Sinus Tooth Pain: Understanding the Two-Way Relationship

Have you ever experienced a throbbing toothache accompanied by sinus pain and pressure? These seemingly unrelated symptoms could actually be connected.

The sinuses and teeth share a unique and complex relationship, where problems in one can cause pain in the other.

A tooth infection can travel up to the overlying sinuses and cause sinus pain, a condition known as sinusitis of dental origin. Conversely, pain can also spread from the sinuses to the teeth.

In this article, we will learn more about this complex two-way relationship between the sinuses and teeth

What are the maxillary sinuses?

The sinuses are air-filled bony cavities. There are several in your face named after the bone they're in. The ones that lie close to the teeth are called the "maxillary sinuses." The term "maxilla" refers to the maxillary bone, a fancy way of saying the upper jaw. Maxillary sinuses are located next to your nose, above your upper back teeth, and on each side of your cheeks.

Their main role is to produce a thick liquid called mucus, which lubricates the nose and prevents it from drying out. In addition, they act as filters, helping to remove bacteria, dirt, and dust from the air we breathe.

What is sinusitis?

Sinusitis refers to inflammation of the sinus cavities, leading to an overproduction of mucus. This buildup can clog the sinuses, causing pressure and pain.

This condition arises when something is preventing the proper drainage of the sinuses. As a result, mucus, bacteria, and dust build up and cause inflammation.

We distinguish three types of sinusitis, depending on duration and intensity:

• Acute form: It's temporary and lasts less than four weeks. Allergies and upper respiratory infections are among the most common causes.


• Chronic form: This one is long-lasting, lingering for more than 12 weeks.


• Recurrent form: This is when sinusitis keeps coming back, with more than four episodes per year.

Pain from sinusitis can spread to the upper back teeth

Sinuses and teeth, particularly the upper and back ones, are like neighbors who don't get along very well. And this goes both ways!

This means that issues in the sinuses can impact the teeth and vice versa. In other words, a problem in your sinuses can cause toothache, and if you have dental problems, it can trigger sinus pain.

It's mainly because they are too close to each other. In addition, the nerves that provide sensitivity to the upper back teeth pass through the sinuses and innervate a large part of them.



As the picture above shows, the nerve branch responsible for the sensation of the upper back teeth also innervates some part of the maxillary sinuses along its pathway. As a result, when the brain tries to determine the source of the pain, it can become a bit confused.

That's why when the sinuses become inflamed, the increased pressure can press on the surrounding nerves and cause discomfort in the entire region, including teeth, upper jaw, eyes, and forehead.

Sinus pain can be caused by dental issues

If sinusitis can cause toothache, the opposite way is also possible.

The upper back teeth and the maxillary sinuses are separated only by a thin layer of bone. Sometimes, this barrier is missing, creating direct communication between teeth and sinuses.

So, an infection from an upper back tooth can make its way up to the sinuses and cause problems there. We call this sinusitis of dental origin.

According to studies, 10% of maxillary sinusitis cases are caused by dental issues.



Here are some of the most common situations where dental issues may lead to sinusitis:

1. Tooth Infection

Infections or abscesses in your upper back teeth can spread to the sinuses above them. When bacteria reach this area, they can irritate the sinus lining, leading to swelling, pain, and sinusitis.

2. Failed Root Canal Treatment

Teeth that have had root canal treatment are not completely immune to problems.

If the root canal doesn’t fully seal and protect the tooth, bacteria can still make their way into the sinuses and cause infections.

Another possible complication can occur during the cleaning and shaping of the root canals. In rare cases, the dentist can accidentally perforate the sinus wall with a sharp instrument, allowing bacteria to enter. While this is usually mild, a severe injury can lead to a sinus infection.

3. After Tooth Extraction

Just like with root canals, removing an upper back tooth can sometimes carry a small risk of affecting the bone and soft tissues that line the sinus.

This can create an abnormal opening between the mouth and sinus, called an oro-antral communication.

Left untreated, it may turn into an oro-antral fistula—a permanent passage that allows saliva and bacteria to leak into the sinus, leading to sinusitis.

Dealing with sinus toothache

Treating a sinus toothache starts with finding the real cause. Is the pain coming from the sinus itself, or is it actually a tooth infection?

If the problem is a dental abscess, treating the infection will usually resolve the pain. Don’t delay seeing your dentist—waiting will only give bacteria more time to spread and worsen the situation. Once the tooth is treated, sinus pain should gradually improve.

However, if your teeth are healthy but you still feel sinus pressure or discomfort, other common causes may include allergies, a sinus infection, or a foreign object trapped in the sinus.

In this case, the right specialist to see is an ENT doctor, who may run tests to pinpoint the issue.

While waiting for your appointment, here are some simple tips to help relieve sinus pain:

1. Stay hydrated: Drink plenty of water to help thin out the mucus in your sinuses and relieve the pressure.


2. Elevate your head while you sleep: Elevating your head while you sleep can help reduce mucus build-up in the sinuses and improve breathing. You can try using an extra pillow to prop up your head or a wedge pillow designed for this purpose.


3. Use a decongestant: Over-the-counter decongestant sprays or tablets can help reduce swelling, promote sinus drainage, and open up your airways, easing pressure and pain.


4. Avoid extra sinus pressure: Don’t cough or sneeze with your mouth closed. This builds up pressure inside your sinuses and can worsen the pain. Instead, keep your mouth open to let the air escape.


5. Add some spice to your meals: Spicy foods can help clear your sinuses and relieve pressure. Just don’t overdo it if you’re not used to spicy foods.