Toothache Pain: When Does It Become Something to Worry About?

I do want to take this time to go over what generally causes a toothache, and discuss the (fairly remote) possibility of "dying from a toothache."
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Toothaches are awful, aren't they?

In fact, they are really high up there on the "pain scale" -- at least in my mind (and the minds of many patients that I see). I mean, think about it -- they are painful enough to drive someone to go see a professional who will drill (drill!) into said teeth (amongst other things). So yes, toothaches hurt.

Oftentimes, a patient will come in and say "Dr. Connelly, this toothache is killing me." Which, while certainly descriptive, is probably not the truth ... or is it?

Before we get started, let me come right out and tell you that no, a normal, classic toothache cannot kill you. Yes, the pain might seem like it can and the underlying issues that caused the toothache could possibly be fatal if left untreated. And, to pile on, some rather nasty afflictions list jaw and tooth pain as symptoms. But no, a toothache, in and of itself, isn't fatal, so relax.

I do want to take this time to go over what generally causes a toothache, and discuss the (fairly remote) possibility of "dying from a toothache."

To begin, a toothache that is really a toothache can be caused by a variety of reasons:

•Decay/Cavities: The "classic" toothache cause is a simple cavity. Bacteria gets where it shouldn't and "viola," you have pain. The cure is usually a simple filling.

•Gum Disease: (aka periodontal disease, Gingivitis etc.) This is where the gums become inflamed and deep "pockets" that trap bacteria are formed. When gum disease is left untreated, tooth pain is often the result. The treatment is typically a deep cleaning -- sometimes referred to as scaling or scraping -- and a solid, consistent oral hygiene regimen.

•Cracked Tooth: Sometimes, teeth break without having a cavity or the like. This can cause toothaches.

•Wisdom Teeth: Your wisdom teeth can cause pain, especially if they become impacted. If you have a toothache towards the back of your teeth/mouth, this could be the cause. Your dentist will be able to tell you more after seeing an x-ray.

•Abscess/Infection: Truthfully, an abscess or infection is usually the result of one of the above issues going untreated for a period of time. This can cause severe pain and swelling around the affected tooth.

Now that I've mentioned abscesses, I want to pause for a second and discuss how this relates to the topic of this post -- about dying from a toothache. While a toothache in and of itself will not kill you, an untreated infection -- anywhere on your body -- could. And (obviously) this includes tooth infections.

So yes, in this roundabout way, if you have a toothache that is caused by infection, the infection itself can possibly be fatal if it's left untreated. Thus, if you have that telltale swelling that signifies an abscess, you should get yourself to a dentist right away. At the very least, he or she will prescribe an antibiotic to reduce or eliminate the infection (which needs to be done before any dental work begins anyway). Also, a fever combined with a toothache should spur you to at least call your dentist.

One thing I also want to mention in terms of tooth infection is the mouth's proximity to the brain. They are next door neighbors, so the infection does not have to travel very far to affect one's brain. There was a fairly high-profile case in recent years where this very thing happened to a 12-year-old boy in Maryland. One more time: tooth infection is not to be taken lightly. I realize some treatments are expensive, but even pulling a tooth -- which is affordable to almost anyone -- is better than leaving it untreated.

Let's move along now and talk about a few other afflictions that list "toothache" as a symptom:

•Temporomandibular joint disorder aka "TMJ": This is an affliction that signifies acute or chronic inflammation of the temporomandibular joint, which connects your mandible to your skull. There are many symptoms for TMJ, including head and neck pain; difficulty biting; a "clicking" or "popping" of your jaw while chewing; and, yes, jaw and tooth pain. Your dentist can give you more information on this, but suffice to say, I have personally seen tooth pain caused by TMJ.

•Sinus Trouble: Your sinuses are right above your upper teeth. It's not overly common, but like TMJ, I have seen sinus issues and inflammation that have caused tooth pain.

•Heart Disease/Heart Attack: This is a biggie. Heart disease and heart attacks do list jaw pain/tooth pain as symptom. Again, this does not mean that if you have a toothache you are having a heart attack, but if you do have any kind of history of heart or coronary trouble or risk, you should pay extra attention to how your teeth and jaw feel. Especially if the toothache is accompanied with light-headedness and/or sweating (or any other heart attack symptoms).

I don't want to scare anyone -- in most cases, a toothache means a trip to the dentist for a filling is in order. But it's handy to know what else it might mean.

Until next time, keep smiling.

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