Causes

The most common cause of pain when chewing can be traced back to a damaged tooth. This tooth is usually affected by caries, which continues to fight its way through the healthy hard tooth substance and migrates towards the tooth pulp. Caries is a bacterium that develops from plaque and processes sugar.

The end products of this process are organic acids which demineralize the tooth, i.e. break down the hard tooth substance. In this way, a hole is created. In most cases, this causes pain even when chewing is not required, when the caries is already more advanced.

However, even a “normal” caries can cause pain when chewing force is applied, since food components press on the affected area. Especially sweet and sour foods, such as jelly babies, can cause tooth pain. If the pressure decreases, the pain is no longer present.

Caries is primarily caused by a lack of oral hygiene, which means that plaque is not completely or partially removed, thus providing the bacteria with an optimal breeding ground. But also a poor diet, due to many sugary and acidic foods, or a possible genetic predisposition, promote the development of caries. If the first symptoms remain unnoticed, the caries progresses further and also attacks other areas of the masticatory system.

The further stages can also be considered as a cause for toothache when chewing. If there is pulpitis (inflammation of the tooth nerve) or if the tooth nerve is already dying or has already died, pain may be more intense when chewing. The decisive factor is not only whether food is available, but also how firm it is and whether it is warm or cold.

For example, the pain of pulpitis is much worse with cold food than with warm food. However, if the root of the tooth is dead, it may be painless, since the root contains the important nerve fibers which then no longer allow for further transmission. The bacteria can progress so far that the periodontium can be affected, so that in the end the tooth is loosened or has to be extracted.

If you experience pain while chewing, it is advisable to have a check-up at your dentist to diagnose the caries at the earliest possible stage.In addition to the cause of caries, a tooth that has already been filled can also cause toothache. In this case the pain is rather pulling, especially with hard food present and after a certain time it subsides again. This sensitivity is due to the fact that the tooth nerve has been strongly irritated by the treatment and needs a certain regeneration time.

However, these symptoms should subside, otherwise the filling material may not be properly bonded to the tooth, which makes the filling act like a feather when chewing and needs to be renewed. Even after a root canal treatment there may still be pain in the neighboring teeth. Starting from this position, a toothache while chewing after a visit to the dentist is not uncommon, as the tooth is irritated and needs to rest.

When a tooth is drilled, heat, pressure and high forces are applied to the dental nerve, which must recover from this irritation. Toothache when chewing can also occur under a crown or bridge. If it is a newly fitted crown, it is likely that the temporomandibular joint first has to get used to the position of the tooth again.

If the pain persists, a new bite check (occlusion) with possible grinding back of the crown is necessary. Caries or an inflammation of the pulp (pulpitis) are also possible triggers for toothache under a crown. Another possible cause of toothache when chewing is when the teeth are not properly aligned and do not fit together optimally when chewing.

This pain usually radiates far and can even affect the temporomandibular joint, as it can become inflamed and cause pain with any mouth movement if the teeth are permanently misaligned. A filling that is too high or a dental crown can prevent the correct bite. This is especially possible in the case of larger operations, such as a bridge, implant or total prosthesis.

But even in this case, it is necessary to wait a certain amount of time, as one has to adapt physically and also psychologically to the new unfamiliar situation in the mouth. If, however, after a longer period of time, chewing continues to cause discomfort, it is advisable to have another check-up at the dentist. The dentist can renew the filling or correct the new denture until it fits properly and the normal bite is ensured, so that the toothache during chewing will subside.

Bruxism is one of the most common problems that occur nowadays. This is an unconscious clenching and grinding of the teeth, usually at night. The teeth are exposed to high forces and the temporomandibular joint is also affected, so that pain can occur during chewing due to the continuous incorrect loading.

A permanently misloaded tooth can die, because the strong pressure damages the dental nerve. In addition to the causes mentioned above, “sinusitis” (inflammation of the paranasal sinuses) can also lead to pain in the teeth and thus also when chewing. The sinuses include the maxillary sinus, the frontal sinus, the ethmoidal cells and the sphenoidal sinus.

The disease is usually accompanied by fever, headache and general depression. Viruses, bacteria or allergies are the most common triggers. If the maxillary sinus is inflamed, this pain stimulus continues to the teeth. Especially when chewing, the pain is intensified due to the pressure sensitivity in the upper jaw. The proximity of the root of the molars to the maxillary sinus is also important for this pain interaction.