The possible causes of pain above the pressed tooth are apical periodontitis or periodontal abscess, as follows. 1. Apical periodontitis: Due to the increase of local pressure caused by inflammatory exudation and edema, as well as the chemical effect of inflammatory mediators, the periapical tissues will be swollen and painful, and when pressing on the tooth increases the burden on the periapical tissues and stimulates the nerves leading to severe pain. 2. Periodontal abscess: it is a concomitant lesion of periodontitis in the advanced stage of the disease, the periodontal pockets and deep connective tissue infiltrated with a large number of inflammatory substances, resulting in excessive tension in the tissues, triggering pain, which will be aggravated by pressing on the tooth. There may be other reasons for the pain when pressing on the tooth, so it is recommended to go to the hospital in time to receive regular treatment.