Tooth Pain When Biting Down: Causes, Signs, and Expert Treatment Options

Tooth pain when biting down is an unsettling dental symptom which may cause a sharp or dull ache. Transient discomfort while chewing can be a symptom of a range of underlying oral health problems, compromising everyday life.

Why Does My Tooth Hurt When I Bite Down?

Pain can occur when multiple dental or oral conditions cause biting. Early identification of the cause ensures appropriate treatment and prevents further complications.

1. Tooth Decay and Cavities

Dental decay is one of the most common causes of tooth pain, including sensitivity or discomfort when biting. When tooth decay progresses deeper (into dentine or pulp), pressure from biting can trigger pain, and if not treated, death of the pulp tissues or tooth loss.

Signs to look for:

• Sensitivity to sweet, cold, or hot foods
• Pain when chewing on one side
• Visible holes on the tooth

2. Cracked Tooth Syndrome

As a result of dental trauma, biting on hard objects, or clenching teeth may develop invisible microscopic cracks that can propagate into large crevices, causing sharp pain when pressure is applied.

Key symptoms:

• Sharp, localised pain when chewing
• Discomfort that comes and goes
• Increased sensitivity to temperature changes

3. Dental Abscess or Infection

A dental abscess forms when bacteria infect the dental pulp or gum tissues, resulting in the accumulation of pus. Pressure from biting down can exacerbate the pain due to inflammation and fluid buildup.

You might also experience:

• Swelling in the gum or face
• Bad taste in the mouth
• Fever or generalfatigue

4. Gum Disease (Periodontitis)

Advanced gum disease can affect the supporting tissues around the teeth. Chronic long-standing Inflammation and infection gums and bone loss can create pockets around the teeth, making them mobile and painful when pressure is applied. 
Read more about gum disease (Periodontitis) treatments.

Signs include:

• Bleeding when brushing or flossing
• Receding gums
• Loose teeth

5. Receding Gums and Root Exposure

When gums recede, the exposed root surface of the tooth may become sensitive to thermal, chemical and bacterial sensitivity. As the root cement or dentin lacks the protective enamel covering, it could become sensitive to touch, cold, and pressure.

Common triggers of pain include:

• Brushing too hard and cervical abrasion
• Gum disease and recession
• Age-related wear and abfraction

6. Sinus Pressure or Infection

Pain in the upper teeth, especially molars with roots in the vicinity of the inflamed sinus floors/ Sinusitis or congestion, resulting in pressure that radiates around the roots and often resembles a toothache.

A sinus-related toothache may present with:

• Pain worsens when bending forward
• Nasal congestion or facial pressure
• No detectable dental disease on clinical or radiographic examination

7. High Filling or Crown

Following tooth restoration, if a filling or dental crown is too tall, it may create uneven pressure when you bite. This can cause pain in the treated tooth and may also affect the surrounding teeth.

Telltale signs:

• Pain appears immediately after a recent filling or crown
• Only one tooth feels taller than the others.
• No other signs of infection or decay

8. Bruxism (Teeth Grinding)

Habitual teeth grinding, especially at night, puts excessive pressure on the teeth and can cause microcracks, wear facets, and gum irritation, all leading to biting pain.

Symptoms often include:

• Morning jaw pain or tightness
• Flattened or chipped teeth
• Temporal headaches

9. Misaligned Bite or Malocclusion

Abnormal or excessive pressure on specific teeth, resulting from an uneven bite, can trigger pain during chewing. Over time, this may lead to inflammation of the tissue supporting the periodontal ligament,

Possible signs:

• Shifting teeth
• Discomfort when chewing on one side only
• Crunching noise

Symptoms to Watch Closely

Tooth pain when biting is often accompanied by other signs that help determine the cause. Key symptoms to monitor include:

• Localised pain when biting or chewing
• Pain that comes and goes
• Sensitivity to temperature changes
• Swollen gums or facial tissue
• Bad taste or odour in the mouth
• Fever or feeling unwell
• Gum bleeding or tooth mobility

Diagnosis: What Will Your Dentist Check?

To identify the exact reason for your pain, a professional diagnosis should be made by your dentist by undertaking the following:

Clinical Examination

They’ll check for signs of decay, cracks, swollen gums, and mobility in your teeth.

Dental radiography (X-rays)

X-rays help identify deep cavities, bone loss, infections, or cracks in some teeth.

Bite Examination and Pressure Tests

To localise the painful tooth, Dentists may ask you to bite on a stick or cotton roll.

Check for Sinus Involvement

When sinus pain or upper molar discomfort is not tooth-related, you could be referred to the dental hospital.

Treatment Options

Based on the underlying cause, the most common treatment could be:

Dental Fillings

Mild to moderate tooth decay should be excavated, and the remaining tooth structure should be restored to eliminate sensitivity.
Read more about composite bonding.

Root Canal Treatment

When decay or damage reaches the tooth’s pulp tissues, the degenerated pulp is removed, the root canal is disinfected, and the tooth is sealed.
Read more about root canal alternatives.

Dental Crowns

Used to protect minimally cracked teeth or heavily filled teeth, especially those that cause biting discomfort or are on the verge of fracture.
Read more about dental crown and bridges.

Periodontal Therapy

Root debridement/scaling and root planing, along with supportive periodontal care, may resolve gum disease.
Read more about periodontal treatments.

Bite Adjustment

Occlusal adjustment of the proud fillings, by reshaping the biting surfaces, can relieve pressure and restore comfort.

Night Guards for Bruxism

Custom-made mouthguards protect your teeth from grinding, thereby reducing stress and the potential for cracks. They can also alleviate the pain triggered from the jaw joints

Sinus Treatment

Decongestants, saline rinses, or antibiotics (if bacterial) may be prescribed to relieve pressure caused by sinus congestion.

Preventive Tips

Many cases of biting pain can be prevented with good dental habits. Consider the following:

• Brush with a soft-bristled brush and fluoride toothpaste twice daily
• Floss daily to remove plaque between teeth
• Visit your dentist every 6 months for routine checks.
• Avoid biting hard objects such as ice or pens.
• Wear a mouthguard if you grind your teeth.
• Address orthodontic concerns early.
• Replace old, worn fillings or crowns before they fail.

When to Seek Immediate Dental Help

Tooth pain when biting may occasionally point to serious issues that require urgent care. See a dentist immediately if you experience:

• Severe or worsening pain
• Localised inflammation, or gum swelling
• Pus or discharge
• Loose or fractured teeth
• Difficulty opening your mouth or swallowing
• Fever or feeling systemically unwell

Final Thoughts

We should ignore the recurrent pain when biting instead of managing it with over-the-counter painkillers alone. Early intervention in teeth with mild cavities to complex structural issues makes your treatment more predictable and affordable.

If you’re experiencing pain or discomfort while chewing, biting, or applying pressure to a tooth, don’t delay care. Schedule an appointment with one of our general or specialist dentists at London Specialist Dentists. We’ll thoroughly assess the cause and provide a safe and effective treatment plan tailored to your needs.