As the name suggests Cardiac Toothache refers to pain in the tooth or orofacial region which can be a symptom of Cardiac problem. Cardiac Tooth pain can be an accompanying symptoms of Cardiac pain where the pain radiates from left arm, shoulder, neck and face. It has been seen in certain patients according to a study where Angina pectoris presents as Dental Pain or Tooth Pain. Diagnosing between Craniofacial pain vs Cardiac Pain is the major diagnostic challenge which is being faced by Dentists due to the similarity in the location of the pain. If Diagnosed in time it can help in early intervention of any Cardiac problem which can lead to Myocardial Infarction or Heart Attack if left unattended.
Cardiac Pain is generally seen as heaviness. tightness or throbbing pain in the substernal region which radiated to the left arm, shoulder, neck and the left side of mandible or lower jaw. According to some studies in patients with co-morbidity or history of heart disease, Severe referred pain felt in the mandible and maxilla from outside the head and neck region should be considered as Cardiac Pain and acted upon immediately.
Till few years ago, health professionals were not aware that certain oral bacteria, if permitted entrance into the gingival blood vessels, could cause some strokes and heart attacks (Infective Endocarditis). Toothache remains one of the discreet symptoms but, researchers say that in some cases Craniofacial pain is the sole symptom in Cardiac Ischemia (insufficient blood supply to the heart muscle) or Acute Myocardial infarction which is 10 times more common in females when compared to males.
Cardiac Toothache Symptoms:
1) Pain the Mandible associated with pain in the sub sternal (Middle of Chest) region
2) No Dental pathology seen which can cause the type of Dental Pain the patient is complaining of
3) Pain is sudden in onset and the intensity of pain is varying from Mild to Severe, the patient complains that the pain is gradually increasing in intensity
4) Tooth pain increases on performing any physical activity
5) Pain reduces on taking rest
6) Tooth pain is not relieved on taking Analgesics or Anesthetizing the Mandible
Many studies have shown that many patients have complained of Tooth or Jaw pain after or during suffering from Cardiac pain. Cardiac toothache is usually lowered on taking a dose of sublingual nitroglycerin. Many patients complain on Toothache as the major concern while the pain in the chest as milder pain which can be confusing and lead to a mis-diagnosis. Ischemic changes in the Heart can be associated with Cardiac Toothache.
We know that Oral Bacteria can enter the blood vessels and enter the arteries of the heart depositing or adhering to the fat in the arteries leading to clots which in turn lead to a condition called Infective Endocarditis which is the inflammation of the muscles and heart valves, this can progress into Coronary heart disease. In patients with prior history of Coronary heart disease, tooth ache associated with light headedness or seating should be considered as Cardiac toothache and no time should be wasted and immediate diagnosis should be done.