Why Are Your Upper Teeth Sore? Causes and Treatments

Upper teeth often cause great concern when experiencing a sudden heavy pain or pressure. You may experience pain that feels more like pressure, either a general dull ache or throbbing pressure in just one tooth. Due to the location of your upper tooth roots, there are a number of medical and dental issues that could be causing your issue.

Understanding why your upper teeth are sore will help you get the right treatment.

What Are the Common Causes of Upper Tooth Pain?

Can Maxillary Sinus Congestion Cause Upper Tooth Pain?

One of the most common non-dental reasons for upper tooth pain is the maxillary sinuses. These are air filled cavities located behind your cheeks and above the roots of your upper molars and pre-molars.

Many adults will have very little bone separating the upper tooth roots from the maxillary sinus floor. Some people even have their upper tooth roots extending into the sinus cavity.

When you suffer from sinusitis (whether caused by virus, bacteria or seasonal allergies) the mucus membranes will swell quickly. Fluid will build up inside the sinuses.

This will push the fluid into your upper tooth roots causing a heavy, generalized pressure in the upper teeth. This is caused by the nerves in your teeth being squeezed.

When you bend over or lay flat, the fluid builds up inside your sinuses causing the pressure to increase instantly.

Can Deep Tooth Decay and Pulpitis Cause Upper Tooth Pain?

When tooth decay occurs it means the outside layers of your teeth (enamel and dentine) have been worn away. Harmful bacteria will enter the inner part of your tooth (pulp).

Inside your teeth the bacteria will cause a strong immune reaction. Blood vessels will cause inflammation.

Unlike other tissues, your teeth have a hard outer layer (enamel and dentine). The pressure will cause the fluid to build up inside your teeth.

This will cause the nerves inside your teeth to be squeezed by the pressure causing the patient to experience an intense pain/pressure. This is known as pulpitis.

If left untreated the pressure will cause the nerve to become deprived of oxygen and die. The bacteria will then travel down to the root tip.

Can an Abscess Cause Upper Tooth Pain?

An abscess is an advanced infection at the tip of your tooth roots. This will cause intense pressure and needs to be treated.

Inside the root tip will be a collection of dead white blood cells, bacteria and tissue. This is known as pus.

As more fluid builds up it will try to expand inside the hard bone around your teeth. This will cause intense pressure and push your teeth slightly upwards.

Due to your teeth being pushed up, when you bite down with your upper and lower teeth it will cause a sharp uncomfortable pressure.

Eventually the fluid will start to push through the bone causing a visible swollen sore area on your gums.

Can Bruxism Cause Upper Tooth Pain?

Grinding your teeth or clenching them while asleep can cause lots of pressure on your upper teeth.

While you chew your teeth naturally experience some pressure. When you clench your teeth at night you will create intense pressure that exceeds several hundred pounds.

Inside your mouth every tooth is held in place by millions of shock absorbing fibers known as the periodontal ligament. This will become stretched and inflamed by the intense clenching.

Patients who suffer from bruxism will often awake with a generalized pressure, dull ache or tightness across their upper teeth.

Over time the intense pressure will cause small cracks in your enamel. This will mean any changes in temperature will cause a sudden increase in pressure.

Can Gum Disease Cause Upper Tooth Pain?

Your gums play an important role in how your teeth cope with pressure. Advanced gum disease will cause damage to the bone and tissue.

Plaque will cause bacteria to move into the depths of your gums causing chronic inflammation.

As your gums begin to detach from your teeth deep pockets will form. Food and bacteria will get trapped inside.

These pockets will cause the tissue to swell and pus to form. This will create a pressure on the side of your teeth.

As the bone is damaged your upper teeth will begin to tilt or move. This will create unwanted pressure on the remaining healthy tissue.

Can Cracked Teeth Cause Upper Tooth Pain?

A cracked tooth can be difficult to diagnose as the symptoms often resemble a simple sinus issue or mild sensitivity.

When the tooth is bitten down on the two sides of the tooth segment will bend slightly.

This will cause pressure to build up inside the small tubes in the dentine. This will send a signal to your nerve.

Patients will often complain about a feeling of pressure when chewing. When they stop biting down they will experience a sharp jab of pain.

Often the cracks will be below metal fillings or deep in the root so will not be visible without specialist equipment.

How Can You Tell the Difference Between Sinus Issues and Dental Issues?

Sinus infections will cause pressure across multiple upper teeth on both sides of your face. Dental issues will normally cause a single tooth to be effected.

Teeth with pulpitis will cause sharp pain when consuming hot or cold drinks. Sinus referred pain in your teeth will not be affected by temperature.

Sinus issues will cause pressure to change when leaning forward or bending over. Localized dental infections will cause pain no matter what position you are in.

Sinus related tooth pain will almost always be accompanied by a blocked nose, postnasal drip, soreness or reduced sense of smell. Localized dental infections will not cause any issues in your nose.

If you gently tap a specific tooth with your finger and it causes a sharp pain then it is likely to be a dental abscess. If you tap a tooth experiencing sinus referred pain it will generally cause a dull ache in multiple nearby teeth.

How Is Upper Tooth Pain Diagnosed?

Seeing a qualified dentist will help identify why you are experiencing upper tooth pain.

• Digital X-Rays: Your dentist will take specific x-rays to look at the pulp inside your teeth, bone levels around the tips of your teeth and maxillary sinus height.

• Cone Beam CT Scans: These scans provide detailed images of your roots, cracks and the relationship between your upper teeth and maxillary sinuses.

• Pulp Tests: Your dentist will use gentle heat or electric tests to assess the health of your nerves.

• Periodontal Probing: A specialized tool will be used to measure the depth of your gum pockets. This helps identify any underlying bacterial infections or bone loss.

What Are the Treatment Options for Upper Tooth Pain?

• Root Canal Treatment: If your tooth has become infected causing high pressure in the pulp your dentist will clean out the infected nerve, disinfect the roots and seal the space.

• Night-guards: Custom made guards will protect your teeth from excessive pressures caused by bruxism. This will relieve pressure on your periodontal ligaments.

• Scaling and Root Planing: Deep cleaning will be performed to remove the hardened plaque below your gums. This will remove any bacterial issues causing localized pressure.

• Extraction: If your tooth has suffered severe vertical cracking or massive bone loss it may need to be removed. This will eliminate the infection and relieve pressure on the surrounding bones.

When Should You See a Doctor for Upper Tooth Pain?

• If you notice visible swelling on your cheek, lower eye lid or side of your face you should seek urgent treatment.

• If you are suffering from a high temperature alongside intense tooth pain then you may have a spreading bacterial infection.

• If you are struggling to swallow, open your mouth wide or breathe then seek immediate medical attention.

• If you are experiencing constant throbbing pain that is waking you at night and is not relieved by OTC pain killers then you are likely suffering from nerve pain.

If you are suffering from persistent upper tooth pain you should seek treatment to help identify whether it is a simple sinus issue or serious dental issue. Don’t ignore any tension or tightness in your jaw. Early treatment will prevent small infections from becoming severe bone loss. Book an appointment with your dentist to have a full assessment to identify the cause and get your teeth back to full health.