Can bad teeth actually make you sick, and what happens if I keep putting this off?

We don't use fear to sell

Health scares are an easy way to push someone toward surgery, and we don't use them. Someone frightened into booking hasn't made a real decision, and they often feel resentful once the fear fades.

This page sets out what's known, and what's urgent and what isn't. If you finish it and decide you're not in a hurry, that's a fair conclusion.

Antibiotics don't remove an infection

When decay reaches the nerve of a tooth, the nerve dies and the empty space fills with bacteria. That causes an infection at the root, in your jaw. It's a live infection inside your body.

Antibiotics bring the bacteria down. The pain stops, the swelling goes down, and it's natural to think the problem is solved.

It isn't. Like a splinter that's stopped hurting, the source is still there, and it can flare up again, usually at a worse time.

To clear a dental infection, the source has to be removed, either with a root canal or by taking the tooth out, along with the infected tissue. Once it's gone, the site closes and heals. Bodies are good at healing once they have nothing left to fight.

When a dental infection becomes an emergency

This is rare, but it's real.

There are spaces between the muscles in the floor of the mouth and the neck. An infection from a lower back tooth can get into them and spread quickly, and swelling there can press on the airway.

That's behind the occasional news story about someone dying from a toothache. A toothache usually isn't dangerous. A particular infection, in a particular place, left long enough, can block breathing.

Get seen the same day if you have any of these:

• Swelling that is spreading rather than staying put
• Swelling under the jaw or in the floor of the mouth
• Trouble swallowing
• Trouble opening your mouth
• Trouble breathing
• A fever

If breathing or swallowing is affected, go to an emergency department, not a dental office.

The long-term links

Long-term gum disease is a low-grade infection sitting right next to your bloodstream. Two links to the rest of the body are well established.

Heart and blood vessels. People with gum disease have a higher risk of heart attack and stroke, even after shared risk factors are accounted for. That's a link. It hasn't been shown to be the cause. The American Heart Association says the evidence doesn't show gum disease causes heart disease, and there's no evidence that treating gum disease prevents it.

Diabetes. It works both ways. Diabetes makes gum disease worse, and gum disease makes blood sugar harder to control. Treating gum disease improves blood-sugar control by a modest but meaningful amount over the following months. That finding comes from randomized trials.

It's a good reason to treat gum disease. It isn't a reason to decide anything this week.

If money is why you're waiting

If you have an active infection, waiting another year to save up costs you bone, and bone is what implants anchor into. It can make your treatment harder than it needed to be.

You don't have to do everything at once. Taking out infected teeth is a much smaller procedure than a full arch. It can be done first, on its own, to stop the damage while you plan and pay for the rest.

If that's you, tell us at your consultation and ask how we'd handle it, including whether those extractions are credited toward your later treatment. You should hear that answer before you commit to anything.