When a tooth hurts primarily or exclusively when you apply pressure, such as while biting or chewing, it signals a specific problem within the tooth or its supporting structures. This sensation, often described as occlusal pain, is different from the lingering sensitivity caused by temperature changes. The discomfort arises because the forces of biting compress inflamed tissues that are not normally exposed to pressure. The causes range from immediate mechanical issues to serious internal infections.
Structural Damage and Infection
The most concerning causes of bite-triggered pain involve a compromise to the structural integrity of the tooth or the presence of an established bacterial infection. These conditions create internal pressure or movement that is directly aggravated by the force of chewing. Cracked Tooth Syndrome involves a tiny, often invisible fracture that extends into the inner layers of the tooth. When you bite down, the crack’s two segments flex apart momentarily, stimulating the sensitive pulp tissue and causing a sharp discomfort.
If a cavity has gone deep enough to reach the pulp chamber, the resulting inflammation, known as irreversible pulpitis, can also make the tooth sensitive to pressure. The inflamed nerve tissue within the tooth’s rigid confines has nowhere to expand, and the hydraulic pressure exerted through the dentin when you bite irritates the already swollen pulp.
A more advanced stage of infection is a periapical abscess, where bacteria have traveled through the root canal and formed a pus-filled pocket at the root tip in the jawbone. This accumulation of pus creates pressure that pushes the tooth slightly out of its socket, which is why the tooth may feel “high” in the bite. When you chew, the inflamed periodontal ligament (PDL)—the cushion of fibers surrounding the root—is compressed against the bony socket, causing severe, localized pain.
Pressure from Trauma or Recent Procedures
Not all bite sensitivity is due to structural damage or deep infection; sometimes the pain is a temporary result of excessive force or inflammation in the surrounding tissues. Chronic habits like bruxism, which involves unconscious clenching or grinding of the teeth, can strain the periodontal ligament, leading to what is sometimes called a “sprained tooth.” This repeated overloading causes the PDL fibers to become inflamed and sore, resulting in a dull, generalized ache and sensitivity when chewing.
A temporary, but sharp, cause of bite pain can occur after a recent dental restoration, such as a new filling or crown. If the restoration is slightly higher than the natural tooth surface, it will hit prematurely when the jaws close, creating an uneven distribution of force. This excess pressure overloads the periodontal ligament and can cause intense, localized pain upon contact, but the problem is resolved by adjustment.
In the upper jaw, pain that feels like a toothache on pressure may be referred pain from the maxillary sinuses. The roots of the upper molar and premolar teeth sit directly beneath the floor of the maxillary sinus cavity. When the sinus lining becomes inflamed due to an infection or allergies, the resulting fluid buildup increases pressure within the cavity. This pressure is then transmitted downward onto the tooth roots and their nerve pathways. This sinus-related pain often affects multiple upper teeth on one side and typically worsens when you bend over or move your head suddenly.
Immediate Relief and Professional Consultation
While professional diagnosis is necessary to address the root cause of pressure-induced tooth pain, certain steps can be taken for temporary relief. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, are often the most effective over-the-counter choice because they target both pain and the underlying inflammation that exacerbates pressure sensitivity. A warm salt water rinse can also help soothe irritated gum tissue and temporarily clean the area around a sensitive tooth.
You should immediately stop chewing on the painful side to prevent further irritation or crack propagation, and a cold compress applied to the cheek can help reduce external swelling. However, these measures only mask the symptoms; they do not treat the underlying cause. An untreated abscess or crack can lead to serious complications and even tooth loss.
It is important to seek emergency dental care if your pain is accompanied by:
- Severe facial swelling
- A fever
- An inability to swallow
- Pain so intense that it disrupts your sleep and does not respond to medication
When you call your dentist, be prepared to describe the pain precisely, noting whether it is a sharp jab upon release of pressure, a dull, constant ache when biting, or if it is worsening over time.