When a tooth hurts under pressure, it often signals an underlying issue within the tooth structure or surrounding tissues. This common and unsettling sensation can range from a mild ache to sharp pain, indicating various conditions that require attention. Understanding how teeth register pressure and pain is the first step in identifying the potential causes of this discomfort.
How Teeth Sense Pressure
Teeth are complex structures designed to withstand the forces of chewing while also providing sensory feedback. The outermost layer of the tooth above the gumline is the enamel, a hard, protective tissue. Beneath the enamel lies dentin, a softer layer containing microscopic tubules that connect to the tooth’s innermost part, the pulp. The pulp houses nerves, blood vessels, and connective tissue, making it sensitive.
Surrounding the tooth root is the periodontal ligament (PDL), a specialized connective tissue that anchors the tooth to the jawbone. The PDL acts as a shock absorber, distributing chewing forces and protecting the tooth from excessive pressure. It also contains sensory nerve fibers that provide feedback on pressure and position, allowing the tooth to sense pressure. When pressure is applied to a tooth, these interconnected structures work in concert to transmit sensations. Any compromise to these structures can result in pain.
Common Dental Causes
Pain when pressure is applied to a tooth frequently stems from common dental problems:
Tooth decay, or cavities, can cause pain under pressure as bacteria erode the enamel and dentin, exposing the sensitive pulp to stimuli. As decay deepens, it can lead to a painful jolt with every bite.
Cracked tooth syndrome involves an incomplete crack in the tooth. When pressure is applied, such as during chewing, the crack can flex, irritating the pulp and causing sharp, fleeting pain, often experienced upon releasing the biting force. This pain can be inconsistent and difficult to pinpoint to a specific tooth.
A dental abscess or infection occurs when bacteria invade the pulp, leading to a buildup of pus and inflammation within or around the tooth. The pressure from this accumulation of pus can cause severe, throbbing pain, especially when biting down, and may radiate to the jaw or other parts of the face.
Gum disease involves inflammation and bone loss around the tooth. As supporting bone and periodontal ligament are affected, the tooth can become loose and sensitive to pressure during chewing.
Recent dental work, such as fillings or crowns, can also lead to temporary sensitivity to pressure. This discomfort typically subsides within a few days to a couple of weeks as the tooth heals and adjusts. Sometimes, a filling that is too high can cause extra pressure on the treated tooth, leading to pain that may require adjustment.
Bruxism, the habitual grinding or clenching of teeth, exerts excessive force on the teeth and surrounding structures. This constant pressure can lead to inflammation of the periodontal ligament and pain when biting or clenching, often causing tooth sensitivity.
Other Potential Causes
Beyond direct dental issues, some conditions can cause tooth pain under pressure due to their proximity or systemic effects.
Sinus issues, such as a sinus infection (sinusitis), can cause referred pain in the upper teeth. The roots of the upper back teeth are close to the maxillary sinuses, and when these sinuses become inflamed or filled with mucus, the pressure can be felt as a toothache, often affecting several upper teeth at once. This pain may worsen with changes in barometric pressure.
Malocclusion, or an improper bite, occurs when the upper and lower teeth do not align correctly. This misalignment can lead to uneven pressure distribution on certain teeth, causing them to become sensitive or painful over time. The constant, unbalanced strain can also stress the jaw joints and muscles, contributing to discomfort.
When to Seek Dental Care
Recognizing when to seek professional dental care for tooth pain under pressure is important for preventing complications and addressing the underlying cause. While mild sensitivity might resolve, certain signs indicate the need for prompt evaluation.
You should consider a dental visit if the pain is persistent, lasts more than a day or two, or worsens over time. Pain accompanied by swelling in the face or gums, fever, or a foul taste in the mouth are significant indicators of an infection, such as an abscess, which requires immediate attention.
Visible signs of damage, such as a chipped or cracked tooth, or a loose tooth, also warrant a dental examination. Difficulty eating or sleeping due to the pain also signals necessary professional intervention.
During a dental visit, a dentist will typically perform a thorough examination of your teeth, gums, and mouth, often including dental X-rays to visualize internal structures. The dentist may also conduct specific tests, such as a bite test, to identify the exact tooth causing the pain and assess for cracks or heightened sensitivity. These diagnostic steps help pinpoint the cause of the discomfort and guide appropriate treatment.