There are many reasons that you can feel pain in your tooth when you bite down. A range of conditions causes this kind of toothache, including cavities and damage to the teeth, sinus infection, and gum disease.
In addition to causing sharp stabs of pain when chewing or putting pressure on the tooth, these issues can lead to tooth loss and other problems.
This article looks at the conditions that lead to a painful bite, when to get help, and treatment options.
Most often, pain when you bite down, is caused by complications of poor oral hygiene or damage to the tooth. It can also arise from sinus pressure caused by infection. The following are common causes of tooth pain.
Cavity
The most common causes of a painful bite are cavities (holes in the teeth caused by tooth decay). According to the Centers for Disease Control (CDC), approximately 90% of adults over 20 have had at least one cavity. This issue occurs when the hard outer shell of teeth (tooth enamel) erodes when bacteria in plaque feed on sugars in your mouth.
Cavities can affect any part of the tooth; in cases of gum recession due to gum disease, the roots of the teeth can also be affected. It’s essential to treat cavities as they can progress to more serious issues, including infection and tooth loss.
Cracked Tooth or Other Injury
Tooth pain when you bite down can also arise from physical damage. Loosened or cracked teeth have many causes, including:
- Accidents or falls
- Impact
- Natural wear and tear
- Bruxism (teeth grinding)
- Chewing on ice or very hard foods
Periodontitis
Periodontitis, or periodontal disease, is an advanced form of gingivitis in which the infection causes the gums to pull away from the teeth, and the underlying bone starts to lose mass and weaken.6 The toothache occurs from loosening teeth and decay that commonly results from this condition.
Periodontitis is very common, affecting nearly half of American adults over 30. It’s a progressive condition and a significant driver of tooth loss.
Malocclusion
When properly aligned, the upper teeth should hang over the lower set, and the molars should interlock. If they aren’t lined up, a condition known as malocclusion, they can become worn down and damaged, and their stability can be affected. This can lead to loosened teeth, cracking, tooth decay, and an increased risk of gingivitis and periodontitis, all of which are associated with tooth pain.
Loose Filling or Crown
Dental fillings to repair cavities or dental crowns—specialized caps placed over damaged teeth—can also be at the root of tooth pain.
If these are loose, poorly fitting, or broken, the underlying structures can be impacted, causing discomfort when biting. This arises due to natural wear and tear, poor fit, dental infection, tooth decay under a crown, or teeth grinding.
Abscessed Tooth
Tooth decay, periodontitis, and damage to the teeth can cause the tooth’s pulp to become inflamed and die.
This can lead to the formation of an abscess—a pocket of thicker fluid or pus—where the teeth meet the bone. This painful, serious condition can spread the infection to the bone, teeth, and surrounding tissues if untreated.
Pulp Necrosis
A common result of tooth decay is pulpitis, an infection of the pulp, which is the nerve and blood vessel-filled tissue surrounding the tooth root. This can lead to the death of these tissues, a condition called pulp necrosis.
Pulp necrosis can cause pain upon biting and lead to tooth abscess, among other serious dental issues.
If you’re experiencing pain when biting down on food, you should have your teeth checked out. Signs that prompt a call to a provider include:
- Pain and symptoms lasting 48 or more hours
- Pain medications aren’t easing the pain
- Fever, bright red gums
- Swelling in the cheek or jaw
If your tooth pain is accompanied by swelling around the eye, neck, or mouth, or you have difficulty breathing, go to the emergency room.