Why Does My Tooth Feel Hollow? Causes and What to Do

A sensation of hollowness within a tooth describes a feeling of emptiness, unusual pressure, or heightened sensitivity. While a tooth cannot become truly hollow, this perception indicates underlying changes or issues.

Understanding Tooth Sensation

A tooth’s ability to feel sensations stems from its intricate internal structure. The outermost layer is the hard enamel, which protects the tooth’s crown. Beneath the enamel lies dentin, a porous material containing microscopic tubules that extend towards the pulp. The pulp is the innermost part of the tooth, housing nerves, blood vessels, and connective tissue.

When external stimuli, such as temperature changes or pressure, bypass the protective enamel or cementum, they can reach the dentin. These stimuli travel through the dentinal tubules directly to the nerve endings within the pulp, translating inputs into sensations.

Primary Reasons for a Hollow Sensation

One common reason for a perceived hollow sensation is dental caries, commonly known as cavities. When decay erodes the hard enamel and progresses into the softer dentin, it creates a physical space within the tooth. This erosion can expose the sensitive dentin, leading to increased sensitivity to hot, cold, or sweet stimuli.

Cracked or fractured teeth can also cause a hollow feeling. Even hairline cracks, which may not be visible to the naked eye, can extend through the enamel and dentin, exposing the sensitive inner layers of the tooth. When pressure is applied to a cracked tooth, such as during chewing, fluids can move within these cracks and stimulate the pulp, leading to sharp pain. This exposure makes the tooth vulnerable to external irritants.

Gum recession, where the gum tissue pulls back from the tooth, exposes the root surface. Unlike the crown, the root is covered by cementum, a thin layer that is less protective than enamel, and directly overlies the dentin. When this dentin is exposed, it becomes highly susceptible to external stimuli like cold air or brushing. This direct exposure of sensitive dentin can lead to a feeling of hollowness or heightened sensitivity in the affected tooth.

General tooth sensitivity, also known as dentin hypersensitivity, can manifest as a hollow sensation. This condition occurs when dentin is exposed due to enamel wear or gum recession, allowing external stimuli to reach the nerves through the dentinal tubules. Triggers like cold drinks, hot foods, or even sweet and sour items can cause a sharp, temporary discomfort. This widespread exposure of tubules can make multiple teeth feel affected.

Other Contributing Factors

A dental abscess, an infection at the root of a tooth or in the surrounding gum tissue, can lead to a sensation of hollowness. The accumulation of pus and inflammation creates significant pressure within the bone or tooth. This internal pressure results in a throbbing pain or a feeling of fullness. The infection can cause swelling and discomfort.

Sinus issues, particularly inflammation or pressure in the maxillary sinuses, can cause referred pain that mimics a toothache or a hollow feeling in the upper back teeth. The roots of the upper teeth are in close proximity to the maxillary sinuses. When the sinuses are congested or inflamed, the pressure can be transmitted to these tooth roots, leading to discomfort that is often mistaken for a dental problem. This referred pain can manifest as a dull ache.

Bruxism, the habitual grinding or clenching of teeth, can contribute to a hollow sensation. Chronic clenching and grinding can wear down the protective enamel layer, exposing the underlying dentin. This constant stress can also lead to micro-fractures in the tooth structure, making the teeth more susceptible to sensitivity and discomfort. The repeated force from bruxism can also irritate the dental pulp, causing inflammation.

Recent dental procedures can temporarily cause a hollow or sensitive feeling. After procedures like fillings, crowns, or root canals, the tooth and surrounding tissues need time to heal and adjust. It is common to experience some sensitivity or an unusual sensation as the tooth recovers from the procedure. This feeling typically subsides as the tooth settles into its new state and the surrounding tissues heal.

When to Seek Dental Care

Any persistent or concerning sensation of hollowness in a tooth warrants professional dental evaluation. A dentist can accurately diagnose the underlying cause of the sensation. Signs that indicate a need for immediate dental attention include severe or throbbing pain, visible swelling around the tooth or jaw, or the presence of a fever alongside tooth discomfort. Difficulty chewing or persistent sensitivity to temperature also signal that a dental visit is necessary.

During a dental visit, the dentist will conduct a thorough oral examination of the affected tooth and surrounding areas. This examination includes taking dental X-rays, which can reveal issues not visible during a visual inspection, such as deep decay, bone loss, or abscesses. Sensitivity tests may also be performed to pinpoint the exact tooth and nerve response, helping to determine the extent of the problem. Ignoring a persistent hollow sensation can lead to the progression of underlying dental issues, potentially resulting in more complex and extensive treatments later on.