September 2025 is Dental Infection Control Awareness Month
1
Can toothaches kill?
A sore tooth is more than just an annoying pain. Left untreated, toothaches can lead to all sorts of nasty problems, including sepsis.
Sepsis is part of your body’s immune response to fighting infection. Unfortunately, it’s so aggressive and toxic that it can easily be life threatening. Each year nearly 270,000 people die from sepsis, according to the National Institutes of Health. It’s also a costly condition Sepsis is ranked as the most expensive in-patient cost in hospitals, according to the Healthcare Cost and Utilization Project.
How can a toothache cause sepsis?
The pain of a toothache is caused by infection. It’s possible for the bacteria causing the infection in your tooth to enter your bloodstream through the pulp of your tooth. From there, you can develop a dental abscess, or pocket of pus. An abscess usually causes a lot of pain, swelling, a bad taste in your mouth, fever and even sepsis.
If you have a toothache and visit your dentist, he or she can determine the cause of the problem, treat it and prescribe antibiotics to keep the infection from spreading. You may need a filling, braces, a crown, a root canal or even a tooth extraction, depending on how serious the infection is. These options may not sound appealing, but they’re much easier to manage than sepsis!
Prevention is easy
If you have a toothache, the best way to handle it is to visit your dentist right away. He or she can identify what’s causing the pain and determine the best course of treatment. You can also take the following steps to help you avoid toothaches completely.
- Visit your dentist regularly for cleanings. If you have health conditions that put you at risk for dental issue, consider visiting the dentist more frequently.
- Floss and brush after meals, including after lunch if possible.
- Use a mouthguard if you play sports. A damaged tooth can more easily get infected.
- Don’t use your teeth as impromptu tools, like bottle openers or scissors. They’re tough, but they can break.
Remember, if something feels “wrong” or hurts, let your dentist or dental hygienist know.
-
2
What you need to know about root canals
What are the signs I may need root canal treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. But sometimes, there are no symptoms.
Dentists use a variety of methods to determine which teeth need root canal treatment. One of the first evaluations is a percussion test, where your dentist will tap on the top and possibly the sides of your teeth to assess any pain or tenderness. Other evaluations include hot/cold testing, electric pulp testing, anesthesia or a cavity test.
How does dental pulp get infected?
Dental pulp is the soft tissue that contains nerves, blood vessels and connective tissue. It lies within the tooth and extends from the crown of the tooth to the tip of the root in the bone of the jaws.
When the pulp is diseased or injured and can’t repair itself, it dies. The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp and cause an infection inside the tooth. Left without treatment, pus builds up at the root tip, in the jawbone, forming a pus pocket called an abscess. Left untreated, an abscess can spread to the bone around the teeth and cause permanent damage. Untreated pulp can also develop a severe infection, which may eventually cause sepsis.
Why does the pulp need to be removed?
When the infected pulp is not removed, pain and swelling can result, and the infection can damage your bone. Without treatment, your tooth may have to be removed.
What does root canal treatment involve?
Procedures generally go like this:
1. Your tooth and the surrounding area are numbed with anesthesia.
2. The dentist drills a hole to access the source of decay.
3. Using a long cleaning file, the dentist removes the pulp, bacteria and decayed nerve tissue. He or she scrubs the sides of the canal, using water or sodium hypochlorite to wash away the debris.
4. Almost done! The tooth is sealed, using a temporary or permanent filling. The dentist may choose a temporary filling if he or she wants to apply medication inside the tooth or check the tooth’s recovery after several days. When the tooth is ready for a permanent filling, the dentist places a mixture called gutta-percha in the root canal and fills the access hole with resin or amalgam.
5. Finally, you might need follow-up appointments to place a crown or other restoration. Such restoration can protect a tooth weakened by decay and treatment.
Will the tooth need any special care or additional treatment?
You should not chew or bite on the treated tooth until you have had it restored by your general dentist because your tooth could fracture. Otherwise, just practice good oral hygiene: brushing, flossing and regular checkups and cleanings. Endodontically treated teeth can last for many years, even a lifetime.
How long does the restored tooth last?
Your restored tooth could last a lifetime if you continue to care for your teeth and gums. However, regular checkups are necessary and you may need a crown on your treated teeth, since they’re weaker than live teeth. As long as the roots of a treated tooth are nourished by the tissues around it, your tooth will remain healthy.
Who performs a root canal?
All dentists, including your general dentist, received some training in endodontics while in dental school. Endodontists are specialists who perform only endodontic procedures, both routine and complex. They are also experienced at finding the cause of oral and facial pain that is difficult to diagnose. Your primary care dentist may refer you to an endodontist for root canal treatment.
-
-
3
What causes a toothache?
Toothaches can leave you miserable. You can’t see its cause, it generally doesn’t go away on its own and you can’t massage it like a muscle knot. It’s also often an indicator of a serious problem that requires immediate attention from a dentist.
Most toothaches are the result of tooth decay, which means you probably have advanced gum disease. The pain you feel — usually when you eat or drink something sweet, very hot or very cold — is an alarm bell telling you that the pulp inside your tooth is irritated. The pulp is where the soft tissue and nerves in your tooth are located, so if something is wrong with the pulp, you’ll feel it in the entire tooth.
Common causes of a toothache
A thorough oral exam is the best way to find out why you’re experiencing a toothache, but generally the reasons fall under one of these causes:
- Infection
- Gum disease
- Grinding teeth (bruxism)
- Tooth trauma
- An abnormal bite
- Sinus pressure
- Tooth eruption (in babies and school-age children)
How can I tell what the cause of my toothache is?
It’s important to pay attention to little things that might seem “off” with your teeth and the inside of your mouth.
For example, you might have an abscess, which means that pus has collected around the tooth root. Pus can be a sign of a bacterial infection, especially if it’s accompanied by tissue inflammation, bleeding gums and bone loss around the tooth. In either case, you should see your dentist as soon as possible.
While an abscess means you should visit your dentist, any of the following symptoms could indicate that you need to visit the emergency room:
- Fever
- Pain when you bite
- A foul-tasting discharge
- Difficulty breathing or swallowing
- Swelling around the tooth area
- Continuous pain that doesn’t end, instead of pain just when you eat or drink something
One major health issue related to toothaches is the presence of sepsis, which is when an infection that had previously been localized begins to spread throughout your body. If sepsis develops and is left untreated, it can kill you. Nearly 2,000 people a year are hospitalized with it, and it nearly always develops from a treatable bacterial infection. If you have a toothache, you need to get it examined to ensure it doesn’t develop into a life-threatening condition.
My dentist says there’s nothing wrong with my jaw or teeth. What’s causing my toothache?
The body manifests pain in many ways, and in some cases, what seems to be a simple toothache isn’t one at all. Rather, the pain is a symptom of another problem. Extreme stress, prior trauma, heart conditions and even some forms of cancer can present as pain in the mouth that appears to have no cause.
Do you have a cold or severe allergies? These can cause sinus pressure, which can also put pressure on the roots of your upper molars, leading to tooth pain. Talk with your physician to see if an antihistamine might help relieve the pressure. If the pain doesn’t go away, see your dentist.
Also, if you suffer from chronic pain, migraines, limb movement disorders or similar problems, you should tell your dentist so he or she can better identify the cause of your pain.
The words you use to describe your pain are important, too. The following words often describe types of pain that don’t originate in the mouth, so your dentist will probably ask for more details to help eliminate all known causes:
- Burning
- Tingling
- Electric
- Searing
- Stabbing
- Numb
Your dentist will probably ask how long you’ve been feeling the pain, so think back. It may even be helpful to keep notes for reference once you begin experiencing a toothache.
The most important thing to remember is that pain in your mouth is not normal. If your tooth hurts and something feels wrong, go to your dentist. Hopefully, it’s something minor that can easily be treated, but it’s not worth taking a risk that could endanger your health.
-