What Are the Symptoms of Sepsis in the Teeth?

Introduction

The symptoms people mean when they ask about sepsis in the teeth are the symptoms of sepsis itself: confusion or disorientation, extreme pain or discomfort, fever or shivering and feeling very cold, a high heart rate or weak pulse, shortness of breath, and clammy or sweaty skin. Those come from the CDC, and any of them after a dental infection means calling 911 or going to an emergency room, not booking a dental appointment.

One clarification before the details, because it changes what you are watching for. Sepsis is not a condition of the teeth. The CDC defines it as "the body's extreme response to an infection," wherever that infection started. A tooth can be the starting point, but the symptoms show up throughout the body rather than in your mouth.

How Can a Tooth Infection Lead to Sepsis?

It starts as a local problem. The American Dental Association describes an abscessed tooth as "an infection caused by tooth decay, periodontal disease or a cracked tooth," with pus collecting at the root tip in the jaw bone. Left untreated, the ADA warns, "it can lead to a serious infection in the jaw bone, teeth and surrounding tissues."

From there, the body's response is what matters. The CDC explains that sepsis happens when an infection you already have "sets off a chain reaction throughout your body," and calls it "a life-threatening medical emergency." This is why the distinction above is practical rather than pedantic: you are not looking for a worse toothache. You are looking for signs that your whole body is reacting.

The ADA's clinical guidance on dental pain and swelling treats this as one of three triggers for urgent care, stating that patients "should be referred for urgent evaluation if their condition worsens, they develop a deep space infection, or sepsis is suspected."

It is worth keeping the risk in proportion. Sepsis from a dental infection is uncommon, and the reason it gets attention is the speed and severity when it does happen rather than the frequency. The CDC notes that most people who develop sepsis have at least one underlying medical condition, such as chronic lung disease or a weakened immune system, though it also says "anyone can develop sepsis." Our article on a tooth infection reaching the jaw covers the stages in between.

The Symptoms of Sepsis, According to the CDC

The CDC says a person with sepsis "might have one or more of the following signs or symptoms":

Confusion or disorientation

• Extreme pain or discomfort
  
• Fever, shivering, or feeling very cold
  
• A high heart rate or weak pulse
  
• Shortness of breath
  
• Clammy or sweaty skin

Notice what is not on that list. There is nothing specific to the mouth. That is the nature of the condition, and it is why a dental infection plus any of the above is a reason to get medical help immediately rather than to wait and watch the tooth.

The CDC is direct about the stakes: "Without fast treatment, sepsis can quickly lead to tissue damage, organ failure, and death." It also advises acting fast, and says healthcare providers "should immediately evaluate and treat people who might have sepsis." If you go in, say plainly that you have a dental infection and you are concerned about sepsis.

The Dental Warning Signs That Come First

Sepsis is the far end of a progression, and the earlier stages are where most people can still act. The ADA lists these signs of an abscessed tooth:

• Pain
  
• Swelling
  
• Redness in the gums
  
• A bad taste in the mouth
  
• Fever

Any of those means calling a dentist promptly. The ADA's guidance on dental symptoms is that a toothache should be evaluated by a dentist right away. Our guide to the signs of an infected tooth goes through them in more detail.

One caution from the American Association of Endodontists: an abscessed tooth "may or may not be painful." Severity of pain is a poor measure of how serious an infection is, and pain that fades after an abscess drains does not mean it is resolved.

When to Call 911 or Go to the Emergency Room

Do not wait for a dental appointment if you have:

• Any of the CDC sepsis signs above, particularly confusion, shortness of breath, or a racing heart alongside a dental infection
  
• Difficulty breathing, swallowing, or speaking, which points to swelling near the airway
  
• Swelling that is spreading across your face, jaw, or neck
  
• Swelling around the eye or sudden vision changes
  
• A fever with facial swelling, especially if you cannot reach your dentist

The ADA's general advice for dental emergencies is that "it's important to visit your dentist or an emergency room as soon as possible." You do not need to diagnose yourself first.

How to Lower the Risk

The reliable way to avoid a dental infection becoming a systemic one is to treat it while it is still local. The ADA lists the options for an abscessed tooth as drainage of the infection, cleaning the space between the tooth and the gum when gum disease is the cause, root canal treatment when decay or a cracked tooth is the cause, and antibiotics.

On that last one, AAE guidance is worth knowing: antibiotics are an addition to treatment rather than the treatment, and are reserved for evidence of systemic involvement such as fever, malaise, swollen lymph nodes, or cellulitis, and for patients who are immunocompromised. An antibiotic prescription is not a reason to skip having the tooth treated.

Further upstream, infections mostly begin with decay. The National Institute of Dental and Craniofacial Research notes that early decay often causes no symptoms at all, which is the case for regular checkups: a dentist can find a cavity before it reaches the pulp. NIDCR's prevention list is the familiar one, and it still works:

• Brush twice a day with fluoride toothpaste and clean between your teeth daily
  
• Limit sugary and starchy foods and drinks, and avoid frequent snacking
  
• Avoid tobacco products
  
• Keep regular dental checkups and professional cleanings

Tell your dentist about any condition or medication that affects your immune system, since the CDC notes that most people who develop sepsis have at least one underlying condition.

How Alpine Dental Helps

Alpine Dental provides dental emergency care and root canal treatment at our Lakewood and Jackson, NJ offices. If you have signs of a dental infection, call and describe them, and mention any condition or medication that affects your immune system.

If you have any of the CDC sepsis signs, or trouble breathing or swallowing, call 911 or go to the nearest emergency room first. A dental office is not the right setting for that, and you can call us afterward about the tooth.

So while the symptoms of sepsis in the teeth is a common way to search for this, what you are really watching for are whole-body signs after a dental infection. The dental warning signs come first, and treating the infection while it is still confined to the tooth is what keeps it from getting that far.

Call us at (732) 934-1888 or book an appointment online if you have signs of a dental infection.

Frequently Asked Questions

Can a tooth infection really cause sepsis?

Yes, though it is uncommon. The ADA warns that an untreated abscess can lead to serious infection in the jawbone, teeth, and surrounding tissues, and the ADA's clinical guideline names suspected sepsis as a reason for urgent evaluation. The CDC describes sepsis as the body's extreme response to an infection, which can start anywhere in the body, including a tooth.

What are the early signs of sepsis from a tooth infection?

The CDC's list is confusion or disorientation, extreme pain or discomfort, fever or shivering and feeling very cold, a high heart rate or weak pulse, shortness of breath, and clammy or sweaty skin. These are body-wide rather than dental, which is the point: if they appear alongside a tooth infection, treat it as an emergency.

Is difficulty swallowing a sign of sepsis?

It is not on the CDC's sepsis list, but it is still an emergency. Difficulty swallowing, breathing, or speaking suggests swelling near the airway from a spreading infection. Either way, it means emergency care rather than a dental appointment.

Does severe tooth pain mean the infection is spreading?

Not reliably, in either direction. The AAE notes that an abscessed tooth may or may not be painful, so pain is a poor gauge of severity. Spreading swelling, fever, and the CDC signs above are better indicators than how much the tooth hurts.

How can I prevent a tooth infection from getting to this stage?

Treat it while it is local. That means having a toothache looked at promptly, as the ADA advises, and keeping up the basics NIDCR recommends: brushing with fluoride toothpaste, cleaning between your teeth daily, limiting sugary foods and drinks, avoiding tobacco, and attending regular checkups, which can catch decay before it reaches the nerve.

SOURCES:

• https://www.cdc.gov/sepsis/about/index.html
• https://www.mouthhealthy.org/all-topics-a-z/abscess
• https://www.mouthhealthy.org/top-dental-symptoms
• https://www.mouthhealthy.org/all-topics-a-z/dental-emergencies/
• https://www.aae.org/patients/dental-symptoms/abscessed-teeth/
• https://www.aae.org/uploadedfiles/clinical_resources/guidelines_and_position_statements/aae_systemic-antibiotics.pdf
• https://www.cdc.gov/antibiotic-use/media/pdfs/ada-treatment-guidelines-508.pdf
• https://www.nidcr.nih.gov/health-info/tooth-decay