Strep throat, caused by Group A Streptococcus bacteria, is a common bacterial infection known for triggering a severe sore throat and difficulty swallowing. The infection causes inflammation and irritation in the pharynx and tonsils. This localized pain sensation does not always stay confined to the throat area; it can sometimes manifest unexpectedly as a deep, throbbing ache that feels distinctly like a toothache. This confusing sensation is a classic example of referred pain, where the brain misinterprets signals from one area of the body as coming from another.
How Strep Throat Causes Referred Tooth Pain
Referred pain occurs because the nerve pathways serving the throat, jaw, and teeth share a common relay station in the brain. The glossopharyngeal nerve (Cranial Nerve IX) transmits sensory information from the back of the throat, tonsils, and base of the tongue. When the strep infection causes inflammation, the glossopharyngeal nerve becomes irritated.
Pain signals generated by inflamed throat tissue are sent to the brainstem. These signals often cross paths with the sensory branches of the trigeminal nerve (Cranial Nerve V), which provides sensation to the teeth, jaw, and face. Because the brain is accustomed to receiving pain signals from the teeth via the trigeminal nerve, it can incorrectly map the signal from the glossopharyngeal nerve onto the jaw or lower teeth. This misinterpretation results in the perception of a throbbing or shooting pain in the teeth, even though the teeth themselves are not infected.
Other Sources of Tooth Pain While Sick
Tooth pain coinciding with a strep infection is not always referred pain; other physical issues can cause the discomfort. A common cause is sinus pressure, which can mimic a toothache, especially in the upper jaw. The roots of the upper molar teeth sit very close to the maxillary sinuses. When the infection causes the sinus lining to swell, the pressure can push down on dental nerve endings, causing a diffuse ache in the upper teeth.
Severe illness often triggers a systemic inflammatory response which can exacerbate pre-existing dental problems. An underlying cavity, a cracked tooth, or mild gum disease may suddenly become painful due to the increased inflammation throughout the body. Generalized body aches and stress can also lead to unconscious jaw clenching or teeth grinding, resulting in soreness.
The lymph nodes in the neck and under the jaw commonly swell and become tender while fighting a strep infection. This swelling can press on nearby nerves and muscles, creating a sensation of pain felt in the jaw and teeth area.
When to Consult a Doctor or Dentist
The tooth pain caused by referred sensation from strep throat should begin to resolve shortly after starting antibiotics and as the throat inflammation subsides. Over-the-counter anti-inflammatory medications can help manage this discomfort by reducing the swelling that irritates the nerves. If the pain is generalized and affects multiple teeth without a specific focal point, it is likely related to the infection and should improve within a few days of treatment.
A localized, sharp, or persistent pain that focuses on one tooth may signal a separate dental issue, such as an abscess, which needs a dentist’s attention. You should contact your dentist if the tooth pain remains after the strep infection is cured, or if you notice swelling in the gums or face. Immediate emergency care is necessary if the pain is coupled with difficulty breathing or swallowing, as this could indicate a rapidly spreading infection in the neck.