Tonsillitis is a common condition involving the inflammation of the tonsils, the two oval-shaped pads of tissue located at the back of the throat. This inflammation is usually caused by a viral or bacterial infection, resulting in a painful, scratchy throat and difficulty swallowing. Many people experiencing tonsillitis report discomfort or pain they perceive to be coming from their teeth, even though the infection is limited to the throat. This article explores the relationship between tonsillitis and tooth pain, explaining the neurological mechanism behind this symptom.
The Connection Between Tonsillitis and Tooth Pain
The direct answer to whether tonsillitis can cause tooth pain is yes. This pain is not an indication of a new cavity or a dental abscess, but rather a symptom secondary to the infection and inflammation in the throat. The discomfort is typically felt in the back teeth of the upper or lower jaw, located closest to the inflamed tonsils. This pain is temporary and resolves once the underlying tonsillitis is treated and the inflammation subsides.
This sensation arises because the nerves that supply the tonsils and the teeth share pathways that run close to one another. The brain misinterprets the strong pain signal originating from the inflamed throat, projecting the feeling to an area that is otherwise healthy. This sensory miscommunication is a common biological phenomenon that can occur with various infections.
How Referred Pain Works
The sensation of tooth pain from tonsillitis is a classic example of referred pain, where the brain mistakenly attributes pain from an infected area to a different part of the body. In tonsillitis, the irritation starts with the glossopharyngeal nerve (CN IX), which provides sensory innervation to the tonsils, the back of the tongue, and the upper pharynx.
When the tonsils become inflamed, the glossopharyngeal nerve is strongly stimulated, sending intense pain signals toward the brainstem. These signals enter a central nervous system area that also receives sensory input from the trigeminal nerve (CN V). The trigeminal nerve is responsible for sensation in the face, teeth, and jaw.
Because the pain signals converge in the same region of the brain, the brain interprets the signal as originating from the more familiar area of the face and mouth. This neural crossover results in the perception of a toothache, often a dull or throbbing ache, even though the teeth are healthy. The pain may also extend to the ear, as the glossopharyngeal nerve supplies sensation to part of the ear canal.
Distinguishing Tonsillitis Pain from Dental Pain
Recognizing the characteristics of the pain helps determine its origin and guide treatment. Tooth pain caused by tonsillitis is a dull, generalized ache not confined to a single tooth. This discomfort worsens when swallowing, indicating the source is in the throat. Referred pain does not cause sensitivity to hot or cold temperatures, nor does it intensify when chewing.
In contrast, true dental pain from a cavity, cracked tooth, or abscess is sharp, localized, and easily pinpointed to a specific tooth. A dental issue triggers intense, momentary pain upon exposure to temperature extremes, such as hot coffee or ice cream. Sharp and throbbing pain, especially upon applying pressure or chewing, suggests a direct problem with the tooth structure.
The presence of accompanying symptoms is the most helpful diagnostic indicator. Tonsillitis-related tooth pain occurs alongside signs of a throat infection, including high fever, visible redness and swelling of the tonsils, white patches or spots on the tonsils, and swollen, tender lymph nodes in the neck. If the tooth pain is an isolated symptom without signs of a systemic infection, a dental cause is much more likely.
Management and Next Steps
Management of referred tooth pain focuses entirely on treating the underlying throat infection. Once the tonsillitis resolves, the inflammation surrounding the glossopharyngeal nerve decreases, and the confusing referred pain in the jaw and teeth will disappear. Treatment involves rest, maintaining fluid intake, and using over-the-counter pain relievers like acetaminophen or ibuprofen to manage fever and throat discomfort.
If the tonsillitis is bacterial, a medical doctor will prescribe antibiotics to clear the infection. Patients must complete the entire course of medication to prevent the infection from returning. If the pain is severe and accompanied by signs like high fever, extreme difficulty swallowing, or an inability to open the mouth fully, immediate medical consultation is necessary.
A visit to the dentist is warranted if the tooth pain is sharp, localized to one tooth, or accompanied by visible dental trauma, a loose filling, or swelling around the gums, even if a sore throat is present. When symptoms are confusing, it is always best to seek a professional opinion. A medical doctor can assess the throat infection, while a dentist can quickly rule out or confirm a primary dental cause.