What Can Cause Tooth Pain On Biting?
Here is a non-inclusive list of conditions that can cause a person to have pain or discomfort during biting on a tooth:
- Irreversible pulpitis
- Pulpal necrosis
- Sinusitis/sinus infection
- Malocclusion; occlusal trauma; excursive interference
- Bruxism
- Fractured and displaced restoration
- Fractured cusp
- Cracked tooth
- Split tooth
- Vertical root fracture
- Periodontal abscess
Dentists should avoid the temptation to simply treat a symptom. A diagnosis should be made, and then the diagnosed condition can be properly treated. To differentiate between these conditions, a meticulous clinical work-up should be performed, which might include:
- Medical history
- Recent changes in health
- Recent lifestyle changes
- Recent trauma
- Hayfever, allergies, sinusitis, sinus infections
- Dental history
- Recent dental work
- Recent tooth trauma
- Date of last check-up
- Date of last x-rays
- History of chief complaint
- When pain started
- How frequently symptoms are present
- How long pain lasts when initiated
- Precisely what causes the pain to start
- What makes the pain get better
- Medications taken for the pain
- Can pain be pinpointed to a specific tooth
- Clinical exam
- Visual findings
- Caries
- Craze lines vs. crack vs. fracture
- Fractured tooth structure
- Factured or failing restorations
- Abfractions
- Occlusal wear
- Swelling
- Fistula
- Periodontal appearance
- Explorer findings
- Caries
- Cracks/crazes
- Fractured tooth structure
- Factured or failing restorations
- Periodontal findings
- Pocket depths
- Presence of bleeding, purulence
- Furcation involvement
- Mobility
- Percussion tests
- Palpation of surrounding tissues
- Pulp vitality tests
- Ice
- Heat
- Response to electric pulp tester
- Bite tests
- Transillumination
- Occlusion
- TMJ
- Sinuses
- Staining
- Restoration removal
- Surgical assessment
- Visual findings
- X-rays
- Caries
- Depth of existing restorations
- Resorption
- Root fracture
- Integrity of existing root canal fill
- Bone loss
- Vertical
- Horizontal
- Furcation
- Periapical or periradicular radiolucencies or radioopacitieis
- PDL integrity
- Lamina dura integrity
- Sinuses
- TMJ
See also:
References:
- AAE publication, "Cracking the Cracked Tooth Code: Detection and Treatment of Various Longitudinal Tooth Fractures"
- AAE publication, "Classification of Longitudinal Tooth Fractures"
- AAE publication, "Clinical Determination of Cracks and Fractures Based On Location and Separable Segments"
- AAE publication, "The Obvious and the Obscure: Steps For Crack Detection and Confirmation"
