A toothache experienced specifically when biting down is a common and often distressing dental issue. This type of pain acts as a signal, indicating that something is amiss within the tooth itself or in the surrounding oral structures. Understanding this pain is an important first step toward addressing the underlying problem.
Why Biting Down Causes Pain
Several conditions can lead to discomfort when pressure is applied to a tooth. Cracked tooth syndrome is a common reason, where a tooth has an incomplete fracture that might not be visible, yet causes sharp pain, especially when releasing biting pressure or when biting on certain foods. These cracks can range from hairline splits to deeper fractures and often result from chewing on hard items, teeth grinding, or large fillings.
Dental cavities, or tooth decay, can also cause pain when biting. If decay progresses deep enough to reach the tooth’s inner pulp, which contains nerves and blood vessels, the pressure from biting can irritate these sensitive tissues. Similarly, a loose or damaged filling or crown can expose the underlying tooth structure, leading to sensitivity and pain when chewing. The movement of the restoration under biting force can also directly stimulate the tooth.
Pulpitis, which is the inflammation of the tooth’s inner pulp, commonly results in pain when biting down. This inflammation often stems from deep cavities, trauma, or even repeated dental procedures, causing pressure on the nerves within the tooth. If pulpitis is severe and irreversible, the pain can be more intense and persistent. Periodontal disease, an infection of the gums and supporting bone, can also cause pain when biting by weakening the structures that hold the tooth in place.
Dental abscesses, which are pockets of pus caused by bacterial infections, frequently lead to severe, throbbing pain when biting. The accumulation of pus creates pressure within the jawbone or soft tissues, intensifying the pain with chewing. Bruxism, or teeth grinding and clenching, exerts excessive force on teeth, leading to worn enamel, fractured teeth, and jaw muscle pain, all of which can manifest as discomfort when biting. Referred pain from issues like sinus infections or temporomandibular joint (TMJ) dysfunction can also cause a sensation of tooth pain.
Steps for Immediate Relief
While professional dental care is necessary for a lasting solution, several immediate steps can help alleviate the pain temporarily. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can reduce pain and inflammation. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), is often particularly effective if swelling is present.
Applying a cold compress to the outside of the cheek can help numb the painful area and reduce swelling. It works by constricting blood vessels, which can lessen the severity of the pain. Rinsing the mouth with warm salt water can provide temporary relief by reducing inflammation and helping to cleanse the area. Mix about half a teaspoon of salt into eight ounces of warm water and swish for approximately 30 seconds.
Avoid chewing on the affected side of the mouth and stick to soft foods to minimize pressure on the painful tooth. Keeping the area clean by gently brushing and flossing can help remove any food particles that might be exacerbating the discomfort. These measures offer symptomatic relief but do not address the underlying cause of the pain.
When to See a Dentist and What to Expect
It is important to seek professional dental attention if tooth pain when biting persists for more than a day or two, worsens, or is accompanied by other symptoms. Urgent signs include severe, throbbing pain, facial or jaw swelling, fever, or difficulty opening your mouth. These symptoms can signal a spreading infection requiring prompt treatment.
During a dental visit, the dentist will conduct a thorough examination and ask about the nature of your pain. Diagnostic procedures may include dental X-rays to visualize the tooth’s internal structures and surrounding bone, and sensitivity tests to pinpoint the exact tooth and nerve response. The dentist might also use a bite test or a dental explorer to identify cracks or areas of sensitivity.
Treatment options depend on the diagnosis. For cavities, a dental filling removes decay and restores the tooth. Larger cavities or fractures might require a dental crown, a cap placed over the entire tooth to strengthen it.
If the pulp is infected or severely inflamed, a root canal procedure may be necessary to remove the infected tissue and save the tooth. If the tooth cannot be saved due to severe damage or infection, extraction may be the only option. For pain related to teeth grinding, a custom-fitted nightguard can protect the teeth from further damage.
Preventing Future Tooth Pain
Maintaining good oral hygiene helps prevent future tooth pain. Regular dental check-ups and professional cleanings are important for detecting and addressing potential issues early, before they become painful.
Daily oral hygiene practices, such as brushing twice a day with fluoride toothpaste and flossing once a day, help remove plaque and food particles that contribute to decay and gum inflammation. This consistent care minimizes the risk of cavities and periodontal disease, both of which can cause pain when biting. Avoiding chewing on hard objects like ice, popcorn kernels, or pens can help prevent cracks and fractures in teeth.
If teeth grinding (bruxism) is a concern, wearing a custom-fitted mouthguard, especially at night, can protect teeth from the damaging forces of clenching and grinding. These guards create a barrier between the upper and lower teeth, distributing pressure evenly and reducing wear. A balanced diet, low in sugary foods and drinks, also supports overall oral health by limiting the fuel for bacteria that cause tooth decay.