My Tooth Hurts When I Chew. Why?

Patients often mention, “my tooth hurts when I chew.” They are looking for answers, as well as relief from the pain.

As endodontists, we frequently see patients with this issue. There are a variety of possible causes of this kind of pain. In this article, we will share a few for the purposes of education. Keep in mind this article isn’t a substitute for seeing a dentist or an endodontist.

Pain is a sign from your body that something is wrong. When you scrape your knee or touch a hot stove, you experience pain, and you know to take yourself away from the danger. It’s the same in your mouth! Your pain is trying to tell you something. 

As endodontists, we strive to relieve your pain by saving your natural tooth whenever possible. Our goal is to treat the root of the pain and restore health and balance to your mouth. Doing this requires a thorough examination to uncover the source of the pain.

Here are a few situations that may cause pain while chewing or biting down.

Ten Potential Causes for Why Your Tooth Hurts When You Chew

There are many potential reasons why your tooth hurts when you chew. Here are ten possibilities. Please remember, the best solution is for you to see a dentist or endodontist, who can diagnose your pain and work with you to develop a treatment plan. 

A Cavity

A cavity may cause sensitivity and pain. Smaller and newer cavities are often painless, but deeper cavities can cause more pain and sensitivity.

If the source of the pain is a cavity, seeing your dentist for a filling may stop that pain. Just don’t delay, because cavities won’t reverse themselves.

A Crack or Fracture in the Tooth

Like a cavity, sometimes a small crack or fracture is asymptomatic. However, if the crack is deep and exposes sensitive pulp or nerves, you might notice pain while biting down.

The best treatment for a crack or fracture will vary depending on how damaged the tooth is. See your dentist for an examination.

A High Crown or Filling

The way your teeth fit together is an important part of being comfortable. When a filling or crown puts one tooth too high compared to the others, that can cause tension and pain when you bite down. If this is the case, you would typically start feeling the change following a treatment such as a filling.

If this is the cause of pain, your dentist would be able to resolve it by fixing the crown or filling, so it matches the height of the other surrounding teeth.

Misalignment of the Jaw

When the jaw doesn’t fit together as it should, that can be a source of chronic pain while biting down or chewing. This type of pain is a little different from a highly localized pain from a cavity or damaged tooth because you can feel it throughout your mouth or jaw.

The treatment may vary depending on the severity of the misalignment and the cause. In some cases, orthodontics might resolve the issue.

A Dental Abscess

Sometimes pain focused on a specific tooth is due to a dental abscess. A cyst or swollen area at the tip of the root can result in pressure against the tooth that causes pain, especially when you chew or bite down.

A dentist or an endodontist would need to examine the tooth. In some cases, a root canal might resolve the pain, and in worse cases, possibly an extraction is the solution. The risk of abscess is one reason it is crucial to keep up with your regular dental care and to see a dentist earlier rather than later. Stay on top of those 6-month cleanings!

Injury to the Tooth

Trauma or accidents may cause damage or injury to your tooth. Sometimes this injury causes pain. Cracks and fractures are a couple of possible injuries that may result from tooth trauma.

Your dentist would need to look at the tooth and assess the damage before recommending a treatment.

Sinus or Nasal Congestion

Pressure and tenderness in the sinuses may feel like a sore tooth (or a few sore teeth), due to the location of the sinus.

See your doctor if your dentist determines your pain may be due to sinus issues rather than dental ones. Addressing the congestion, pressure, or infection will resolve the pain. The source of the pain may be as simple as a cold or seasonal allergy, and if so, this is good news for you!


Sometimes a tooth or teeth might feel tender and sore when biting down due to overuse. There’s a tiny ligament that attaches your tooth to the bone. If you grind your teeth, bite down or clench habitually, or chew ice, this ligament can become sore.

If your pain comes from grinding your teeth, your dentist may prescribe a mouthguard to wear while sleeping.

Gum Disease

Gum inflammation or gum disease may cause pain to gum tissue and teeth. Your dentist may determine your pain comes from gum disease if your gums are sore, red, tender, or even bleed while brushing or flossing.

Treatment for gum disease varies by severity. Prevention is the best cure, and in the case of gum disease, the best prevention is flossing your teeth daily, brushing twice a day, and seeing your dentist regularly for professional cleanings. More severe cases may require care from a periodontist.

A Failed Root Canal

Due to the complexity of the root canal system, sometimes a failed root canal might be the culprit causing pain in a specific tooth. If you previously had a root canal in the tooth, that is something to look into.

In this case, you may need retreatment. The team at Ballantyne Endodontics is skilled and experienced in retreatment after a failed root canal.

Next Steps: See Your Dentist

If you are experiencing new or worsening pain, and if your tooth hurts when you chew, see your dentist or endodontist right away. The sooner you are diagnosed and treated, the sooner you can return to life without the pain.

Talk with your dentist or possibly your endodontist about the specifics of your pain. Be prepared to answer the following questions:

  • How intense is the pain on a scale of 1 to 10?
  • What activities cause pain or tenderness? (Like chewing or drinking something cold?)
  • Have you had any recent accidents, trauma, or treatments, like caps or root canals?
  • Describe the sensation. Is it a jolting, shooting pain, or more of a mild ache?
  • What medications or treatments are you on?
  • Do you clench or grind your teeth when stressed or sleeping?

At Ballantyne Endodontics, we strive to help Charlotte residents maintain their natural teeth without pain. Depending on the source of the discomfort you’re experiencing, a root canal or endodontic treatment may be the solution.

Contact us today to schedule a consultation or learn how to request a referral from your general care dentist.