Tooth Hurts When You Bite Down? The Usual Causes and What to Do
Updated: Oct 7
Pain when you bite down usually comes from one of a short list of causes: a filling or crown that sits slightly high, a crack in the tooth, decay, an inflamed nerve, or an infection at the root. Some of these are a small adjustment. Others get worse the longer they wait, so it helps to know which one you are likely dealing with.
Below are the usual causes in plain words, what to do while it hurts, and how to tell a pain that can wait from one that needs a call today. If your face is swelling, or you have trouble breathing or swallowing, go to an emergency department now and come back to this later.
The short version
• Pain that starts soon after a filling or crown often means the bite needs a small adjustment. Call and ask us to check it.
• A sharp flash when you bite or let go can mean a crack. An ache that lingers, a bad taste or swelling can mean the nerve or an infection.
• Chew on the other side, skip hard and sticky food, and note what sets it off.
• Call today for swelling or a lingering ache. Go to the ER if swelling spreads toward your eye or neck, or breathing or swallowing is hard.
Written by Dr. Gloria Jung, DDS, BSc, at Lux Dental in downtown Vancouver. Reviewed on 2 October 2026 against guidance from the American Association of Endodontists, the American Dental Association, Cleveland Clinic and peer-reviewed dental literature, listed at the end of this post.
Why does my tooth hurt when I bite down?
Because something about that tooth, or the way your teeth meet on it, has changed. Biting presses on the whole tooth at once, so a problem in the filling, the enamel, the nerve or the root can show up as the same sore bite.
Cleveland Clinic lists a damaged filling or crown, a cracked tooth, cavities, an abscess, grinding and gum disease among the causes of toothache. The symptoms overlap enough that a StatPearls review calls diagnosing a cracked tooth "notoriously challenging", which is why the clue that comes with the pain matters. The diagram shows where each cause sits. The table pairs each one with its clue.
Five places a sore bite can start. The same causes are written out in the table below.
Cause | The clue | How soon, and the usual fix |
New filling or crown sits high | Hurts when the teeth meet, began after dental work | This week. The high spot is reshaped |
Cracked tooth | Sharp pain on biting, sometimes on letting go | This week, sooner if it worsens. Bonding, a crown or a root canal |
Cavity | Pain in one tooth with sweets, cold or biting | This week. A filling |
Inflamed nerve | An ache that lingers after hot or cold | Call today. A filling if early, a root canal if not |
Abscess | Throbbing, a bad taste, a bump on the gum, swelling | Call today. Drainage or a root canal |
Gum pocket or trapped food | Tender gum, food catches in one spot | A day or two, then this week. We clear it and treat the gum |
Grinding or clenching | Sore jaw and teeth, worse on waking | This week. A night guard |
Sinus pressure | Upper back teeth ache with a cold or stuffy nose | A dentist checks the tooth. Your doctor takes the sinuses |
Several rows are minor: a bite a little off, food lodged under the gum, a sore jaw after a week of clenching. The rows that are not minor come with clues, so the next sections take the causes one at a time.
Could a new filling or crown be sitting too high?
Yes, if the pain began soon after dental work, and it is one of the easiest causes to put right. Cleveland Clinic lists pain when biting down as a possible complication of a new filling: the filling interferes with your bite, and your dentist fixes it by reshaping the filling. A crown that sits high can do the same.
To find the high spot, the dentist has you bite on articulating paper, a thin strip that marks where the teeth touch first, and adjusts the restoration if needed. StatPearls describes the same check.
Mild sensitivity and gum soreness after a filling are normal and should fade in a week or two. Pain on biting is the part that does not belong, and I would call rather than wait it out. A high spot is a simple correction, and there is no reason to keep chewing on it.
If the pain is throbbing, or lingers after hot or cold, that is a different story. Cleveland Clinic notes it can mean decay had reached the pulp, or that the nerve is damaged, and a root canal may be needed.
What are the symptoms of a cracked tooth?
Sharp pain when you bite down, sometimes a quick flash when you let go, and a tooth that is hard to pinpoint. StatPearls reports a sudden sharp pain on biting as the most frequent symptom, a fleeting sharp pain on release in some patients, and sensitivity to cold drinks and food. The American Association of Endodontists adds that the pain may come and go, and that even your dentist may have difficulty locating which tooth is causing it.
"But Dr. Jung, it only hurts for a second, and then it is fine." A second is still information. Pain that comes and goes is how a cracked tooth is described, not a sign that it has settled. StatPearls warns that a crack that looks minor and feels mild can extend into the pulp or the root, and that early detection protects the outcome.
What we can do depends on how deep the crack goes. Cleveland Clinic lists bonding, smoothing and adjusting where the tooth hits too hard, a crown, a root canal and, when the root is badly damaged, extraction. The American Association of Endodontists says the sooner a cracked tooth is treated, the better the outcome. Our emergency page answers the common worry directly: a crack that does not hurt much is still worth an exam.
A tooth that looks chipped is a separate topic, covered elsewhere. This post is about pain you feel when you bite.
Could it be a cavity, an inflamed nerve or an abscess?
Yes, and the clue is how the ache behaves after you stop biting.
Cavity. The American Dental Association says a toothache usually indicates a cavity, though it can also signal gum disease, an abscess or an impacted tooth. Decay caught early is removed and the tooth is filled.
Inflamed nerve (pulpitis). Cleveland Clinic describes two stages. In reversible pulpitis, the dentist repairs the tooth and seals it with a filling. In irreversible pulpitis the pulp cannot recover, and the main sign is lingering sensitivity to heat or cold. That stage needs a root canal or extraction. An ache that hangs around after hot or cold has gone is a reason to call today, not next week.
Abscess. An abscess is a pocket of pus. Cleveland Clinic says the pain can be shooting or throbbing, and may hurt all the time or only when you chew, with a bad taste, a swollen gum, a loosening tooth, jaw swelling or fever. It also says an abscessed tooth will not heal on its own. If one bursts you may feel sudden relief, but the infection is still there, so call anyway. Treatment is drainage, a root canal or extraction. Antibiotics can help, but they do not remove the cause.
Can gums, trapped food or grinding make a tooth hurt when I bite?
Yes, and these are often the minor ones.
Food packed between teeth or under the gum can make a tooth tender to bite on. Cleveland Clinic lists a popcorn hull stuck in the gum among the causes of toothache, and says irritated gums from a hard bite usually settle in a day or two. The American Dental Association's advice is to rinse with warm water and gently floss out anything caught between your teeth. If the gum stays swollen or sore, have it looked at: an infection in the gum is one of the three kinds of abscess Cleveland Clinic describes.
Clenching and grinding can leave the jaw sore and the teeth tender. Cleveland Clinic says over time they can wear enamel and loosen teeth, and it names grinding as a cause of both cracked teeth and an inflamed nerve. A night guard protects the teeth, though it does not entirely stop the clenching, as our post on night guards explains. If your jaw is tight or your teeth feel sore when you wake up, ask us about grinding.
Can sinus pressure make an upper tooth hurt when I chew?
Yes. Cleveland Clinic says sinus pressure commonly refers pain to the teeth, especially the upper molars, and a sinus infection can come with a headache, a stuffy nose or a cough.
If an upper back tooth aches along with a cold, allergies or a blocked nose, the sinuses are a fair suspect. A dentist can check whether the tooth itself is the problem. If it is not, your doctor can take it from there.
One tooth that will not settle?
Monday to Saturday, 9am to 5pm, at 1631 Davie Street.
What should I do right now while it hurts?
Chew on the other side, and keep a short note of what sets the pain off.
Chew on the other side. Keep food soft and mild until the tooth is seen, and avoid very hard or sticky food.
Rinse and floss gently. Warm water first, then floss around the tooth to clear anything lodged, as the American Dental Association advises.
Write down the pattern. Which tooth or side, whether it hurts on biting, on letting go, or with hot, cold or sweet, how long it lingers, whether it wakes you, and whether it began after dental work. A dentist starts from your symptoms and their likely causes, so these notes help the diagnosis.
Use pain relief only as the package directs. An over-the-counter pain reliever may take the edge off. Do not put aspirin or any other painkiller directly on the tooth or gum, which can burn the tissue. If medicine does not ease the pain, call today: Cleveland Clinic counts that as a dental emergency.
Is a tooth that hurts when I bite an emergency?
Not on its own, but a few signs turn it into one. Mild pain with an obvious, passing cause can be watched for a day or two. A toothache that lasts longer than two days is the point where Cleveland Clinic says to call a dentist.
The chart sorts what you notice into four steps: wait, book this week, call today, and the emergency room. The same steps are in the table under it.
From wait, to book, to call, to the ER. The same four steps are written out in the table below.
How soon | What you notice, and what to do |
Can wait a few days | Mild tenderness that eases each day, such as after a hard bite or once trapped food is flossed out. Chew on the other side and keep notes. Book an exam if it lasts past two days. |
Book this week | Pain that keeps returning on biting, a flash on letting go, pain after a new filling or crown, or a crack that barely hurts. Book an exam online. |
Call today | An ache that lingers after hot or cold, a bad taste, a swollen gum, a pimple-like bump on the gum, a loose tooth, or pain that medicine does not ease. Call 604-670-1256. |
Emergency room | Swelling spreading toward the eye or neck, trouble breathing or swallowing, fever with facial swelling, bleeding that will not stop, or a suspected broken jaw. Go to the nearest emergency department or call 911. |
Lux treats dental emergencies six days a week, and our emergency page says we may be able to see you the same day where availability allows. Same-day visits depend on availability, so call first and we will tell you when to come in. We are closed on Sunday. If one of the emergency room signs appears while we are closed, the emergency department is the right place.
Swelling, a lingering ache, or pain that medicine will not ease?
Will tooth pain when biting go away on its own?
Sometimes, but not when the cause is the tooth itself. Cleveland Clinic says tooth pain can fade on its own when a gum was only irritated, often within a day or two. A true toothache, meaning pain that starts in the tooth, usually points to a problem that needs treatment.
Pain that fades is not proof that the cause has gone. A cracked tooth can hurt on and off, the American Association of Endodontists says, and an abscess that bursts can bring sudden relief while the infection stays. A sensible rule: if the pain is still there on the third day, or it comes back each time you bite, book the exam.
What happens at Lux when I come in with a sore tooth?
A treatment room at Lux Dental, downtown Vancouver.
We find the cause first, because the same sore bite can come from several different places. The exam starts with your history, which is why your notes help. Then:
An exam and a bite test. These show which tooth, and which part of it, reacts to pressure.
X-rays. These show the tooth, its roots and the bone around it.
3D imaging, which we have on site. CBCT is a 3D scan. Cleveland Clinic notes it can show bone loss that may be a sign of a fracture, but it does not reliably show a crack itself: a 2021 review in Dentomaxillofacial Radiology found that some narrow fractures in the root could not be detected by CBCT. That is why a dentist uses the exam, the bite test and imaging together, rather than leaning on any one of them.
Treatment ranges from a small bite adjustment to a filling, a crown or a root canal, and the options are on our restorative dentistry page. We explain them in plain language, and you decide.
If a dental visit makes you anxious, tell us when you call. Google lists sedation dentistry among Lux's services at the time of writing, and I would rather you came in nervous than stayed home in pain.
Sore-tooth visits at Lux Dental in downtown Vancouver
The practical details:
We are open Monday to Saturday, 9am to 5pm, and closed Sunday. A Saturday appointment means a sore tooth does not have to wait for the work week.
Call for anything urgent, book online for anything that can wait. Same-day emergency appointments are offered where availability allows.
We speak your language. I speak English, Korean and Mandarin, and our team also speaks Korean and Vietnamese.
Find us at 1631 Davie Street in downtown Vancouver.
Frequently asked questions
Why does my tooth hurt when I bite down but not otherwise?
Pain that only appears under pressure usually points to the bite or the tooth's structure: a filling or crown sitting high, a crack, decay, or an early problem at the root. Cleveland Clinic lists all of these among the causes of toothache. Pain that shows up only when you bite can still be serious, so note when it happens and have the tooth examined within a few days.
Why does my tooth hurt when I chew on one side?
Because one tooth on that side is taking the load while it is sore. The usual suspects are a filling or crown sitting high, a crack, decay, or food packed between the teeth. Chew on the other side, floss gently around the tooth, and note what sets it off. If it is still sore after two days, book an exam, as Cleveland Clinic advises for a lingering toothache.
Why does my tooth hurt when I bite after a filling?
A common reason is that the filling sits slightly high and takes the bite first. Cleveland Clinic says pain when biting down can occur if a new filling interferes with your bite, and your dentist can fix it by reshaping the filling. Mild sensitivity should fade within a week or two. A throbbing ache, or pain that lingers after hot or cold, deserves a call sooner.
How do I know if my tooth is cracked?
You cannot be sure at home. Typical signs are sharp pain on biting, sometimes a flash when you let go, and sensitivity to cold, but cracks can be hard to find. A dentist combines your history, a bite test, a close look and imaging. A 2021 review found that even 3D imaging can miss some narrow fractures in the root.
Is tooth pain when biting an emergency?
Not usually on its own. Call a dentist the same day for a swollen gum, a bad taste, an ache that lingers after hot or cold, or pain that medicine does not ease. Go to the emergency department or call 911 for swelling spreading toward the eye or neck, trouble breathing or swallowing, or fever with facial swelling. Milder pain can be booked as an exam this week.
Will a tooth that hurts when I bite go away on its own?
Sometimes, if the cause was an irritated gum from a hard bite, which Cleveland Clinic says usually settles in a day or two. Pain that starts in the tooth usually needs treatment, and fading pain is not proof of healing: a cracked tooth can hurt on and off, and a burst abscess brings relief while the infection remains. If it lasts past two days, book an exam.
Can a sinus infection make my teeth hurt when I bite?
Yes. Cleveland Clinic says sinus pressure commonly refers pain to the teeth, especially the upper molars, and a sinus infection can come with a headache, a stuffy nose or a cough. If only an upper back tooth hurts and you have cold or allergy symptoms, a dentist can check the tooth. If it is healthy, your doctor can look at the sinuses.
Book a sore-tooth exam in downtown Vancouver
Pain on biting is a clue. Bring it in, and we will work out what it is telling you.
If a tooth hurts when you bite, bring it to Lux Dental. We are rated 4.9 on Google from 179 reviews at the time of writing, and we are open Monday to Saturday, 9am to 5pm, closed Sunday. Book an exam online if it can wait. If it is swelling, a lingering ache or pain that medicine will not ease, call us, and we may be able to see you the same day where availability allows.
Or call 604-670-1256. Lux Dental, 1631 Davie Street, Vancouver. Monday to Saturday, 9am to 5pm.
Sources: American Association of Endodontists, Cracked Teeth (patient information page); American Dental Association, MouthHealthy, Top Ten Dental Symptoms and Dental Emergencies; Cleveland Clinic, Cracked Tooth (updated 29 April 2024), Dental Fillings (13 May 2024), Pulpitis (18 July 2022), Abscessed Tooth (22 January 2026), Periapical Abscess (29 July 2026), Toothache (11 April 2023), Dental Emergencies (15 September 2022), Sinus Pressure (9 February 2023) and What's Causing Your Toothache? (28 November 2022); John K and Pepper T, Cracked Tooth Syndrome, StatPearls (updated 7 May 2024); Lin Z et al., Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience, Dentomaxillofacial Radiology (2021); Lux Dental, emergency dentist page (read 2 October 2026). Google rating, review count and listed services checked 2 October 2026.
Dr. Gloria Jung, DDS, BSc, Lux Dental
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