A tooth aching when pressure is applied is a common dental symptom, often signaling an underlying issue within the tooth structure, surrounding gums, or bone. This discomfort can range from a dull ache to a sharp pain, typically worsening when biting, chewing, or touching the affected area.
Common Causes
Tooth decay, specifically deep cavities, frequently causes pain when pressure is applied. As bacteria erode enamel and dentin, they can reach the tooth’s innermost layer, the pulp. Pressure on the compromised tooth can then irritate the inflamed pulp, causing discomfort.
A dental abscess or infection at the tooth’s root tip can also manifest as pain with pressure. This occurs when bacteria infect the pulp and spread into the bone surrounding the root, forming a pocket of pus. The accumulation of pus creates localized pressure within the jawbone, which intensifies when external forces like biting are applied to the tooth.
Gum disease, particularly advanced periodontitis, contributes to tooth sensitivity under pressure. Chronic inflammation and infection destroy the supporting bone and ligaments around the teeth, leading to tooth mobility. When a tooth is loose due to this support loss, biting pressure can cause it to shift slightly, irritating the compromised periodontal tissues and bone.
Cracked tooth syndrome involves a fracture in the tooth that is often microscopic and difficult to detect visually. When pressure is applied, such as during chewing, the crack can flex or open, causing a sharp, fleeting pain as the underlying dentin or pulp is momentarily exposed. This pain subsides immediately after the pressure is released.
Bruxism, the involuntary grinding or clenching of teeth, exerts excessive and prolonged force on the teeth and their supporting structures. This constant pressure can lead to inflammation of the periodontal ligaments, muscle soreness, and even small fractures. Consequently, the teeth may become sensitive and painful when subjected to normal chewing forces.
Sinus infections can cause referred pain to the upper back teeth, making them sensitive to pressure. The roots of upper molars and premolars are anatomically close to the maxillary sinuses. When inflamed or fluid-filled, pressure transmits to tooth roots, mimicking dental pain upon biting or tapping.
Recent dental work, such as a new filling or crown, can sometimes lead to temporary sensitivity to pressure. This post-operative discomfort results from inflammation of the pulp due to the dental procedure itself. The sensitivity typically resolves within a few days to weeks as the tooth recovers.
Trauma or injury, such as a direct blow to a tooth, can cause internal damage to the pulp or periodontal ligament, even without visible external signs. The impact can lead to inflammation or bruising, making the tooth highly sensitive to any pressure, including light touch or chewing.
When to Seek Professional Help
Seek prompt professional dental attention if tooth pain under pressure persists or worsens. Severe pain not subsiding with over-the-counter pain relievers indicates a serious issue needing immediate evaluation. Swelling in the gums, face, or jaw, especially with redness or warmth, suggests an active infection needing urgent treatment.
A fever or malaise alongside tooth pain can signify a spreading infection needing prompt medical and dental intervention. Difficulty opening the mouth, chewing, or swallowing may indicate a severe infection, possibly an abscess. Pain radiating to other parts of the head or neck, such as the ear or temple, suggests nerve involvement or a widespread inflammatory process.
Visible signs of infection, such as pus discharge from the gums or a small pimple-like bump near the tooth, indicate an abscess. Any tooth pain from recent trauma, even if minor, warrants immediate dental assessment to rule out hidden fractures or internal damage. Ignoring these symptoms can lead to more extensive damage, infection spread, and systemic health complications.
Temporary Relief Measures
While waiting for a dental appointment, several temporary measures can help alleviate tooth pain caused by pressure:
- Take over-the-counter pain relievers, such as ibuprofen or acetaminophen, to reduce inflammation and discomfort. Follow dosage instructions for safe use.
- Rinse your mouth with warm salt water several times a day. Mix about half a teaspoon of salt in eight ounces of warm water and swish gently before spitting.
- Apply a cold compress to the outside of the cheek near the affected area to numb pain and reduce swelling. Use an ice pack wrapped in a cloth for 15-20 minutes at a time.
- Avoid chewing on the affected side of the mouth to prevent further irritation and allow the tooth to rest.
- Opt for soft foods, such as mashed potatoes, yogurt, or soups, to minimize pressure on the painful tooth during meals.
- Limit consumption of extremely hot, cold, sugary, or acidic foods and beverages to reduce sensitivity and prevent exacerbating the pain.
These measures offer symptomatic relief but do not address the root cause of the pain, making professional dental care necessary for a lasting solution.
Professional Diagnosis and Treatment
Upon visiting a dentist for tooth pain under pressure, diagnosis begins with a thorough dental examination. The dentist will visually inspect the affected tooth and surrounding gums, gently probe tooth surfaces, and often tap lightly to assess sensitivity and pinpoint pain. This physical examination provides initial clues about the problem.
Dental X-rays are routinely taken for a detailed view of the tooth’s internal structure, roots, and surrounding bone. Periapical X-rays show the entire tooth, detecting abscesses or bone loss. Bitewing X-rays reveal decay between teeth or under fillings, while 3D scans may be used for complex cases like suspected fractures or widespread infection.
Vitality testing is performed to assess the pulp’s health. This involves applying a cold stimulus, like a cotton pellet sprayed with refrigerant, or using an electric pulp tester to determine if the nerve is alive. These tests help differentiate between inflammation, irreversible damage, or necrosis of the pulp.
Treatment options are tailored to the diagnosis. For tooth decay or minor cracks, a dental filling is often sufficient to restore the tooth and eliminate sensitivity. Larger cavities or fractures may require a dental crown, which encases the tooth for strength and protection. If deep decay or infection has reached the pulp, root canal treatment removes infected tissue to save the tooth.
If a tooth is severely damaged or infected beyond repair, extraction may be the only option. Gum treatments, such as scaling and root planing, treat periodontitis by removing plaque and tartar below the gum line and reducing inflammation. Antibiotics may be prescribed for active infections, often with other treatments, to eliminate bacteria. For bruxism, a custom-fitted night guard can protect teeth from grinding forces. If sinus issues are the cause, a referral to an ENT specialist may be made for medical management.