Can vitamin B12 deficiency cause toothache? The surprising oral health connection

December 20, 2025 •

4 min read

According to research, oral symptoms can often be among the first indicators of a vitamin B12 deficiency, sometimes appearing even before other systemic signs like anemia. So, while a lack of B12 doesn't directly cause a traditional cavity-related toothache, it can lead to various oral pains and sensations that mimic it.

Quick Summary

Vitamin B12 deficiency can induce oral pain through indirect effects such as nerve damage and inflammation of soft mouth tissues. It may result in burning mouth syndrome, glossitis, or mouth ulcers, all of which can feel like tooth discomfort. A comprehensive dental and medical evaluation is essential to determine the root cause of the pain.

Key Points

Indirect Cause: Vitamin B12 deficiency doesn't cause cavities but leads to oral pain through nerve damage and soft tissue inflammation.
Nerve Involvement: The deficiency can cause neuropathy that affects facial nerves, leading to pain that feels like a toothache.
Oral Symptoms: Common signs include glossitis (a sore, swollen tongue), burning mouth syndrome, and mouth ulcers.
Distinguishing Pain: B12-related pain is often a generalized burning or tingling, unlike the localized sensitivity of a typical cavity.
Dental Evaluation First: A dentist can rule out common dental problems before a B12 deficiency is considered as the cause of oral pain.
High-Risk Groups: Vegans, the elderly, and people with malabsorption issues are more susceptible to B12 deficiency.
Treatment is Effective: Oral and neurological symptoms often improve significantly with appropriate B12 supplementation.

How Vitamin B12 Deficiency Leads to Oral Pain

While you won't get a cavity from a lack of vitamin B12, the deficiency can cause oral discomfort that is often confused with a toothache. This is primarily due to its crucial role in nerve function and red blood cell production. When B12 levels are low, nerve health is compromised, and the supply of oxygen to oral tissues is reduced, leading to inflammation and pain.

Neuropathic Pain and Trigeminal Neuralgia

One of the most significant ways a B12 deficiency can lead to pain is through nerve damage, or neuropathy. Vitamin B12 is essential for producing myelin, a protective sheath around nerves. Without sufficient myelin, nerves can become damaged, leading to abnormal sensations. The trigeminal nerve is responsible for transmitting sensation from the face to the brain, and a related neuropathy, trigeminal neuralgia, can cause intense, sharp, or stabbing pain that is often confused with dental pain. This pain can be felt in the teeth, jaw, or gums.

Glossitis and Burning Mouth Syndrome

Among the most common oral manifestations of B12 deficiency are glossitis and burning mouth syndrome.

Glossitis: This condition involves the inflammation and swelling of the tongue. With B12 deficiency, it often presents as a smooth, sore, and red 'beefy' tongue because the papillae, the small bumps on the tongue's surface, have wasted away. The soreness and sensitivity can create a generalized oral ache.
Burning Mouth Syndrome (BMS): Patients with B12 deficiency frequently report a persistent burning or scalding sensation in the mouth, often without any visible signs of inflammation. This chronic pain can be mistakenly attributed to a toothache, especially if the pain is localized or widespread in the jaw and gums.

Other Oral Symptoms

Beyond nerve and tongue issues, low B12 can also cause other oral problems that result in pain:

Recurrent mouth ulcers.
Angular cheilitis (cracks at the corners of the mouth).
Pale oral mucosa.
Altered taste sensation (dysgeusia).

Comparison: Typical Toothache vs. B12-Related Oral Pain

Understanding the subtle differences between a typical, structurally-related toothache and oral pain caused by a B12 deficiency is vital for accurate diagnosis and treatment. Seeking a dental professional's opinion is the best course of action.


Feature	Typical Toothache (Dental Origin)	B12 Deficiency-Related Pain (Systemic Origin)
Nature of Pain	Sharp, throbbing, or shooting pain usually localized to a specific tooth. Triggered by hot, cold, or pressure.	Burning, tingling, soreness, or generalized ache across mouth, tongue, or jaw. Pain may be persistent but without a clear dental trigger.
Associated Symptoms	Swelling around the tooth, bad taste, fever, sensitivity to sweets.	Fatigue, pale skin, weakness, nerve issues (tingling in hands/feet), cognitive problems.
Visual Signs	Cavities, gum inflammation, abscesses, cracks in teeth, or loose fillings.	Smooth, red, and swollen tongue (glossitis), pale oral mucosa, mouth ulcers.
Response to Treatment	Responds to dental treatment like fillings, root canals, or extractions.	Resolves with B12 supplementation (injections or high-dose oral therapy).

Underlying Causes of Vitamin B12 Deficiency

Several factors can lead to a B12 deficiency, making some individuals more susceptible to related oral pain:

Dietary Factors: Since B12 is primarily found in animal products, those on strict vegan or vegetarian diets are at high risk if they do not supplement properly.
Pernicious Anemia: This autoimmune disease prevents the absorption of B12 in the stomach, requiring regular injections.
Malabsorption Issues: Digestive conditions like Crohn's disease, celiac disease, or a history of weight-loss surgery can affect B12 absorption.
Aging: The ability to absorb B12 tends to decrease with age.
Medications: Certain medications, such as some heartburn drugs and metformin, can interfere with B12 absorption.

The Role of a Dental Professional

For anyone experiencing unexplained oral pain, a visit to the dentist is the crucial first step. A dental professional can rule out or treat common dental causes of pain, such as cavities, abscesses, or gum disease. If no dental issue is apparent, they can identify the specific oral manifestations of a B12 deficiency, such as glossitis or stomatitis, and refer you to a physician for a blood test to check vitamin B12 levels. Early diagnosis and treatment are important, as chronic B12 deficiency can lead to irreversible neurological damage.

Conclusion

In summary, while a vitamin B12 deficiency does not directly cause toothache in the traditional sense, it can be a significant contributor to oral pain. The discomfort, which can manifest as burning mouth syndrome or a sore tongue (glossitis), is often mistaken for a dental problem. Addressing B12 deficiency is vital not only for relieving these oral symptoms but also for preventing more serious, systemic neurological issues. Anyone with persistent, unexplained mouth pain should consult both a dental professional and a medical doctor to investigate all potential causes and ensure proper care. For more information on nutritional deficiencies and their oral signs, refer to this article published on the National Institutes of Health website.

Frequently Asked Questions

Vitamin B12 is essential for producing myelin, a substance that insulates nerves. A deficiency can cause demyelination and nerve damage, or neuropathy, leading to abnormal sensations like tingling, numbness, or pain in the mouth and jaw area.

A regular toothache is typically localized to one tooth and is often triggered by temperature changes or pressure. B12-related oral pain is often a more generalized burning, soreness, or tingling sensation that affects the mouth, tongue, or jaw, without a specific dental trigger.

Yes, a vitamin B12 deficiency is a common cause of glossitis, which is an inflammation of the tongue. This can make the tongue appear red, smooth, and swollen, causing it to feel sore and painful.

Oral manifestations can be early indicators of a vitamin B12 deficiency. Initial signs may include a sore or inflamed tongue (glossitis), a burning sensation in the mouth, or recurrent mouth ulcers.

It is best to start with a dental visit to rule out common dental problems like cavities or gum disease. If no dental cause is found, your dentist may refer you to a physician for blood tests and further evaluation of a potential B12 deficiency.

Burning mouth syndrome (BMS) is frequently associated with vitamin B12 deficiency. While not the only cause, low B12 can contribute to the persistent burning sensations, pain, and discomfort characteristic of BMS.

Yes, supplementation with vitamin B12, either through injections or high-dose oral tablets, is the primary treatment for a deficiency and can lead to significant improvement or full remission of oral symptoms.