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Toothaches can reveal sinus or heart problems
Published November 13, 2005
Toothaches happen. This ordinary and fairly common complaint can actually be more complicated than it first appears.
Tooth decay is the main cause of toothache, but it’s not the only one.
Teeth decay when bacteria build up on the surface of the teeth. These bacteria feed off the sugars and starches we eat. The bacteria then form acids that eat at the teeth.
If the bacteria penetrate the first layer of the tooth (the enamel or white part), it requires filling. Sometimes aggressive bacteria will even eat through the next layer of the teeth, the dentin. Again, a filling is the recommended treatment.
But if the decay progresses through enamel and dentin to the inner structure of the tooth itself (called the pulp), a root canal is required. In a root canal, the dentist removes the dying, bacteria-infested pulp and fills the inside of the tooth with an inert material.
Not all toothaches are a result of tooth decay. If a tooth is cracked or chipped, it can cause pain. An exposed root can cause pain. This might happen as gums recede with the progression of gum disease.
A less well-known cause of toothache is something dentists are increasingly calling “sinus toothache.” Sinus toothache isn’t actually a toothache in the true sense of the word. It occurs when swollen sinuses place pressure on the nerves of the face and jaws. In some people with sinus problems, a sinus flare-up can simulate a toothache, especially in upper back teeth.
It usually takes a dentist to determine if a toothache is caused by something related to the teeth (decay, damage, exposed root) or if it might owe to sinus pressure. The best cure for sinus toothache is to get rid of the sinus infection and do nothing special about the tooth. This requires a physician, who will treat the sinus infection. As sinus pressure is relieved, the toothache goes away.
Another cause of toothache can be TMJ or temporomandibular joint syndrome. People with TMJ have pain and limited mobility in their jaws. TMJ pain can sometimes be “confused” in the body with toothache. That is, a person with TMJ may occasionally feel as if she has a toothache, when in fact it’s just TMJ pain that the body misinterprets as a toothache.
A newly recognized and much rarer cause of toothaches can actually be angina or heart problems. When the blood vessels that supply the heart muscle with oxygen-rich blood get blocked, chest pains (angina) can result and even progress to a heart attack. For most people, this is painful, but sometimes it occurs “silently” (with no symptoms).
Angina sometimes manifests as a toothache or pain in the jaw or neck. If a toothache occurs and the dentist cannot find a dental cause (and there was no simultaneous sinus trouble), a toothache that comes on suddenly and goes away on its own may be worth a visit to a cardiologist. Some tests can reveal whether there is an underlying heart problem.
Jo Ann LeQuang is a medical writer based in Angleton who regularly contributes to The Facts.
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