WHY DO MY TEETH HURT WHEN I BITE DOWN?

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When a patient has a toothache, one of the most common questions is, “Why do my teeth hurt when I bite down?” Unfortunately, the answer is not straightforward because there are various reasons why teeth become painful while biting, chewing, and eating. This article and accompanying video will break down all the possible reasons why your teeth hurt when you bite. It will also help narrow down which possibility applies to you and give you a few remedies for your biting pain.

To start the narrowing down process of your pain, a dentist will need answers to a few questions. First, how intense is the biting pain? Is there a time of day the pain intensifies? Can you locate the pain precisely, or does it feel like a general area? Where is the pain? Is there something that initially caused the pain, like chewing a hard nut? Is the biting pain a zing? Finally, does the pain feel sharp or dull? Your teeth hurt when you bite down for one of the following reasons: Tooth ligament inflammation, tooth infection, gum infection, sinus infection, temporomandibular joint disorder, cracked teeth, or dentin hypersensitivity.

Do You Have Tooth Ligament Inflammation Pain to Biting?

Let's start with inflamed ligaments. Your teeth are anchored to your jawbone by tiny ligaments. Tooth ligaments can become stretched, bruised, inflamed, and sore if they receive too much pressure causing inflammation. The pain associated with tooth ligaments can be intense or even subtle. Therefore let’s go over what causes teeth to receive too much pressure and cause a toothache.

What Happens If You Grind Your Teeth Too Much?

If you grind or clench your teeth too much, your tooth ligaments can become inflamed. Most people clench and grind their teeth at night when they sleep, but it can happen during the day too. Some do it more than others, and you will do it at specific points in your life more than other times. Most people don’t even know they are clenching or grinding. In fact, clenching can temporarily make clenching pain feel better, thus creating a vicious cycle of pain when more inflammation increases. Most of the time, people with clenching pain find it difficult to locate the pain because many teeth distribute excessive pressure and soreness. Sometimes, you can narrow the pain down to just one or two teeth. The pain due to clenching will typically coincide with a nighttime or morning soreness routine depending on how your body responds. Also, many people will say this pain comes and goes for a day or week at a time.

Is There A Teeth Grinding Solution?

If you want to naturally relieve your pain from grinding teeth, you need to find a root cause. Once you have found the root cause, you can find a teeth-grinding solution. Here are nine things I have my patients do to find the root cause of their teeth grinding.

 If they are vitamins and supplements that are not doctor prescribed, they go on a two-week hiatus and monitor their pain levels. Next, I have my patients change their sleeping positions and stop using memory foam pillows. Then we cut out caffeine from the diet and drink more water. Eliminating caffeine may initially make clenching and the pain worse. The patient should also set aside 30 minutes a day to destress or meditate. If they are on an intense exercise program, they should go to a very low-intensity workout for two weeks. We also establish a balanced diet if the patient is on a nutrient-limiting diet.

If we establish that none of the previous possibilities are the solution to teeth grinding, then we move on to three other possibilities with the patient's doctor. First, the patient discusses alternative medications or lowering the dosage of any current medications they are on with their doctor. If they have signs of sleep apnea, the patient will also discuss their options with the doctor. Lastly, if the patient has sinus issues, they can review different remedies.

I estimate that eighty percent of people with bruxism can find the underlying cause for their grinding and clenching by taking those steps. Once you have found the reason, the best teeth grinding solution is to eliminate that factor from your life if it is medically safe. Watch this YouTube video or go to this web page for a more detailed explanation of clenching and grinding.

Do You Have a High Filling, Crown, or Tooth?

A high filling, crown, or tooth is the next cause of inflamed ligaments. If a tooth is too high, it will take more force than the rest of the teeth when biting. Over time the ligaments will become inflamed and sore. Usually, you can pinpoint this to one tooth, and typically it recently had dental work done. You can tell if you have a high filling, crown, or tooth because your bite will feel uneven, or maybe a tooth is slightly loose. A dentist just needs to file down the high spot on a tooth, filling, or crown, and the pain and inflammation usually subside. I am always surprised when I have to adjust the bite by how many people don’t realize their bite is off. Only when I reduce the high filling and it feels normal again, do they realize it was off before.

Do You Have Pain From Food Stuck In The Gums Or Teeth?

Getting food stuck in the teeth and gums will cause inflamed ligaments. This pain is intense and localized to the area of food impaction, so it is easy to pinpoint. If you have food stuck in your gums, the pain is most intense when eating. For example, a popcorn kernel stuck in the gums is a big culprit for the pain of food impaction. Popcorn kernels get stuck in the gums easily because they can suction to the tooth. Food impaction is very common for people with adjacent teeth that don’t contact each other tightly or at all.

The best remedy to food stuck in the teeth and gums is to remove the debris with floss. For my favorite floss and all my favorite dental products, click here. Unfortunately, some food is tough to loosen even with great floss. A tip that you can do with the floss to remove the debris is to tie knots in the floss and thread it back and forth until the food comes out. I have a video about this technique too. Ultimately if you have a gap in the teeth causing a lot of food impaction, a dentist can do a filling or crown to tighten the space and minimize food impaction.

Can You Have Pain Due to Missing Teeth?

Yes. Every time you bite, there is a lot of force and pressure on your teeth. If you are missing teeth, the remaining teeth receive that excess pressure. So the increase in pressure on fewer teeth will result in inflamed ligaments. Therefore it is common for people with missing teeth to have pain in biting and chewing. In this case, you usually need dental implants or at least a partial denture to get some biting pain relief. Dental implants will restore the distribution of the biting force.

Do You Have Biting Tooth Pain After Getting Hit In The Face?

Another cause of inflamed ligaments is trauma. For example, if you fell and hit your teeth, or something hit you in the face, and now it hurts to bite, you likely have inflamed ligaments. Because the trauma put extreme pressure on the tooth, it caused inflammation in the ligaments, which made them hypersensitive to pressure stimuli. It doesn’t have to be a hit to the face; if you unexpectedly bite on something hard, it can also cause tooth ligament trauma.

Typically dentists just monitor the pain in cases of trauma. Most of the time, the biting pain subsides in a few days to weeks. Ligament trauma pain in teeth isn’t too problematic unless the pain returns, indicating more damage than just the tooth ligaments, which will lead us to the subsequent possible biting pain.
Tooth Ligament Pain Animated
Tooth ligament or periodontal ligament pain.
Worn-down enamel is a sign of clenching and grinding issues.
Nightguard On Model Talon Splint
Night guard is a remedy for excessive grinding and tooth ligament pain.
Filling Botulinum Toxin Syringe
Botulinum toxin reduces clenching that causes tooth ligament pain.
Filling Marked For a High Spot
High spots on a filling that can be adjusted down to reduce periodontal ligament biting pain.

Do You Have a Tooth Pulp Infection Causing Biting Pain?

If you have a deep cavity or bumped your tooth, the pulp in the center of your tooth can become inflamed, whether it is recently or in the past. Cold sensitivity will usually accompany the inflammation, which you can learn about in my cold sensitivity video. Eventually, if the tooth doesn’t heal, the tooth’s blood supply will deteriorate, and infection will enter the pulp. The infection will make the nerves in or around the tooth hypersensitive to pressure and biting. The pain levels can vary but are usually sharp and pinpointed by pressing or tapping on the offending tooth. If the tooth with biting pain has had trauma, including past dental work, or had a deep cavity, it likely has a tooth pulp infection.
Tooth Pulp Dies Irreversible Pulpitis
Dental pulp inflammation or pulpitis pain.

Do You Have an Abscessed Tooth Causing Biting Pain?

Like a pulp infection, an abscessed tooth will cause biting pain but not likely any cold sensitivity as the tooth nerve has already wholly died. The tooth is now the source of the infection since it no longer has a blood supply to fight it, but then the infection migrates to the tissues around it, causing a pocket of infection eating into the bone called an abscess. Because it affects the tissues around it, abscesses will mimic symptoms of other routes like infected gums, which we will get into in a moment. Usually, a dentist quickly locates an abscessed tooth by taking an x-ray and tapping the teeth. Sometimes an abscess will create a bump on the gums above the infected tooth. A root canal and extraction are the only permanent remedies for abscessed teeth, but antibiotics will work for temporary relief.
Tooth Dying Infection Abscess Animation
Pathway of a dying tooth, pulpitis, and dental abscess.

How Does Gum Disease Cause Pain to Biting?

Gum disease, called Gingivitis or Periodontitis, is the next route that causes chewing and biting pain. The longer plaque, tartar, and bacteria sit on your gums, the more destruction it does to the ligaments and bone that hold your teeth in place. This process is a gum infection or gum disease and is how it causes pain to biting. In this case, you will likely have a lot of plaque buildup, even if it isn’t visible. Gum disease manifests typically when your gums easily bleed when flossing and brushing. Gum disease may never cause pain for some people, but it can be pretty intense for others.

Usually, the pain associated with gum disease is constant and exacerbated by chewing. It is also ordinarily hard to pinpoint. You can also heavily limit your sugar intake, but very few will take me up on that. However, the main remedy is a deep cleaning once you have gum disease. Home care like brushing and flossing will do little until you receive a deep cleaning. Consider yourself lucky if you develop pain from gum disease because it warns you of your condition. Those who don’t get pain with gum disease are people that end up with dentures because they let gum disease go until it is too late. To help avoid gum disease, watch my best daily tooth care routine video and see your hygienist at least twice a year.
Gum Disease Pain Animation
Gum disease, or periodontitis, progressing into pain and infection.

Does A Cracked Tooth Hurt When You Bite Down?

The next mechanism of biting pain can be a nightmare for all dentists: Tooth fractures or cracked tooth syndrome. Fractured teeth can be easy or difficult to diagnose because they mimic so many different problems. Most fractures don’t appear on an x-ray. Many teeth will have sizeable fractures and never have any issues or pain. You probably have some cracks in your teeth now, but they are not causing pain! Then other teeth may have tiny or invisible fractures that cause severe pain. Dentists refer to these as cracked tooth syndrome. Cracked tooth syndrome is when you produce all the symptoms of a cracked tooth but no obvious way to prove it yet. For example, many fractured teeth will hurt when you bite down only in a specific direction, so the dentist cannot reproduce the pain. If you can’t reproduce the pain or see its effects, you cannot diagnose the problem with certainty.

Some people develop biting pain that makes diagnosing a cracked tooth easy. Biting pain that comes right after you release the bite's pressure is a sign exclusive to fractured teeth. Patients commonly describe Fractured tooth pain as a zing instead of something dull. While these symptoms indicate a likely fractured tooth, any type of biting pain can arise from a broken tooth, but other biting pains won’t eliminate other possibilities. The good thing is if you CAN duplicate the biting pain due to fractured teeth consistently, it is self-evident what is going on or at least which tooth is the issue.

Depending on where and how big the fracture is will determine the remedy for fractured teeth. Usually, you need a dental crown or extraction to fix the fracture, so your tooth doesn’t hurt when you bite down. Sometimes a root canal can also be performed.
Craze lines or small cracks in teeth that do not cause pain.

Can Dentin Hypersensitivity Cause Biting Pain?

Let's move on to a more rare biting pain called dentin hypersensitivity. Dentin hypersensitivity itself is not rare, but it doesn’t usually cause biting pain. When you wear down your tooth's enamel by grinding it away or something else, the underlying level called dentin has more nerve endings and can become sensitive to the touch. Usually, these feel like little zings or little shocks to the touch. Often, they will manifest in these small dips or bowls on the biting surface of your tooth. If these dips cause dentin hypersensitivity, they will also likely be sensitive to cold. These spots can become so sensitive that biting, chewing, and eating will set off the pain for some people.

Anti-sensitivity Toothpaste, like my favorite toothpaste, will minimize the sensitivity for about half the people who use it. The longer you use it, the better it works. After that, the dentist does a filling to prevent food and teeth from touching the sensitive spot most of the time. Anti-sensitivity fillings usually work well to stop the sensitivity. You can purchase anti-sensitivity toothpaste when you click here.

Dentin Hypersensitivity Tubules
Dentin Tubules that cause dentin hypersensitivity. 
Worn Down Teeth with Dentin Hypersensitivity
Wear on teeth that expose dentin and can cause dentin hypersensitivity.  Each tooth had sensitivity no matter the size of the wear. 

Can You Have Sinus Infection Tooth Pain To Biting?

Sinus infections, or sinusitis, can cause biting pain on your upper teeth. If you could look at the bottom of your sinus, you would see little bumps where the roots of your teeth butt up against the floor of your sinus. When there is pressure in your sinuses, that pressure can be translated to your upper molars and makes them hypersensitive, especially to the bite. The good news is whenever your cold, virus, or allergy subsides, so should the sensitivity to biting. Decongestants can also help if you want to take them. However, some decongestants will increase teeth clenching and worsen the problem.
Floor of Sinus and Tooth Root Proximity
Proximity of tooth roots to the floor of the sinus cavity.

Why Do I Have Jaw Pain When Chewing & Biting?

Temporomandibular joining disorder, known as TMJ or TMD, is another route of chewing pain. TMD is a very complex topic, but I will narrow it down. The TMJ is your jaw joint, and TMD is its disorder. One of the following issues causes TMD: TMJ inflammation, chewing muscle inflammation, TMJ degeneration, TMJ displacement, and tooth ligament inflammation. Often, TMD manifests itself as pain when chewing or clenching. Therefore, if you feel chewing pain in the jaw instead of the gums or teeth, it indicates TMD as the problem. Watch my videos on TMD for more on the subject.

You may further locate where TMJ issues are coming from by putting pressure on your jaw muscles. If pressure on the jaw muscles causes pain, your TMD is likely due to muscle inflammation. However, if they do not have any pain to pressure, the TMD chewing pain is likely coming from the temporomandibular joint itself.

Botox, I have found to work well as one way to correct TMD by calming down overactive muscles. Also, trigger point injections can relieve muscle pain. However, it is best to discover if you have any issues inciting excessive clenching before other treatments.
Masseter Muscle Pain
Location of masseter muscle pain.
Dental Pain Symptoms and Relief Rancho Cucamonga Dentist
Location of TMJ capsule pain and inflammation.
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