Tonsillitis is the inflammation of the tonsils, the two lymph tissues located at the back of the throat. While the condition is known for causing a severe sore throat, it can also produce discomfort that seems to originate elsewhere, including the teeth. This discomfort is typically a form of referred pain, where the brain misinterprets the true source of the painful signal, localizing the ache in the teeth or jaw.
How Tonsillitis Causes Referred Tooth Pain
The reason tonsillitis can cause pain that feels like a toothache lies in the shared neural pathways of the head and neck. This mechanism is known as referred pain, where an internal organ or inflamed structure sends pain signals through nerves that also supply a different area of the body. The brain then incorrectly attributes the sensation to the secondary area, such as the teeth or jaw.
Specifically, the Glossopharyngeal nerve is responsible for this sensory crossover. This nerve provides sensation to the tonsils, the back of the tongue, and parts of the upper throat. Crucially, its branches also contribute to the sensation of the ear and the angle of the jaw, which is near the back molars.
When the tonsils become significantly inflamed due to infection, the Glossopharyngeal nerve transmits intense pain signals to the brain. Because this nerve pathway is shared, the brain may mistakenly interpret the signal as originating from the area it also innervates, such as the lower jaw or teeth. This results in the sensation of a toothache, even though the teeth themselves are healthy and unaffected by the infection. The tooth pain is often felt most intensely near the back molars on the same side as the affected tonsil.
Recognizing Other Tonsillitis Symptoms
While referred tooth pain rarely occurs in isolation when caused by tonsillitis, the primary sign is a severe sore throat lasting longer than 48 hours. When examining the throat, the tonsils appear visibly red and swollen, sometimes displaying white patches, streaks, or pus-filled spots. The presence of these classic signs alongside what feels like a toothache helps distinguish tonsillitis from a dental issue.
Accompanying symptoms often include:
- High temperature or fever and generalized fatigue.
- Painful swallowing (odynophagia), which makes eating and drinking difficult.
- Tender and swollen lymph nodes in the neck and jaw area.
- A muffled or scratchy voice, bad breath, or headache.
If a sore throat is also accompanied by a runny nose or cough, the tonsillitis is more likely caused by a viral infection.
Treatment Options and When to See a Doctor
Managing the referred tooth pain involves treating the underlying tonsillitis and utilizing symptomatic relief. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help reduce both the throat pain and the fever, which in turn diminishes the inflammatory signal causing the referred tooth discomfort. Applying a warm compress to the jaw or gargling with warm salt water several times a day can also provide soothing relief for the generalized pain in the area.
It is important to see a doctor for a proper diagnosis, as tonsillitis can be caused by either a virus or bacteria, such as Group A Streptococcus, which causes strep throat. A doctor will typically perform a physical examination and may conduct a throat swab test to determine the cause of the infection. If the infection is bacterial, antibiotics will be prescribed, and it is imperative to complete the full course as directed, even if symptoms improve quickly.
If the tonsillitis is viral, antibiotics are ineffective, and treatment focuses entirely on rest, hydration, and symptom management. Immediate medical attention is necessary if symptoms are severe or concerning. These red flags include:
- Difficulty breathing.
- An inability to swallow saliva or liquids.
- Severe pain that does not improve with pain medication.
- Difficulty opening the mouth.
- The appearance of one tonsil being significantly larger than the other, which may indicate an abscess.