Someone walks up a steep hill and feels a heavy ache spread along the lower jaw, then notices it fade a few minutes after they stop. That pattern, jaw or tooth pain that arrives with exertion and eases with rest, should be treated as a possible heart symptom. The right response is to call Triple Zero (000), not to book a dental appointment, because no dental examination or X-ray can rule out a heart cause.
The Heart Foundation lists the jaw, along with the neck and back, among the places some people feel heart attack pain, and studies of heart patients show it can be felt in the teeth. Most jaw pain is not cardiac. This article explains how to recognise the pattern that is, and why it is worth acting on even when you are unsure.
Call 000 now if the jaw pain comes with any of these
Stop reading and call Triple Zero if jaw, tooth, throat or ear pain is happening together with:
- pressure, heaviness, tightness or burning in the chest, arm, shoulder, neck or back
- pain that started or worsened with effort, such as climbing stairs or carrying something, and eased when you stopped
- shortness of breath
- sweating, particularly a cold sweat
- nausea or vomiting
- dizziness, light-headedness or feeling faint
- sudden, unexplained exhaustion
Do not drive yourself, and do not take medicines, including aspirin, on the strength of a web page. The call-taker can advise you. Paramedics would much rather find a dental problem than arrive too late.
Why a heart problem can be felt in the face
The heart cannot signal precisely where pain is coming from. One explanation is that nerve signals from the heart meet, in the brainstem and upper spinal cord, nerve cells that also receive signals from the trigeminal nerve, the nerve that supplies the face, jaws and teeth. When two sources feed into the same pathway, the brain can attribute pain from one to the location of the other. This is known as referred pain, the same principle behind heart pain felt in the left arm. The exact pathways are still debated.
Research has linked jaw and facial pain during cardiac ischaemia particularly with reduced blood supply to the lower (inferior) wall of the heart.
How often heart problems cause jaw or tooth pain
Kreiner and colleagues asked patients with confirmed cardiac ischaemia exactly where they felt pain, and reported in the Journal of the American Dental Association (2007) that close to four in ten described pain somewhere in the head, face, jaw or throat. A small proportion had pain only in those areas, with no chest pain at all.
It is important to read that the right way round. These studies began with people already known to be having a heart event and asked what hurt. They do not tell us what share of toothaches are heart attacks, which is very small. What they do show is that facial pain is a real way for heart trouble to present.
That matters because heart attacks without typical chest pain are more likely to be recognised late. Studies have found worse outcomes in people whose heart attacks present atypically, partly because of that delay. Recognising the pattern quickly is the point.
Telling cardiac pain apart from a toothache
A study by the same research group in the Journal of Dental Research (2010) compared how people described the two kinds of pain. Pain of cardiac origin in the face was most often described as pressure or burning. Dental pain was more often described as throbbing or aching. Cardiac pain was also less likely to be confined to one tooth, and could be felt across the jaw, in the throat or near the ear, on either side.
| More typical of a toothache | More typical of heart-related pain | |
|---|---|---|
| Feel | Throbbing, aching, sharp with hot or cold | Pressure, heaviness, burning |
| Location | Usually one tooth you can point to | Spread across the jaw, throat or ear, either side |
| Triggers | Biting, hot, cold or sweet food and drinks | Physical effort, emotional stress, cold weather |
| What eases it | Avoiding the tooth, pain relief | Resting |
| Other signs | Gum swelling, tenderness over one tooth | Breathlessness, sweating, nausea, dizziness |
| Next step | Book a dentist | Call 000 |
Use this as a reason to act, not a way to talk yourself out of calling for help. Only medical tests such as an electrocardiogram can exclude a heart cause.
Other non-dental causes of facial pain have their own patterns. Several upper back teeth aching together after a cold suggests the sinuses, covered in our article on sinus toothache and referred pain. Brief electric-shock pain set off by light touch is typical of trigeminal neuralgia. Aching with clicking and clenching usually comes from the jaw joint and muscles, explained in our guide to TMJ and jaw pain.
Women often present differently, but chest pain is still most common
The Heart Foundation notes that the less typical heart attack symptoms, such as jaw, neck or back pain, are particularly common in women. That does not mean jaw pain is the main symptom in women. Chest pain or discomfort remains the most common heart attack symptom in both women and men. The accurate point is narrower: women are somewhat more likely to have symptoms other than chest pain, and those symptoms tend to be recognised later.
Pain that does not behave like a dental problem
Published case reports describe people who had dental treatment, including extractions, for pain that did not settle, and who were later found to have coronary artery disease, with the pain resolving once the heart was treated. These are individual reports and say nothing about how often this happens. They do illustrate a useful rule: pain that does not fit a dental cause, or does not respond to dental treatment, deserves a different question.
The evidence is thin, and the advice still stands
Much of what is known about facial pain from the heart comes from case reports and a small number of studies, often from the same research groups. Systematic reviews have rated the overall quality as low and could not firmly establish how often facial pain is the only symptom. Dramatic misdiagnoses are also more likely to be published than ordinary toothaches.
None of that changes what to do. Uncertainty about how often something happens is not evidence that it does not happen. Calling 000 for pain that turns out to be dental costs very little. Waiting with a heart attack can cost a great deal.
What a dental visit can and cannot show
A dentist can test whether a tooth's nerve is healthy, check whether it hurts to bite on, and look for infection on an X-ray. Those tests can confirm a dental cause. They cannot exclude a heart cause. One clue dentists use is that numbing a suspected tooth with local anaesthetic should stop pain that is coming from that tooth; if it does not, the pain may be referred from elsewhere. If a heart cause is suspected during a dental visit, treatment stops and the person is directed to urgent medical care.
This acute warning sign is separate from the long-term link between gum inflammation and cardiovascular disease, which plays out over years. Our article on gum disease and heart health covers that connection.
Questions people ask about jaw pain and the heart
Can a heart attack feel like a toothache?
Yes, occasionally. It tends to feel like pressure or burning rather than throbbing, is often spread rather than in one tooth, and is linked to exertion. If that fits, call 000.
Is left-sided jaw pain more worrying?
Heart-related jaw pain can occur on either side or both. The side matters less than the pattern: brought on by effort, eased by rest, or accompanied by breathlessness, sweating, nausea or dizziness.
When should I go to hospital for jaw pain?
Straight away, by ambulance, if the pain fits the heart pattern above. Jaw pain with facial swelling, fever or trouble swallowing is a different emergency, usually from infection, and also needs hospital care the same day.
If a heart cause has been checked and ruled out and the pain turns out to be dental, our dentists see new patients at our Melrose Park practice. You can see current offers on our current deals page or contact the practice during opening hours.
This article is general information only and is not personal advice. If you think you may be having a heart attack, call Triple Zero on 000.
