"A tooth infection can kill you, but rarely," warns a Cleveland Clinic expert. Here's how to recognize the risks and how it can escalate.
How Long Until a Tooth Infection Kills You? An Expert Doctor Answers a Surprisingly Common Question
Published on Feb. 01, 2025
About the expert
Sasha Ross, DMD, MS, is a board-certified periodontist who has been with the Cleveland Clinic since 2013. She earned her dental degree from the Harvard School of Dental Medicine and completed her residency in periodontics at the University of Illinois at Chicago Hospitals. Dr. Ross also holds a Master’s degree in Oral Science.
Oral health issues are a common problem, with the World Health Organization (WHO) estimating that around 3.5 billion people globally are affected by oral diseases. This is a good reminder that taking care of your mouth isn’t just about having an attractive smile: While routine dental care can address many problems, leaving a condition like a tooth infection untreated can lead to rare but severe cases when bacteria from an untreated tooth infection can spread beyond the mouth, entering the bloodstream and leading to life-threatening conditions such as sepsis or endocarditis.
Sasha Ross, DMD, MS is a board-certified periodontist with the Cleveland Clinic, specializing in diagnosing and treating conditions affecting the gums and supporting structures of the teeth. Ahead, Dr. Ross offers expert insights on the dangers of untreated infections, key symptoms that should never be overlooked, and practical tips for preventing dental problems from developing in the first place.
What is a tooth infection?
“A tooth infection is an accumulation of inflammatory cells at the base of a tooth or along its side,” explains Dr. Ross. Commonly referred to as a tooth abscess, this condition can occur due to a dying or dead nerve, debris like a popcorn kernel or tartar trapped under the gum tissue, or a fracture in the tooth root. These factors create the perfect environment for bacteria to thrive, leading to an infection that requires prompt attention.
Symptoms of a tooth infection
Tooth infections can present in a variety of ways, with some of the most common symptoms including:
- Throbbing pain during chewing, brushing, or at rest
- Sensitivity to hot or cold foods
- Swelling in your gums or face
- Bleeding gums
- Fever
- Foul taste in the mouth
- Swollen lymph nodes
Dr. Ross adds: “Interestingly, many tooth infections do not cause pain and are discovered incidentally on a dental x-ray.” This is why maintaining regular dental checkups is essential for catching and addressing potential issues early.
Can a tooth infection kill you?
“A tooth infection can kill you, but rarely,” says Dr. Ross. When an infection cannot drain into the oral cavity, it may spread to the surrounding soft tissues, leading to a condition known as facial cellulitis. This is a bacterial skin infection that causes redness, swelling, and pain in the face, and if left untreated, it can progress rapidly.
One severe complication of facial cellulitis is Ludwig’s angina, a condition where the infection causes significant swelling in the neck and tongue, potentially obstructing the airway. This is a medical emergency that can quickly become fatal. “Before antibiotics, mortality from Ludwig’s angina was over 50%. Now, mortality is less than 10%,” explains Dr. Ross. Ludwig’s angina is most commonly associated with infections in the lower second or third molars.
In addition to Ludwig’s angina, untreated tooth infections can lead to other severe complications, such as:
- Sepsis: A systemic response to infection that can lead to organ failure and death.
- Brain abscesses: If the infection spreads to the brain, it can result in a dangerous collection of pus and swelling.
- Heart infections: Oral bacteria can sometimes enter the bloodstream and cause infective endocarditis, an infection of the heart’s inner lining.
Risk factors for severe tooth infections
There are certain factors that can increase the likelihood of complications from a tooth infection, including:
- Poor oral hygiene: Inadequate dental care can lead to untreated infections.
- Avoiding the dentist: Delaying treatment allows infections to worsen.
- Weakened immune system: Conditions like uncontrolled diabetes, AIDS, and organ transplantation can reduce the body’s ability to fight infections.
- Smoking: Damages the oral environment, making it easier for infections to take hold.
- Excessive alcohol use: Impairs immune function and overall health.
How long until a tooth infection kills you?
The Cleveland Clinic notes that a tooth infection can take weeks or even months to spread, and there’s no precise timeline for how quickly it might become dangerous. However, in severe cases, complications can escalate rapidly. For example, Ludwig’s angina can progress to a life-threatening condition in just a matter of hours, warns Dr. Ross.
To understand this risk, it’s helpful to know how a tooth infection develops and worsens. A tooth infection begins when bacteria invade the tooth’s inner pulp due to untreated cavities, cracks, or trauma. If not addressed, the infection can spread to surrounding tissues, bone, and even the bloodstream, increasing the potential for severe complications.
When to see a dentist
If you have persistent tooth pain, swelling around the gumline, or heightened sensitivity, these are signs it’s time to see your dentist. These are early signs of an infection that need attention. However, certain symptoms indicate an urgent need for medical care, including fever, severe pain, difficulty swallowing, or visible drainage from the infection site.
Dr. Ross highlights a particularly concerning symptom: facial swelling. “If you have facial swelling and cannot reach your dental provider, please go to the ER,” she advises.
How are tooth infections treated?
“Tooth infections are treated differently depending on their cause and severity,” explains Dr. Ross. The treatment plan can range from minimally invasive procedures to more advanced interventions.
Dr. Ross shares a breakdown of common treatment approaches:
Root canal
For infections originating inside the tooth, a root canal performed by an endodontist (a specialist in root canals) may be the solution. This procedure removes the infected tissue within the tooth, helping to eliminate the infection. “For a root canal to be successful and get rid of the infection long-term, most teeth will need crowns after—a treatment that your general dentist would do,” notes Dr. Ross.
Professional cleaning
If the infection is caused by debris trapped under the gum, known as a periodontal abscess, treatment typically involves:
- Numbing the affected area.
- Cleaning under the gum to remove debris.
- Placing an antibiotic beneath the gum if necessary.
- Prescribing an oral antibiotic and, sometimes, an antibacterial mouth rinse.
Tooth extraction
When a crack in the root of a tooth is the source of the infection, the tooth may need to be extracted. This step is often essential to prevent further complications and to stop the spread of infection.
IV antibiotics and drainage
In cases where the infection causes significant swelling, such as in the cheeks, more intensive treatment may be required. This can include administering intravenous (IV) antibiotics to control the infection and draining the swelling to relieve pressure and reduce discomfort.
It’s important to note that tooth infections require professional treatment to fully resolve. While the body’s immune system can sometimes manage mild infections temporarily, it’s unlikely to eliminate a serious tooth infection without medical intervention.
Home remedies, though helpful for temporary relief, are not a substitute for professional care. Applying cold compresses and taking over-the-counter pain relievers, as recommended by your doctor, can help alleviate discomfort while you wait for your appointment. However, these measures won’t address the root cause of the infection. If you think you have a tooth infection, always reach out to your dentist so you can get the appropriate treatment you need.
How to prevent a tooth infection
Dr. Ross lists ways to help you lower the risk of developing a tooth infection:
- Practice good oral hygiene: Brush your teeth twice daily and floss regularly to remove plaque and food particles that can lead to infections.
- Visit your dentist regularly: Schedule cleanings and dental exams at least twice a year. If you have periodontal disease, you may need more frequent cleanings and specialized care from a periodontist.
- Avoid harmful habits: Stop smoking and limit alcohol consumption, both of which can increase your risk of oral health issues.
- Manage overall health: See your physician annually to ensure your medical conditions, such as diabetes, are well controlled, as poor systemic health can impact your oral health.
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