There is something particularly frustrating about a tooth that doesn’t really hurt until you use it.
You can go through your day feeling fine, take a bite of something, and suddenly one tooth lets you know exactly where it is.
Sometimes the pain is sharp. Sometimes it feels like pressure or a dull ache. Sometimes you only notice it when you bite on something hard.
So what does it mean?
Pain when you bite down is usually a sign that something about that tooth needs to be looked at. The cause can range from something relatively simple to a problem that needs treatment sooner rather than later.
The tricky part is that you can’t always tell which tooth it is based on how the pain feels. Often times a tooth that hurts on the bottom can be caused by the tooth above it on the top. Our teeth and nerves are complicated beings… Let’s dive into it.
A Cracked Tooth Is One Possibility
A crack can cause a very specific type of pain when you bite. You may notice it when chewing, particularly on one side. Some people also notice pain when they release their bite rather than when they first bite down.
And the patricularly difficult thing about cracked teeth is that the crack isn’t always obvious.
It may not show up as a visible line in the mirror. It may not be visible on a traditional x-ray. Your dentist may need to look at the tooth from several angles and consider your symptoms, bite and history together.
Additionally, if a tooth has a large filling or has already had significant dental work, a crack may be one of the possibilities your dentist considers.
When we’ve ruled out other options, I’ll usually walk my patient down the hallway to take a 3D CBCT x-ray that allows me to see if there is a crack hiding somewhere in their bothersome tooth.
Your Tooth Could Have a Cavity
A cavity can cause sensitivity or pain, particularly when the decay has progressed far enough to affect the deeper parts of the tooth.
Unfortunately, not every cavity causes pain until the tooth has significantly decayed to this point. When pain finally does appear, the tooth may already need more attention than a small filling. This is why regular checkups and x-rays are so important.
The Tooth Could Be Inflamed or Infected
Another possibility is inflamation or infection.
The tissue inside your tooth contains nerves and blood vessels. When that tissue becomes severely inflamed or infected, you may experience pain with chewing or pressure.
You might also notice:
- Sensitivity to hot or cold
- Spontaneous tooth pain
- Throbbing
- Pain that wakes you up
- Swelling around the tooth
- Tenderness in the gum
- A bad taste or drainage
Just keep in mind that not everyone experiences all of these symptoms.
Sometimes the Problem Is Your Bite
As dentists that have pursued extensive education regarding temporomandibular joint, occlusion and bite force interferences and the ways that they manifest in the mouth and body, I can say this is one of the causes of tooth pain that both Dr. Kakaris Porter and I find most interesting… And it’s one that patients don’t always expect.
Sometimes the tooth itself isn’t necessarily cracked or infected. The way your teeth are coming together can place excessive force on a particular tooth.
This can happen after dental work, with grinding or clenching, or simply because the bite is placing more pressure on one tooth than the others.
A tooth that is repeatedly taking more force than it should can become tender.
That’s why checking the bite can be an important part of figuring out what’s going on. And for cases where the pain is extreme, it’s often very helpful for us to record your individual 4D jaw motion. This allows us to pinpoint any interferences in real time and space, and helps us effectively treat what is causing your pain.
What If It Only Hurts When I Bite on Something Hard?
This is definitely still worth paying attention to.
People often think, “It doesn’t hurt otherwise, so I’ll just avoid chewing on that side.”
That may make the problem less noticeable, but it doesn’t tell you why the tooth hurts, and avoiding the tooth can sometimes become a habit while the underlying problem continues and potentially becomes worse.
Why Can't You Just Tell From an X-Ray?
Dental X-Rays are extremely useful, but they’re only one piece of the puzzle.
Some dental problems are easier to identify clinically than radiographically.
A dentist may combine:
- Your symptoms
- A visual examination
- Tapping or pressure testing
- Bite evaluation
- Cold or other sensitivity testing
- X-Rays
- Your dental history
The goal is to figure out what is actually causing the pain before deciding what the tooth needs.
When Should You Get It Checked?
Don’t wait for severe pain before having a tooth evaluated, and definitely call your dentist if the pain is getting worse, persists, or is accompanied by swelling, fever, significant sensitivity, or difficulty chewing.
And remember, if your face or neck is swelling or you are having trouble breathing or swallowing, that’s an emergency and requires immediate medical attention.
The Bottom Line — Dr. Kakaris's Take
One of the biggest mistakes we see with tooth pain is assuming that the amount of pain tells you how serious the problem is, which, often times, isn’t the case.
A tooth that barely bothers you can still have a significant problem. Another tooth may be extremely sensitive because of something much more straightforward.
That’s why we don’t want to simply quiet the symptom and move on. We always want to figure out why that particular tooth hurts when you bite down.
Once we know the cause, we can talk about what the tooth actually needs, and just as importantly, what it doesn’t need.
Thanks for reading,
Dr. Arestea Kakaris, DDS
Dr. Arestea Kakaris has served the Downriver Michigan community with trustworthy care for over 45 years. She is committed to providing honest recommendations and advanced treatment for your dental health.
Whether you’re looking for answers to your dental questions, or you want an honest second opinion from dentists that have your best interest in mind, Dr. Arestea Kakaris and Dr. Alexander Kakaris Porter are ready when you are.
Call today to schedule your consultation (734) 676-1656.