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Thomas P. Connelly, D.D.S.

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

Posted: 06/11/11 12:38 PM ET

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.

 

Follow Thomas P. Connelly, D.D.S. on Twitter: www.twitter.com/dr_connelly

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 p...
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 p...
 
 
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11:46 AM on 06/14/2011
Public service announcement: Did you know that meth use can actually cause you bad breath. Hence, stopping its use could actually be a good halitosis treatment. Alcohol and drug use are just one of the reasons for bad breath. Getting an insurance is probably a good thing to do if you have bad breath because it might be a sign of underlying sickness and you might need the coverage later on. Without prejudice to the insurance company denying your claim if your sickness was already pre-existing.
06:17 AM on 06/13/2011
Well written article ..!!
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sophie M
ANTI WAR./animal rescue
07:28 PM on 06/12/2011
my boyfriend is a vet, with PTSD........
no ........ dental care..he has had teeth pulled........
because he was in so much pain.
disgusting.
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Judith Jaehn
Animal Activist!
11:44 PM on 06/15/2011
I've had that kind of pain and I thought I was going to die....I had 3 pulled, horrible..
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frank day
Republican = FAIL
06:56 PM on 06/12/2011
We are lucky and have dental insurance.

Even so, it costs a freaking fortune in copays and coinsurance. Not to mention the deductible.

Many people are skipping treatment.

My dentists office is like a ghost town.
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Scott Douglas
03:44 PM on 06/12/2011
Only one sentence on cracked teeth. I've lost four molars due to them cracking right up into the jaw. It doesn't show up on an X-Ray and won't be discovered until the dentist starts to drill. He/she will start drilling for about thirty seconds and stop, shake his head and say "Oh no, it's a cracked tooth". It will have to come out. Then they rearrange you so your head is practically on the floor and your feet are sticking in the air and out come the pliers. The pain is excruciating but mercifully quick. They tell you to wear a bite guard at night while sleeping as it's usually a result of grinding your teeth in your sleep. I tried a bite guard twice. Both times I woke up to find the thing on the other side of the room. Oh well.
02:30 PM on 06/12/2011
If you live in an area where there is a University with a Dental School check their website for treatment info. They will fix your teeth for cheap since they are using students to do the work. I got 4 fillings xrays and exams for $200 at UPenn . Better then $600 if i would go to a regular dentist.
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sophie M
ANTI WAR./animal rescue
01:39 PM on 06/12/2011
Can anyone explain, why dental care , is not covered under your health insurance plan?
Why ..a separate policy?
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h23154
10:30 PM on 06/12/2011
Yes. Because unless you pay for it you do not get it. For example, why isn't life insurance part of your health insurance? If you want it buy it. It's available.
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sophie M
ANTI WAR./animal rescue
11:25 AM on 06/13/2011
your example makes no sense , neither does your insult.
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MeinNH
Ooooo Silly Me
08:48 AM on 06/13/2011
Dental and Vision care are separate money makers .... it is always about money and not health.
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sophie M
ANTI WAR./animal rescue
11:27 AM on 06/13/2011
bizare. i am surprised , they don't have a separate heart insurance, etc.
12:56 PM on 06/12/2011
At minimum, be absolutely clear that your children understand and practice good oral hygiene without fail. With fluoride in the water system cavites are almost extinct so it generally will come down to how good a job you do in cleaning your teeth and oral cavity and it is so much easier to do a good job when you start young.
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Greatest Darthfruit
So, you the brains of this outfit, or is he?
11:59 PM on 06/11/2011
take my advice: if a tooth hurts go to the dentist right the way!! don't wait!
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MIvoter1231
I rarely answer replies, too many are just hateful
07:18 AM on 06/12/2011
Yeah, right. You paying? I'll be happy to go in that case. Otherwise, I'll pass on your advice. I can't afford it no matter what I do.
12:46 PM on 06/12/2011
If there is a dental school in your area their charges are a fraction of normal charges and some have good information about how to obtain free care if that is your situation. (At least primary and preventive care)
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JohnDewey
Knowing Doing Being
11:07 PM on 06/11/2011
This article is all well and good, but what working class Americans really need is affordable dental care.

It's typical that this was written by a cosmetic dentist who tosses off the phrase, "if you have that telltale swelling that signifies an abscess, you should get yourself to a dentist right away," as though that were even remotely possible for most of us.

American dentistry, in the main, is focused on whiter, prettier teeth for the wealthy, rather than basic, accessible dental health for everybody.
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MIvoter1231
I rarely answer replies, too many are just hateful
07:15 AM on 06/12/2011
AMEN! No insurance, no cash, no treatment. My dental health is putting my life at risk. But do you think there's a dentist in town that give a tinker's dam? Not bloody likely. The clinics? Not bloody likely. They haven't accepted new patients in nearly three years, unless I'm willing to have all my teeth yanked. Sorry, missing teeth would ensure failure in my field, much less ensure long term unemployment. Try smiling at a client with no teeth.

I just finished my third course of antibiotics in a month (and the subsequent side effects), thanks to a friend that dates a doctor. She got me samples that kept the last, and one of the worst, flare ups of an abscess I've lived with for nearly 4 years from killing me. I live with multiple broken teeth, a serious chronic abscess and two other teeth that could break with my next bite.

So yeah, tell me to go to the dentist when I have a toothache. Right. I'll just hop over to the friendly neighborhood dentist and be turned away at the phone because I'm one of the people that can't get care no matter where I turn! I'd praise dentists if one, just one, was willing to help people like myself who have life threatening dental problems and no resource to get treatment. But once again, not bloody likely!!
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HotheadPaisen
Longform bio awaiting the Donald's approval.
01:10 PM on 06/12/2011
Actually there are dentists like that, though I haven;t seen any. Every so often there will be a 'free care day' for medical dental stuff in many cities. Google for info every so often and you may get lucky. I volunteer at our local Free Clinic, and if there's one in your area they are usually great. I just got info on free mammograms through the Dept of Health in my city but there's quite a long waiting list.
I wish those people who think there is NOTHING wrong with the American version of health 'care' could spend several days at their local free clinic. It is mind changing, life altering and humbling.
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02:26 PM on 06/12/2011
I have to agree with you on that! Plus, dentists no longer seem to care what the patient wants done first. I went to a dentist a couple years ago to get a crown fixed - wanted that done FIRST (as I had the cash on hand), then we could work on everything else with the remaining funds. He decided that my fillings were "too old" and needed to be replaced, even though x-rays did not show any decay under them. He wanted to replace them all with "natural looking fillings", even though he ADMITTED not having much experience doing them. For one tooth, it took EIGHT shots of Novacaine to dull it - then he proceeded to fill it. About three weeks later, he discovers a "shadow" at the root of the recently filled tooth. Now I'm on a course of antibiotics to fight the recurring abscess which swelled my jawbone up to the size of a golf ball. As for whether I will be returning to that dentist, the answer is "Hell no". Plus, I'm broke now so I couldn't afford to go back even if I wanted to.
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HotheadPaisen
Longform bio awaiting the Donald's approval.
01:06 PM on 06/12/2011
Exactly. Before I had to suck it up and take out student loans (at middle age no less) almost my entire debt is for dental work, which even with expensive insurance, I could only get by putting it on a credit card the dental chain was more than happy to issue...
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Runey
anti-religionists, converge and amass
04:34 PM on 06/11/2011
nice article
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FZliveson
Beating the Conundrum
01:14 PM on 06/11/2011
Sad to say but my dream is to "come into some money" so I can afford a lot of dental work. I miss having great teeth and am choosing to keep food on the table and other things in my life in order before trying to find the massive monetary instruments to get teeth fixed. I've has a few tooth aches and " muscled my way through" because neither funds nor insurance were available to cover the dental work. Bummerooski!
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multidoc
Re-animating the dead since 1922
01:56 PM on 06/11/2011
Check local dental schools if you have any for relatively inexpensive, excellent work.
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FZliveson
Beating the Conundrum
06:13 PM on 06/11/2011
Thanks. The one I did check with was about 1/3 the price of normal dentistry but it is still way out of my reach at present.
been2there
Facts have a liberal bias.
12:37 AM on 06/12/2011
Relatively inexpensive can be way above what someone can afford. As the poster said, the choice was food or teeth.
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sophie M
ANTI WAR./animal rescue
01:31 PM on 06/12/2011
exactly.it makes no sense , that we pay for a health care insurance ..and dental is not covered..
why?? 2 separate policies are necessary?........is unknown.
i have never met a dentist i like. .to me they are mongers...overcharge and poor work and u are stuck with it .
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MeinNH
Ooooo Silly Me
12:55 PM on 06/11/2011
Our teeth apparently are not a part to be insured unless you buy dental insurance .... many people do not have either. How nice it would be to go and get the proper dental care and screenings...but oh no, not for the American people. We have to fear death or having to find $500 (which in many cases won't happen) before a dentist will even see you for tooth pain. This nation is disgusting.
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MIvoter1231
I rarely answer replies, too many are just hateful
07:20 AM on 06/12/2011
You got that right. An important component to our overall health and we can't get insurance, much less care. Guess there are enough people with cash or insurance that it just doesn't matter what happens to the rest of us.
12:08 PM on 06/11/2011
Ahh to be young and toothless in the USA! How long till the British make fun of our teeth? Oh, but that just poor peoples problem isn't it... You all have top notch dental insurance from you wonderful middle class jobs. Oh wait, you don't...