I have pain in my upper right 2nd bicuspid. The pain started suddenly one day a few weeks ago. It hurts mainly when I chew hard foods like nuts or crackers, though sometimes at other times. I don't remember biting anything hard before it happened. Chewing soft foods is not painful. It does not seem to be sensitive to cold or hot or sugary foods. I have pretty good dental hygiene habits and brush twice a day and floss once a day, use mouthwash. I'm a 34 year old male, and I've only had one cavity, which I believe was in the adjacent molar, but I'm pretty sure the pain is not from that tooth but from the bicuspid. Is this a cavity (maybe interproximal), a cracked tooth, gum disease, or what?
Welcome, and thank you for putting your trust in me!Your insightful speculative differential diagnosis is actually right on the mark. The symptom of "pericementitis"-- pain in response to biting pressure, suggests any of the following problems:--acute/subacute pulpitis or acute endodontic abscess--periodontal abscess--cracked tooth--injury due to excessive chewing force - "occlusal trauma"--in the case of upper molars and premolars, acute sinusitis can be mistaken for tooth pain.I can appreciate the fact that you are relatively resistant to tooth decay, but the possibility of pulp disease due to decay cannot be ruled out if you haven't kept current with regular dental checkups.In order to determine an appropriate remedial course of action, your dentist will need to implement a formal diagnostic protocol-- visual, tactile, and x-ray examination of the tooth. This will enable him to determine which of the above four issues apply in your case. Depending on the outcome of that exam, your dentist may choose to either place a filling, perform a root canal treatment, adjust the bite, or remove the tooth and plan for prosthetic replacement.Diagnosis is key, and the next therapeutic step is entirely dependent on identification of the underlying problem. Depending on the severity of the symptoms, it may be prudent to arrange for a visit to your dentist as soon as possible-- before the weekend, if feasible.Hope this helps...