow and relieving pressure on the nerve endings.
The relief suggests the infection has involved the tissues surrounding the tooth root. This change in sensation indicates a shift in the pathology from pain originating solely in the pulp to pain originating in the surrounding bone and ligament. This type of pain is a strong indicator that the internal damage is severe and will not resolve.
Necessary Next Steps and Treatment Options
This temporary comfort should not be mistaken for the problem resolving itself, as the underlying infection will continue to spread. A dentist will perform a thorough examination, including taking X-rays to visualize the bone around the root tip for signs of an abscess or inflammation. They will also use pulp vitality tests, such as applying cold or an electrical stimulus, to determine the health status of the internal pulp tissue.
If the diagnosis confirms irreversible pulpitis or the presence of a periapical abscess, the primary goal of treatment is to remove the source of the infection. The most common treatment to save the tooth is Root Canal Therapy. This procedure involves accessing the pulp chamber, removing the infected or necrotic tissue, thoroughly cleaning and disinfecting the internal canal system, and then sealing the space to prevent future bacterial re-entry.
In cases where the tooth structure is too compromised by decay or fracture, or if the infection is too severe, the alternative treatment is tooth extraction. Before your dental appointment, manage the discomfort by taking over-the-counter anti-inflammatory medications, avoiding chewing on the affected side, and applying a cold pack to the outside of the cheek.