Tooth pain when touched: causes, symptoms and treatment

Tooth pain when touched, pressed, or while chewing may indicate deep tooth decay, an infection, a cracked tooth, or inflammation of the tissues surrounding the tooth root. Even if the pain only occurs when biting into food, it is important to see a dentist to determine the exact cause.

Teeth are anchored in the bone by the periodontal ligament, a tissue that helps distribute the forces exerted during chewing. When this ligament or the tissues surrounding the root become inflamed, even slight pressure can cause pain.

If the pain occurs only when touched or spontaneously, without any obvious trigger, this information should be passed on to your dentist to ensure an accurate diagnosis.

"A tooth may become painful when pressed even if it shows no visible signs of decay. The problem may be localised at the root or in the gum, or it may be caused by a crack or an unbalanced bite." - Dr. Mariana Oniță, Dentist at DENT ESTET Oradea Clinic.
 

There are many possible causes of toothache, ranging from tooth decay to a dental abscess or bruxism.

Deep tooth decay and inflammation of the dental pulp

An untreated cavity can progress to the dental pulp, the tissue inside the tooth that contains nerves and blood vessels. Initially, sensitivity to cold or sweet foods may occur, followed by persistent pain.

If the inflammation or infection spreads to the tissues surrounding the root, the tooth may become painful when touched or when chewing.

Infection at the root of the tooth and a dental abscess

A dental infection can cause inflammation of the periapical tissues, which surround the tip of the root. In such cases, the patient may feel that the tooth is more sensitive or that it hurts with every bite.

Pulsating pain, swelling of the gums or face, and severe sensitivity may also occur. A dental abscess requires dental assessment and treatment.

Tooth cracks and fractures

A cracked tooth can cause a sharp pain when you bite down, sometimes particularly when the pressure is released.
Cracks are not always visible to the naked eye and may require specific tests to identify them. Treatment depends on their location and extent.

Gum inflammation and periodontal disease

Periodontal disease affects the tissues that support the teeth. As it progresses, it can lead to inflammation, bone loss and tooth mobility.
In some cases, the affected teeth become sensitive to pressure, and chewing may cause discomfort. Bleeding gums and receding gums are other signs that require attention.

Bruxism and tooth strain

Grinding or clenching the teeth exerts excessive force on them and on the supporting structures.

Sensitivity may be more pronounced in the morning and may be associated with muscle pain, jaw tension or discomfort in the temporomandibular joint area.

Fillings or dental crowns that alter the bite

A filling or dental crown that makes premature contact with the opposing teeth can put excessive strain on the tooth whilst chewing.

If the pain has started after a dental restoration, your dentist can check your bite and determine whether the dental contacts need adjusting.

The diagnosis begins with a dental consultation, during which the dentist assesses:

• symptoms;
• treatment history;
• when the pain first started.

“The examination may include pulp sensitivity tests, percussion testing, assessment of tooth mobility, and evaluation of the bite. Dental X-rays help identify problems that are not visible during a clinical examination. In selected cases, cone-beam computed tomography (CBCT) may be recommended to obtain a three-dimensional assessment of the dental and bone structures.” – Dr. Mariana Oniță

Treatment is determined by the identified cause, not just by the severity of the pain. Some problems require restorative treatment, whilst others may require endodontic or periodontal treatment.

Until your appointment:

• Avoid chewing on the affected side;
• Do not repeatedly press on the tooth to check whether the pain persists;
• Do not apply aspirin or other irritants directly to the gum; 
• Do not take antibiotics without your dentist’s advice;
• Do not try to adjust a filling or crown yourself.

An emergency dental assessment is required if:

• the pain is severe, persistent or getting worse;
• swelling develops in the gums or face;
• the tooth suddenly becomes loose;
• symptoms such as a fever develop;
• there are signs of infection and pain following dental trauma;
• you experience difficulty breathing or swallowing.

At DENT ESTET clinics, clinical and imaging assessments aim to identify the cause of the pain and determine the appropriate treatment.
Depending on the diagnosis, a team of experienced dentists specialising in Restorative Dentistry, Endodontics, Periodontology and Prosthodontics may work together.

Meet the DENT ESTET medical team

The treatment plan is personalised, with a focus on treating the problem and preserving the natural tooth wherever possible.