Experiencing tooth pain specifically when you bite down is a common dental complaint. This discomfort can range from a dull ache to a sharp, sudden sensation and often indicates that pressure on the tooth is irritating sensitive internal structures or surrounding tissues.
Potential Reasons for Pain
One frequent cause of pain when biting is cracked tooth syndrome. These cracks are often microscopic and may not be visible to the naked eye or on standard X-rays. When pressure is applied to a tooth with such a crack, the fracture can flex, irritating the sensitive pulp tissue inside the tooth and causing sharp, fleeting pain that may occur only when biting in a specific way or on certain foods.
Tooth decay, or cavities, can also lead to pain when biting down, especially if the decay has progressed deeply into the tooth. As decay erodes the outer enamel and reaches the underlying dentin, the nerve endings become exposed, making the tooth sensitive to pressure.
Loose or damaged fillings can also cause pain when biting. Over time, constant chewing pressure can cause fillings or crowns to wear down, chip, or crack, compromising the seal. This can expose sensitive areas of the tooth or create an uneven biting surface, leading to discomfort.
Gum disease can contribute to biting pain. As the gums become inflamed and infected, the supporting bone and tissues around the teeth can be compromised. This can result in teeth becoming loose or the roots becoming exposed, making them sensitive to chewing pressure.
Bruxism, the unconscious grinding or clenching of teeth, can also cause pain when biting. The excessive force exerted during bruxism can strain the teeth, leading to worn enamel, sensitivity, and even small cracks. This constant pressure can inflame the nerves within the teeth or aggravate existing dental conditions.
An infection at the root tip, known as a dental abscess, can cause pain when biting. An abscess is a pocket of pus that forms due to a bacterial infection. The swelling and pressure from the pus within the bone can cause throbbing pain that worsens with biting or pressure.
Sometimes, pain felt in a tooth may not originate from the tooth itself but is referred from another area. For example, inflammation or pressure in the maxillary sinuses can cause discomfort that feels like tooth pain when biting down. This occurs because the roots of the upper molars are in close proximity to the sinus cavities.
When to See a Dentist
If you experience persistent tooth pain when biting down, it is important to see a dentist. Any discomfort that lasts longer than a day or two needs attention, especially if it worsens.
You should promptly contact a dentist if the pain is accompanied by:
- Swelling in your face or gums, a fever, or a foul taste in your mouth, as these can be signs of an infection.
- Increased sensitivity to hot or cold temperatures in addition to biting pain.
- Difficulty eating or speaking comfortably due to the pain.
- Any visible damage to the tooth, such as a chip or crack.
- Changes in your gums.
Immediate Steps for Relief
While waiting for a dental appointment, several measures can alleviate tooth pain when biting down. Avoiding chewing on the affected side of your mouth can prevent further irritation. Opting for soft foods will also reduce the pressure on the painful tooth during meals.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can manage the pain temporarily. Applying a cold compress to the outside of your cheek near the painful area can reduce external swelling and numb the region. Rinsing your mouth with a warm saltwater solution can reduce inflammation and keep the area clean. These steps offer short-term relief but do not address the underlying cause of the pain.
How Dentists Diagnose and Treat
When you visit the dentist for pain when biting, the diagnostic process begins with a thorough visual examination of your teeth and gums. The dentist may use a small instrument to pinpoint the exact tooth and specific area of pain when pressure is applied. This helps identify issues like cracks or high spots on restorations.
Dental X-rays are taken to look for issues not visible to the naked eye, such as cavities, infections at the root tip (abscesses), or bone loss due to gum disease. The dentist may also perform sensitivity tests using hot or cold stimuli to assess the health of the tooth’s pulp. Probing the gum pockets around the teeth can evaluate for signs of gum disease.
Treatment approaches vary depending on the diagnosed cause. For cavities, a filling will be placed after removing the decayed tissue. Cracked teeth may be treated with a crown to protect the tooth from further fracture, or root canal therapy might be necessary if the crack extends into the pulp. Deep infections, such as abscesses, require root canal therapy to remove the infected pulp and seal the tooth, or extraction if the tooth is beyond repair. Gum disease treatment ranges from professional cleanings to more advanced periodontal procedures. For bruxism, a custom night guard is fabricated to protect the teeth from grinding forces.