Sore Throat or Tooth Infection or A Bigger Problem?

Lymphadenitis: Is Tooth A Cause?

A brief article on how pain in your tonsillar area or in your lymph nodes could be due to infection in the mouth.

Swollen Lymph Glands – Is tooth a cause?

A lymph node or lymph gland is a pea-sized organ of the immune system. They are an important part of the immune system and are widely distributed throughout the body, interconnected by lymphatic vessels. They act as the reservoir of immune cells and are tightly packed with white blood cells like T lymphocytes, B lymphocytes and macrophages. Lymph nodes also act like filters. They trap the foreign particles or cells, effectively removing them out of circulation.

What is the significance of these lymph glands?

Lymph glands along with the white blood cells help to fight infections caused by bacteria, viruses, fungi, etc. and trap allergens and foreign particles. As a response to these infections or disease process they may become enlarged due to inflammation. Swollen lymph gland is known medically as lymphadenopathy. The lymph glands may be enlarged due to infections, glandular fever, immune system disorders or even cancer. So a swollen or a painful lymph gland may indicate some underlying pathology. If required your doctor can find out the cause of enlarged lymph node with blood tests, X-ray or a biopsy.

What are the common causes of swollen lymph glands?

This swelling is usually a result of local infection. Local infection is contained in a particular area of the body, for e.g. head and neck. Typical examples are –

·         Skin or wound infections, such as Cellulitis or Erysipelas

·         Dental Abscess or pus

·         Common cold

·         Throat infections

·         Ear infections

Swelling may also occur due to virus or bacteria entering the blood and affecting the whole body. Sometimes bacterial infection may cause blood poisoning and develop into a life threatening condition. Some of the examples of these systemic causes are –

·         Rubella

·         Measles

·         Glandular fever

·         Staph infection

Rarely lymph glands may be swollen due to cancerous growth. You can differentiate the selling due to cancer when the lymph gland;

·         Slowly gets bigger

·         Is in an unusual location

·         Is painless

·         Is firm or hard in consistency

Some of the unusual causes of swollen lymph glands may be lupus, rheumatoid arthritis, cat scratch fever, toxoplasmosis, syphilis, tuberculosis, etc.

Can an infected tooth cause swollen lymph node/gland?

Yes. The bacteria or micro-organisms affecting the wisdom tooth and harbouring in the mouth is primarily due to strains of Streptococcus and Staphylococcus. In case of the partially erupted wisdom tooth that hides under the gum tissue, forming a pocket in the mouth - food accumulation is often observed. These are favourable conditions for micro-organisms to grow and usually result in acute infections around these teeth and collection of pus. Considering the fact that this is an inaccessible zone and the dependent position of the tooth often harbours infection, lymphadenitis is a common problem. This when ignored, infection spreads backward into the area of your tonsils and throat causing inflammation and pain in your lymph nodes.

Infection in the lymph nodes could also be due to the other teeth. The various lymph nodes closest to the offending tooth are affected depending on their location. Infection in the mouth could also be due to tuberculosis or syphilis. The diagram below illustrates the harmful position of a partially erupted wisdom tooth.

Symptoms and Diagnosis

Infected lymph nodes enlarge and are usually tender and painful.  Sometimes the skin over the infected lymph node looks red and feels warm to touch. Occasionally pockets of pus develop.

Enlarged lymph nodes that do not cause pain, tenderness or redness may indicate a serious disorder such as Tuberculosis, Lymphoma or Hodgkin's disease.

Usually lymphadenitis can be diagnosed on the basis of symptoms and its cause is an obvious nearby infection. When the cause cannot be identified easily, a biopsy or a tissue sample under a microscope and a culture may be needed to confirm diagnosis.

The video shows the lymph nodes in the head and neck region which are often affected due to infection in the oral cavity and surrounding areas.

When you should see a doctor?

See your doctor if:

·         you also have a sore throat or find it difficult to swallow or breathe

·         you also have unexplained weight loss or a persistent fever

·         your glands feel hard or don’t move when you press them

·         your glands have been swollen for more than two weeks or are getting bigger

·         your glands are swollen for no apparent reason and you don't feel unwell

Treatment and Prognosis

1. Treatment depends on the organism causing the infection.

2. For a bacterial infection, antibiotics are usually given orally or intravenously.

3. Warm compresses may relieve the pain in inflamed lymph nodes.

4. Usually once the lymph node infection has been treated, the nodes shrink and pain subsides.

5. Sometimes the nodes remain firm but no longer feel tender.

6. Abscesses must be drained surgically.

                7. For a tooth related infection, the tooth should be removed or treated .

The video shows the lymph nodes in the head and neck region which are often affected due to infection in the oral cavity and surrounding areas.

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Thank you
Dr.Sreenita Chowdhury
drsreenita@tutdental.com