Why Does My Tooth Hurt Every Time I Bite?

Pain when you bite down can be surprisingly difficult to ignore. You may feel completely comfortable most of the time, only to experience a sharp pain or tenderness as soon as you chew on a particular tooth.

There are several possible reasons for this. A cracked tooth, decay, infection or a problem with an existing filling or crown can all cause discomfort when pressure is applied.

Importantly, pain when biting does not automatically mean the tooth needs to be removed. Many painful teeth can be treated and preserved. The first step is finding out what is causing the pain and how much of the tooth has been affected.

Why Can a Tooth Hurt Specifically When You Bite?

Biting places pressure on the tooth and the tissues supporting it.

If a tooth is damaged, inflamed or infected, that pressure can trigger pain that may not be noticeable when your mouth is at rest. The sensation can range from mild tenderness to a sudden, sharp pain that makes you stop chewing on that side.

The pattern of the pain can sometimes provide useful clues, but symptoms alone cannot reliably tell you what is wrong. A dental examination — and sometimes an X-ray or other investigation — is needed to identify the cause.

Here are some of the problems your dentist may consider.

1. A Cracked Tooth

A crack is an important possible cause of pain when biting.

Cracks are not always obvious. Some are too small to see easily, and a tooth may look relatively normal from the outside.

When pressure is applied during chewing, parts of a cracked tooth can move very slightly. This can irritate the sensitive tissues within or around the tooth and produce a sharp or intermittent pain.

You may notice that:

• One particular tooth hurts when chewing.
• The pain is sharp rather than constant.
• Certain foods or biting at a particular angle trigger it.
• The tooth has also become sensitive to hot or cold.

A cracked tooth does not necessarily have to be extracted. Depending on where the crack is, how far it extends and whether the nerve inside the tooth has been affected, treatment may include a filling, crown or root canal treatment.

However, some cracks extend so deeply that the tooth cannot be predictably restored. In those circumstances, removing the tooth may be recommended.

2. Tooth Decay

Decay can also cause pain when eating.

Tooth decay damages the hard structure of the tooth. In its earlier stages, you may have no symptoms at all. As it progresses, it can cause toothache or sensitivity, particularly when eating or drinking something hot, cold or sweet.

If decay progresses towards the centre of the tooth, it can irritate or infect the pulp — the soft tissue containing nerves and blood vessels.

Treatment depends on how much tooth structure has been affected.

Smaller areas of decay may be treated with a filling. If infection has reached the pulp, root canal treatment may sometimes be needed to save the tooth. Where a tooth is too extensively damaged to restore reliably, extraction may be considered.

This is why it is useful to have persistent biting pain assessed rather than simply avoiding chewing on the affected side.

3. An Infection or Dental Abscess

Pain when biting can sometimes be associated with an infection.

A dental abscess is a collection of pus caused by infection in a tooth or the surrounding tissues. An affected tooth may become painful or particularly tender when pressure is applied.

Other possible symptoms include:

• Intense or throbbing toothache.
• Swelling of the gum, face or jaw.
• Sensitivity to hot or cold.
• An unpleasant taste in the mouth.
• Difficulty chewing or opening your mouth.
• Feeling generally unwell or developing a high temperature.

A dental abscess needs dental treatment and will not resolve permanently on its own.

Depending on the source and condition of the tooth, treatment may involve draining the infection, root canal treatment or removing the tooth. Antibiotics may be appropriate in some circumstances, but they do not replace the dental treatment needed to address the source of the problem.

4. A Loose, Damaged or Failing Filling

Sometimes the painful tooth has already been treated.

Fillings and other restorations can become damaged or develop problems over time. A loose or broken filling can expose sensitive areas of the tooth or allow bacteria to reach areas that were previously protected.

The tooth may then become sensitive or painful when you chew.

This does not necessarily mean anything is seriously wrong. The restoration may simply need replacing. However, if decay or infection has developed underneath it, further treatment could be necessary.

A dentist will need to examine both the restoration and the remaining tooth to determine what is happening.

5. Gum and Supporting-Tissue Problems

The problem may not always originate inside the tooth itself.

Your teeth are supported by the gums and bone around them. Gum disease can damage these supporting tissues and, when it becomes more advanced, teeth can become loose.

An infection can also develop within the gum tissues, producing an abscess and tenderness around the affected area.

If the tooth feels different when you bite, appears loose, or the surrounding gum is swollen or painful, the supporting tissues need to be assessed as well as the tooth itself.

Treatment will depend on the underlying cause and how much support remains around the tooth.

Does Pain When Biting Mean My Tooth Needs to Come Out?

No.

This is an understandable concern, particularly if the pain is severe, but extraction is only one possible treatment.

The priority is usually to establish whether the tooth can be predictably saved.

Depending on the diagnosis, treatment could involve:

• Repairing or replacing a filling.
• Treating tooth decay.
• Protecting a cracked or weakened tooth with a restoration.
• Root canal treatment if the pulp has become infected.
• Treating gum disease.
• Managing an abscess.
• Extracting the tooth when it cannot be predictably restored.

The appropriate treatment depends on what has caused the pain and the condition of the tooth.

At UK Dental Specialists, oral surgery includes routine and more difficult extractions, including wisdom teeth, as well as the removal of buried or broken teeth and fractured roots. However, the decision to remove a tooth should follow appropriate assessment and diagnosis rather than being based on pain alone.

When Might Extraction Be Necessary?

Dentists generally consider whether a painful tooth can be treated and retained before recommending its removal.

Extraction may become an appropriate option when the tooth is too badly damaged to restore predictably. Examples can include extensive structural damage, certain deep fractures or infection affecting a tooth that cannot reasonably be saved.

The decision is individual.

A tooth that appears badly damaged to a patient may still have treatment options. Equally, a tooth that looks relatively normal from the outside can sometimes have a significant crack or problem below the surface.

This is why examination and appropriate investigations are so important.

What If the Pain Comes and Goes?

Intermittent pain is still worth taking seriously.

A cracked tooth, for example, may only hurt when you bite in a particular way. Other dental problems can also produce symptoms that fluctuate.

Pain becoming less noticeable does not necessarily mean the underlying problem has resolved.

If the same tooth repeatedly hurts when you chew, arrange a dental assessment rather than continually avoiding that side of your mouth.

When Should You Seek Urgent Dental Advice?

Persistent toothache should be assessed by a dentist, but some symptoms require more urgent attention.

Seek urgent dental advice if you think you may have a dental abscess, particularly if you have increasing pain, swelling, difficulty opening your mouth or a high temperature.

More extensive swelling can require emergency medical attention. If swelling is making it difficult to breathe, speak or swallow, NHS guidance advises calling 999 or attending A&E.

These symptoms should not be monitored at home while waiting to see whether they improve.

How Will a Dentist Find Out What Is Causing the Pain?

Your assessment will usually begin with a discussion about your symptoms.

You may be asked:

• When the pain started.
• Whether it is sharp, dull or throbbing.
• Whether biting or releasing your bite triggers it.
• Whether hot or cold foods cause sensitivity.
• Whether you have noticed swelling.
• Whether the tooth has previously been filled, crowned or root-treated.
• Whether you remember injuring the tooth.

The tooth and surrounding tissues can then be examined. Further tests or imaging may be needed depending on the suspected cause.

At UK Dental Specialists St Albans, the patient pathway begins with a consultation with the relevant specialist, followed by a clinical examination. The findings, diagnosis and available treatment options are then discussed before a treatment plan is agreed.

For cases requiring oral surgery, UK Dental Specialists provides a specialist oral surgery service for patients who need procedures that may not be appropriate for their general dental practitioner to provide. This includes moderate-to-difficult extractions, wisdom tooth removal and the removal of buried or broken teeth and fractured roots.

Can a Specialist Help with a Difficult Extraction?

Yes. Some extractions are more straightforward than others.

A tooth may be difficult to remove because of its position, the shape or condition of its roots, previous damage, or because part of the tooth has broken below the gum.

UK Dental Specialists’ oral surgery team includes clinicians with specialist oral surgery expertise and provides both routine and more complex extraction procedures. Treatment may be carried out under local anaesthetic or, where appropriate following assessment, with intravenous sedation.

The important point is that referral for oral surgery does not necessarily mean you are facing a major operation. The type of procedure required depends on the individual tooth and your clinical circumstances.

Don’t Assume a Painful Tooth Has to Be Removed

If your tooth hurts every time you bite, there is a reason for it — but that reason cannot be diagnosed reliably from the symptom alone.

It could be a crack, decay, infection, a damaged restoration or a problem with the tissues supporting the tooth. Some causes can be treated relatively simply, while others require more involved treatment.

And although extraction is sometimes the most appropriate option for a severely damaged or infected tooth, it is not the inevitable outcome.

Having the tooth assessed gives you the opportunity to understand what is causing the pain, whether the tooth can be saved and which treatment options are appropriate for you.

If you have persistent pain when biting or have been advised that you may need a difficult extraction, UK Dental Specialists can assess the problem and explain the appropriate treatment options.

FAQs

Why Does My Tooth Hurt When I Bite but Not at Other Times?

Biting places pressure on the tooth and its supporting tissues. If there is a crack, inflammation, infection or another problem, that pressure may trigger pain even when the tooth feels comfortable at rest. A dental examination is needed to determine the cause.

Can a Cracked Tooth Be Saved?

Sometimes. Treatment depends on where the crack is and how far it extends. Options may include restorative treatment or root canal treatment. If a crack extends too deeply and the tooth cannot be predictably restored, extraction may be necessary.

Does an Abscessed Tooth Always Need Extracting?

No. Some infected teeth can be treated with root canal treatment and retained. Other teeth may need removing if they cannot be saved. Your dentist or specialist needs to assess the tooth before recommending treatment.

Should I See a Dentist If It Only Hurts When I Chew?

Yes, particularly if the pain keeps returning or affects the same tooth. Intermittent pain can still indicate a dental problem that requires treatment.

What Happens If My Tooth Cannot Be Saved?

If assessment shows that the tooth cannot be predictably restored, extraction may be recommended. Your dentist or specialist can explain why removal is advised and discuss what happens next.