If you’re noticing pain in a tooth when you bite down or when you touch the tooth, it could be a sign that something’s wrong. You may need treatment to alleviate the pain and possibly address underlying causes.
A number of possible factors can lead to this kind of dental pain.
A cavity, which is basically a hole in your tooth, is often responsible for this kind of pain and sensitivity. Cavities often develop before you feel or see any noticeable symptoms.
The way your teeth meet when your jaws come together is called occlusion. When your teeth don’t fit together quite right, they can get worn or cause pain in your teeth when you bite, or even cause pain in your jaw. This is called malocclusion.
Injury to the tooth
You may not even realize that you have a cracked tooth until you bite down and feel a sharp pain when you release the bite. The pain may disappear quickly once you let up, or it might come and go.
Other symptoms of a cracked tooth include a sensation that feels like something’s caught between your teeth (even if it isn’t), and pain when eating and drinking. But some people don’t experience any symptoms at all.
You may experience:
- red, tender or bleeding gums
- a build-up of plaque
- bad breath
Recessed gums or exposed root
Receding gums are a type of periodontal disease, also known as gum disease.
When your gums begin to pull back from your teeth, they expose more of the tooth surface and can even leave part of the root exposed. This can make your tooth very sensitive and even painful to touch. It’s more common in adults over 40.
Nasal or sinus congestion
The roots of your upper teeth are very close to your sinuses, so any extra pressure, congestion, or an infection in that area might be responsible, especially if several of your teeth ache rather than just one.
This pain is also called sinus toothache, and it’s usually felt in the upper posterior teeth that are near the sinuses.
Loose filling or crown
A loose filling or crown can cause some pain when you bite down. When a filling is loose, bacteria can creep beneath it and irritate your tooth and possibly also the nerve.
Damage or death of the pulp tissue (pulp necrosis) inside your tooth can also cause pain. But that’s not the only possible sign. In the early stages, your tooth may also be very sensitive to heat, cold, and foods that are very sweet, so you may feel a tinge of pain when eating.
If your pain not only lingers but worsens, and you develop some swelling in your gums, you may have an abscessed tooth.
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The treatment depends on the cause of your tooth pain.
A dentist will likely recommend one of the following treatments for a cavity, which will depend on the severity of the decay and whether the decay has reached the tooth’s pulp:
- direct or indirect pulp cap
- root canal (which might also require a crown)
Bite issues can require a variety of potential treatments, including orthodontia.
Once the specific bite issue is identified, your dentist can talk with you about options to improve the alignment of your teeth, which might include shaving down a tooth (enameloplasty) to improve your bite or a set of braces.
In some cases, a tooth might need to be capped, have a crown replaced, or be removed if it’s causing problems with your bite.
The treatment for a cracked tooth can vary, depending on where and how badly it’s cracked. Small cracks are usually repaired, but extensive cracks or cracks that extend into the gum line may require removal of the tooth.
Treatment might start with scaling and root planing to remove plaque and calculus. But there are also several different kinds of surgery that your dentist might recommend, including bone grafting or flap surgery, which involves lifting up your gums for a deep cleaning.
Your dentist will examine your gums closely to see if an infection has taken hold. If so, you may need to take an antibiotic, use an antibiotic mouthwash or apply an antibiotic gel on your gums.
In severe cases, your dentist may recommend flap surgery or graft some tissue to help the gums regrow.
Nasal or sinus congestion
Nasal congestion or sinus congestion can be short-lived, but it sure can be painful while it’s going on. Home remedies may alleviate the congestion and the pressure it’s creating. Some include:
- using a humidifier
- applying a warm compress
- taking a steamy shower,
- saline spray
Many sinus infections
Loose filling or crown
The most likely fix is a replacement filling or new crown. While you’re waiting for the new filling or crown, your dentist might suggest taking an over-the-counter pain reliever. Call your dentist right away if the crown or filling falls out.
If your dentist determines that the pulp tissue inside your tooth has died, you may need a root canal and crown. It’s also possible that your dentist will tell you that you need to have your tooth extracted.
An infection in your tooth could spread and threaten more tissue. It could even lead to sepsis, which is a life-threatening infection. Your dentist will likely drain the abscess and clean out the affected area.
Depending on the severity of the situation, you might need a root canal or a tooth extraction. Your dentist may also prescribe antibiotics to clear up the infection.
Tooth pain can often be the sign of a larger problem with your teeth or gums. If you don’t address it promptly, the pain could worsen. Or you might have to get extensive dental work or risk losing a tooth. If you notice some pain, speak with a dentist.
Most communities have a few options for affordable emergency dental care.
- Dental schools. Dental and dental hygiene schools offer services for a reduced price. But you may need to ask in advance if they provide emergency dental care.
- Community health centers. You can get free or reduced-cost dental care at a community center funded through the Health Resources and Services Administration’s Bureau of Primary Health Care.
- Medicaid. Adults who are enrolled in Medicaid, which is a state-run healthcare program for people living on a low income, can usually access emergency dental services. But more comprehensive services vary from state to state and may be limited, depending on where you live.
- Medicare. If you qualify for this federal program that covers adults over 65, you may be able to access certain kinds of emergency dental care.
- Veterans Affairs dental insurance program (VADIP). Veterans can apply for dental coverage benefits through the U.S. Department of Veterans Affairs (VA). You might also seek out a local VA dental clinic for emergency care.
One more thing: if you do have dental insurance, call a dentist and ask what options are available to you. They might be able to work out a payment plan, depending on the severity of your dental issues and their ability to address it at that time.
Don’t assume that the pain in your tooth will go away if you don’t mess with it. Ideally, you’d want to make an appointment to see your dentist before it gets worse. And keep an eye out for other signs of gum disease or tooth decay, like swelling or bleeding gums.
If pain or sensitivity develops suddenly and becomes intense, see a dentist as soon as possible.