A sharp, sudden pain in the teeth or jaw immediately following a cough is a common and confusing symptom. Although it seems counterintuitive that a respiratory action could cause dental discomfort, the body’s interconnected anatomy makes this frequent. While the pain is typically brief, it signals that the forceful expulsion of air or an underlying condition is irritating sensitive structures in the mouth and face. Understanding the different origins of this pain, whether respiratory or dental, is the first step toward finding relief.
Sinus Pressure and Maxillary Teeth
The most frequent non-dental cause of pain upon coughing involves the relationship between the upper teeth and the maxillary sinuses. These large, air-filled cavities are situated directly above the roots of the upper back teeth (molars and premolars). Sometimes, the tips of the tooth roots are separated from the sinus only by a thin layer of bone, or may even slightly protrude into the sinus space.
When a person has a cold, flu, or sinusitis, the lining of the maxillary sinuses becomes inflamed and mucus accumulates. This fluid buildup creates increased pressure within the confined space, pressing mechanically on the adjacent tooth roots. A sudden, forceful cough exacerbates this pressure, momentarily irritating the nerves serving those upper teeth.
This is known as referred pain, where the brain interprets the pressure signal from the sinus nerves as originating from the dental nerves. Unlike pain from a cavity, this discomfort often affects several upper teeth simultaneously, typically on one side of the face. The pain feels like a dull ache or pressure that worsens when changing head position, such as bending over, which shifts the fluid inside the sinus.
Pain from Structural Dental Damage
Coughing can expose pre-existing vulnerabilities in a tooth’s physical structure, causing a sudden flash of pain. The jarring motion and rapid pressure fluctuation during a vigorous cough create shifts in compromised dental structures. This movement can irritate an already inflamed dental pulp, the nerve center deep inside the tooth.
If a tooth has deep decay, a cavity may have eroded the protective enamel and dentin layers, leaving the pulp vulnerable. A hairline tooth fracture or a vertical root crack can widen minutely with the pressure change from a cough, causing sharp pain. Loose or failing dental restorations (fillings or crowns) can also move slightly when jarred by a cough, momentarily stimulating the underlying tooth structure. Pain caused by structural damage is usually localized and may also be triggered by biting pressure or temperature changes.
Sensitivity Due to Gum and Root Exposure
Pain upon coughing can also originate from the neck and root surface of the tooth, distinct from crown damage. This sensitivity typically stems from gum recession, where the gum tissue pulls away from the tooth. This recession exposes the root surface, which is normally covered by gum tissue and a thin protective layer called cementum.
The exposed root surface is composed of dentin, a layer filled with thousands of microscopic channels called dentinal tubules. These tubules lead directly to the tooth’s internal nerve, allowing external stimuli to affect the nerve when exposed. When a person coughs, the rapid intake or expulsion of air, especially if cold, passes over the exposed dentin and triggers a sharp, short-lived pain known as dentin hypersensitivity. Conditions like periodontal disease or aggressive brushing contribute to this root exposure and subsequent air sensitivity.
When to Consult a Dentist
If pain resolves quickly after a cough and is accompanied by nasal congestion, it often points to a sinus issue. However, certain symptoms require a dental evaluation. A visit is warranted if the pain is focused intensely on a single tooth, rather than a general ache across multiple teeth, or if the toothache persists or throbs long after the coughing fit has ended.
Red flags include a visible sign of a dental problem, such as a lost filling or crown during a coughing episode. Persistent sensitivity to hot or cold temperatures, or pain when biting down, suggests a possible cavity, crack, or infection. Dentists use diagnostic tools like X-rays and tapping tests to determine if the pain originates from the tooth itself or is referred pain from an adjacent structure. Ignoring persistent or localized tooth pain increases the risk of the problem worsening into a serious infection.