Can a Sinus Infection Be Caused by a Tooth?

Can a Sinus Infection Be Caused by a Tooth?

Sinus Infection Can Cause Tooth Pain

A couple of years ago, I wrote a post discussing sinus infections, prompted by my wife’s experience.  She had severe tooth pain caused by a sinus infection.  While that post discusses how a sinus infection can cause tooth pain, it never addressed the opposite question: Can a tooth cause a sinus infection?

Sinuses are simply chambers in your head that allow air to circulate to get warm and moist before it travels down to  your lungs.  Normally, the body is able to keep the sinuses clean and healthy, despite the dark, moist environment that bacteria love.

However, when conditions are right, bacteria can grow out of control in the sinuses, causing a sinus infection.  One cause of sinus infections is the common cold.  Interestingly enough, teeth can also cause sinus infections.

Before we get into a discussion on how teeth can cause sinus infections, we’ll talk about where the sinuses are located.

Where Are Sinuses Located?

There are a few different sinuses located in the facial area — around the cheeks, nose, and above the eyes.   The diagram below gives you a little better idea of where the sinuses are, and how they look when they are healthy, versus how they look when they are infected.

How Sinusitis Can Cause a Toothache

If you look at the diagram above and imagine a row of upper teeth, you can see how the roots of the upper teeth come into close contact with those sinuses on each side of the nose.   These sinuses are known as the maxillary sinuses.  While there are several sets of sinuses, the maxillary sinuses are the only sinuses that can also be infected by a tooth-related problem.

How Often Do Teeth Cause Sinus Infections?

Hupp’s Contemporary Oral and Maxillofacial Surgery textbook states, “Periapical or periodontal infections of maxillary posterior teeth may erode superiorly through the floor of the maxillary sinus.  Approximately 20% of cases of maxillary sinusitis are odontogenic.”

Basically, that’s a fancy way of saying that tooth and gum abscesses of the upper back teeth can eat through the bone and invade the maxillary sinus.  It further says that about 20% of all maxillary sinus infections are caused by tooth infections, rather than another cause.

Below, you’ll find a couple of examples of how tooth infections or abscesses can cause sinus infections.

A Case of an Abscess Close to the Sinuses

Here is an x-ray of a tooth that had a root canal and crown done previously, but the infection at the roots had never quite healed.  I have outlined some of the important structures below for those of you who are not accustomed to reading x-rays.

Abscess Near Sinus in a Molar

I colored the sinus blue and the tooth infection red in the x-ray below:

As you can imagine, the infection and the sinuses do overlap, as you can see in the x-ray below.

Abscess Near Sinus in a Molar Abscess and Sinus Outlined

Although it looks like the sinus and the infection are overlapped on the x-ray, it doesn’t necessarily mean that the infection has broken into the sinus and causing a sinus infection.  It could be that the abscess is either in front of or behind the sinus in this x-ray, because the x-ray is simply a snapshot of the whole area and doesn’t tell us if things are closer to the front or the back.

If you take a look at the x-ray above, you can see how close the maxillary sinus is to the upper teeth.  Sometimes there is only a thin membrane separating the roots of the upper teeth and the sinus, making it very easy for an infection to travel into the sinuses.

Although this person wasn’t exhibiting any symptoms of a sinus infection, but the x-rays do a good job of showing just how close the abscess is to the sinus.

A Case of Sinusitis Caused by a Tooth

This person had chronic sinusitis for the last few years, that started shortly after she had a metal post put into one of her upper back teeth.  Upon looking at her x-rays I noticed that the metal post that was put in one of her upper teeth looked like it had pierced through edge of the tooth and gone slightly into the bone.  This caused an abscess that was leaking into her sinus.

Here’s the x-ray of her upper right teeth:

Sinus Infection Caused by a Tooth Abscess

To make the x-ray below easier to see, the tooth is green, the infection is red, and the sinuses are blue:

Sinus Infection Caused by a Tooth Abscess with Abscess, Tooth, and Sinuses Outlined

Sadly, due to the fracture in the tooth caused by the large metal post, the tooth had to be extracted.

The oral surgeon who extracted the tooth told me that the tip of the tooth broke off just above the metal post, causing the root fragment to get pushed into the sinuses during extraction.  He had to open up the sinus to retrieve the root and he was able to suction out a lot of the infection — he said it was a pretty bad infection.

Teeth Can Cause Sinus Infections

While sinus infections can cause teeth to to hurt, hopefully this post has helped you see that infections from the upper back teeth can easily make their way into the sinuses and cause sinus infections.

It is important to remember that unhealthy teeth are just one cause of sinus infections, and that there are several other causes.  If you suspect your sinus infection is caused by a tooth, you should see your dentist to confirm this.

Do you have any questions, concerns, or comments?   Feel free to leave a comment in the comments section below.  Thanks for reading!

Top Image © Lightspring/
Sinusitis Diagram © Alila Medical Media/
All Other Images ©


  1. Im glad i read this article. I didnt know how close the maxillary sinus are to the teeth. I am in a great deal of pain. My ear nose tounge head and upper left teeth hurt. I went to a family doctor and she told me that everything was altight and i had probably sinus and it was nothing she can do. She told me to take some ibuprofen for the pain, and over the counter medicine. Im still in pain and after reading this article i decided to call my dentist. Last year i was experiencing a similar pain, and i have a root canal in one of my left teeth. I can not believe this may happen again in the same side . I was hopping it was just a sinus problem, i dont know why my nerves are dying since i take good care of my tooth…..

    • Glad it helped, Irene. There is a possibility that there is some residual infection around the tooth with the root canal, and that could cause sinus issues as well. I hope your dentist can pinpoint the problem for you – Have a great day!

      • I have a question also I had a filling done on my bottom tooth an since that I been getting massive pain in my bottom right side of my jaw and the pain is leading up to my ear what should I do, The pain is leaving me with sleepless nights??

  2. I have been battling allergies late this season due to our late spring season this year. My sinuses started hurting over a week ago.. first the right side and now the left.. the left side is worse and I have a lime green thick mucus that is hard to discharge. Yesterday I had some mild pain in my back upper teeth especially in the eye tooth. Today it is unbearable so I have started amoxicillin and am looking for some home remedies for the tooth pain… it is worse than any abscess or cavity I have ever experienced!!.. any suggestions??.. I cannot touch them together and any talking, eating is just plain unbearable. Thank you for any tips you may have.

  3. Like stated sometimes it is very difficult to ascertain whether the abscess is really into the sinus. Thats why everyone needs a 3D tomo, In this day and age, they are just so cost prohibitive. As always the pricing over the years should come down.

    And of course we get a lot of false alarms too, where we have molars with no fillings with no signs of fractures and they say that their teeth are throbbing. Usual signs they say are that their teeth feel taller or sensitive to bite. And it only takes radiographic evaluation to realize that the sinuses are draped over the molar and premolar roots and they are congested.

  4. I have had a problem with my sinuses ever since I had my teeth cleaned in Feb of this year.
    I went to the doctor and she put me on antibiotics over 5 times and they never cleared up the infection because I still have pain in one side of my nostril on the right side and my right ear hurts and I have swelling on the right side of my throat that feels like an infection. I have had this problem ever since they worked on one of my front teeth that had a cavity in it. I can’t see the cavity anymore because they filled it in with a feeling but
    I have had pain in it ever since they drilled in it and whenever I drink cold or warm stuff the sensitivity is horrible. I think it is a teeth problem probably a sinus tooth infection and Im going to a dentist to maybe get a root canal in it because I cannot stand the pain anymore and the pain infects my ear and my other teeth.
    I have had this problem for over 4 months now and I cant stand it anymore.

    I had a really bad tooth infection in 2012 in one of my molars and a doctor tried to tell me it was a really bad sinus infection but this tooth caused me so much pain that my dentist said it could have killed me because my tooth had a hole inside of it and he said that I started developing bad swelling in my cheek.
    So I had to have my tooth removed and thank God I did. But before I had the tooth removed the doctor that I saw gave me amoxicillan so at least that helped my swelling but very little until I had my tooth removed.

    I hope I don’t have to have my front tooth removed I hope I can get a root canal done instead. I’d just rather get dentures if I could do anything then maybe I wouldn’t have these sinus problems?

    Because usually when I get sinus or allergy problems its just from the summer or winter because of the seasonal allergy problems but nothing like I have had this year.

    • Hello Im Merilyn
      I had a tooth removed in the upper right. The tooth had broken and had become very irritating so I decided to get it removed and OMG my ear my right side of my face and the right side of my nose swell. It hurt the whole weekend I went back to the dentist had sinus infection caused by that tooth now taking antibiotics amoxicillin still feel bad but getting alittle relief.

  5. Bacteria in your mouth can buildup and eventually cause a tooth infection,which in turn may spread to the sinus. The first maxillary molar,s one of the largest and strongest teeth in the upper jaw is usually the culprit because of its proximity to the maxillary sinus.The mucus must move upwards to drain from the sinus into the nose,which does not happen when standing up and thus the sinus gets infected more frequently than the other air cavities.

  6. Can a sinus infection cause pain in your lower jaw? I have swelling in my lower left jaw and pain in my left ear. I went to the doctor and was told that I do not have an ear infection.

  7. Hi, I have a problem with one of my teeth that has had a root canal done then crowned then the root canal redone by a specialist then recrowned. The tooth is on the right upper and forth from the back. The problem seems to occur when I get a cold, with pressure build up and a bad smell coming from around the top of the crown. My dentist tells me to rinse wth salt and hot water but it comes back. Any ideas?

  8. It is common that a Crown tend to leave a Oder in the mouth my suggestion to you
    Is every morning and evening use a water pik and add 2 ounces of mouth wash
    To the water bin for your water pik. After brushing your teeth!!! Hope this helps…

    • Hi Angela,

      No, it’s not common that crowns cause bad odor. A single crown should not. But *clumsily made* crowns cause odor if they are designed as food traps. ‘Flossability’ needs to be tested before permanently cementing a crown. Do hyper-busy dentists have the time for that? I hope so.

      Dental bridges, however, if not taken care of extremely well, commonly cause bad breath. In this case, your waterpik suggestion makes sense. Use all you have in your hygiene-arsenal if you have a bridge (or a crown that traps food) – special floss-holders for bridge wearers, waterpik, mouthwash, thin-bristled toothbrush!

      One word to mouthwash: use NON-ALCOHOLIC ones (better for your gum health) & rotate through a few brands – bacteria will get used / resistant to one type after a few weeks.

      Hope it helped,


  9. I help…..I have been dealing with what I thought was a chronic sinuses infection for 5 yrs. Antiobotic after antiobotic which clears it up and it’s back within a week…This infection is only on one side and is above a tooth with a crown…the crown is 14 yrs old and the dentist says it’s leaking and he could see where bacteria has gotten to the bone…the dentist also said he don’t think it would cause a sinuse infection which makes me wonder if it really is sinuses or an infection in the root canaled tooth . He wants to do a 2nd root canal and put medicine in and leave it for 2 weeks..I’m wondering should I get it pulled?

  10. I first noticed what I call a blood blister while riding in a pick-up. It broke after holding a cell phone against my cheek and hitting a bump causing it to pop. A few days later I noticed it was back. It is very high on my gums – just below my cheek bone. A month later it was still there and was time for the dentist visit to get my teeth cleaned. It turned out to be above a tooth that needed root canal. He said they 2 were connected. I had the root canal and expected the blood blister to disappear but it did not. Today he cut it off calling it a “sinus tag”. Do you think it will return? What is going on? Also, I am not and never have had any pain thru all of this.


  11. I first noticed what I call a blood blister while riding in a pick-up. It broke after holding a cell phone against my cheek and hitting a bump causing it to pop. A few days later I noticed it was back. It is very high on my gums – just below my cheek bone. A month later it was still there and was time for the dentist visit to get my teeth cleaned. It turned out to be above a tooth that needed root canal. He said they 2 were connected. I had the root canal and expected the blood blister to disappear but it did not. Today he cut it off calling it a “sinus tag”. Do you think it will return? What is going on? Also, I am not and never have had any pain thru all of this.


  12. I have very bad teeth. almost all of my teeth have bad cavities. a few of them are black and rotted down to almost the root. I have been recently diagnosed with chronic sinusitis. I have not been able to smell at all for over 8 years now. can that be caused by my teeth since they are so bad?

  13. Hi Doctor, I recently had a sinus infection. Before that my back tooth got infected several times. My crown is loose. I do not want to lose my tooth. He wants to pull it. This will cause me alot of trouble eating since I have a empty space on the other side from a tooth pulled years ago. And the space will show when I smile. Is there any options f8r me

    • Yes, Snap On teeth are an inexpensive option (compared to others) and will cover the holes left in your mouth from the removed teeth.

  14. can orthodontics work cause a sinus infection? I am currently having orthodontics work done to spread my top teeth apart to make them fit better to my bottom teeth,and I am having sinus issues that I have not had before.

  15. I had 7 upper teeth removed last November, one was the last molar on the right upper side. Six months after having the teeth pulled I went back to the dentist because i was having problems with my sinuses. The x-ray showed something close to the sinus. I went to a EMT doctor who had a CT scan done and that showed a tooth fragment had been left behind. I have had two sinus surgeries because of the infection that this has caused. . Another surgery is possible, I have been told that a tooth fragment is different then a tooth root and that this fragment is more then likely the cause of all of this. Can a tooth fragment cause such a huge problem?

  16. I suspect I have a similar problem. Had root absorption 15 years ago and we (dentist and periodontist) have been babying the tooth knowing that it will have to come out someday. The tooth is some times loose, some times not. But I had a periodontist cleaning last week and from my eye to ear and upper left area where the bad tooth is (including forehead) is numb and some pain. I have antibotics on hand and it seems to help. There are no easly solutions for an implant since I need a sinus lift. I am lucky to have had this tooth this long. But I suppose it has to go.

  17. Hi, I have been doing some research on this topic, and have a question for the dentist. I have what looks like an abscess on my, counting from the top left front tooth 4 over (sorry not good with dental language), at the crease of my upper lip and gum line. Went to the dentist, January 5, to get an antibiotic to get this cleared up. I was told my teeth look good, because I have had root canal treatments on this tooth and it has a crown (which fell off the prior Saturday, but was replaced Monday). I was told I have a sinus infection, but all articles are stating the back molars. Also I have been on medicine since Monday, Cephalexin 500 3x a day for 10 days. The abscess has not went away or has not improved at all. Should I see a regular doctor? My dentist is old school and really doesn’t explain much.

  18. I used to get severe pain on this sphenoid sinus area periodically. I had a decayed tooth on the left side which I noticed late. Last week I did a tooth coloured restoration for the cavity on my left tooth from clearbrook dental in Oshawa. This also brought down the pain I used to get. Is there any relation between cavity and sinus?

  19. I have a had root canel twice on this tooth with a crown finally . Last year about this time started bothering me again with painful on that specific tooth,.i t came and went for a month at which time I was back in Canada,,X-rays were taken but one of my lowers was in née of a root canal and could be causing the referred pan.. Happillily thr problem seem remedied,,however the problem has risen again. Very painful on the original upper right crown with root canal what???

  20. I have a tooth that broke down to the gum line. I’ve had 2 sinus infections but today my face hurts when I touch it right down to the broken tooth. I have an appointment with a new dentist tomorrow and will probably extract although I think it may be infected.. ie the pain in my face upon touching. Long story short, is there anything I can do to drain my sinus before I go to the dentist tomorrow? Thanks in advance

  21. I need realy help. When I was 14 I lost three of my last molars top left side because an infection in a one and a bad bridge work. 15 years later appeared a piece of bone in the palate inside through the skin that the oral surgeon had to take by surgery. After another 18 years I decide d that I needed implants for those three molars . I’m damage my right side and I don’t have to good teeth. My oral surgeon did all his job lift my sinus let them heal, put the first step the screws but the one near my first tooth got infected realy bad and he took it. After one year he put it back on and the pain started agin realy bad like was infected but no it was a not visible perforation that went to my sinus not know due to another infection or the screws but in the X-ray didn’t show perforated only when he sprayed to clean I passed out due to the pain and blood and fluid were coming out my nose . We wait another 6 months and now he did some plasma fibrin insertion ( the other 2 screws are fine) after one week he took off the stitches one didn’t closed well and then sin started again after 12 days , he put another stich and tells me that seams my bridle is near the muscle and the nerve and he will have to cut it internally in 4 months when he will try to put again for third time the screw for the future implant. I’m very scared the pain still there Percocet doesn’t make this pain at all better. I have chronic sinus infection since very very young girl(7 years old) now I’m 50 and I don’t know what to expect can you help me?

  22. Hi everyone. Having read this article makes me think that I might have a sinus infection. I can taste some bad smelling stuff coming out from my upper-left. Gives me bad breath, but I have no pain. I went to my dentist and asked him to take x-rays of that area to see what causes this, he said there is nothing there. Bear in mind, I have root canal done on one of my upper-left teeth.

    I don’t know whether its a bad root canal treatment (had it done a long time ago) or sinus infection.
    Is it possible to treat the sinus infection without surgery?

  23. Hell Dr.
    A month ago I had a root canal on tooth # 12. About 1 week after my left side of face started hurting so bad I went to my regular dentist and he said I had a sinus infection. He gave me antibiotics which did not help. So he told me to go back to specialist, which I did. He checked my teeth and said it was fine and I had to disagree with him. My face is swollen, can’t eat and in so much pain. I have had to wear tissue in my ears for the last 6 years since I have started all this dental work. If I take it out for any length of time my whole face and teeth hurt so bad it’s unbearable. He suggested a second opinion but why should I if he says his work is right? I now have severe bronchitis so I’m not feeling to good. I haven’t a clue what to do here. He also suggested a CT scan as the roots in my teeth are so long he thinks maybe they have gone into the head area because of the pain in my eye and head. Any thought would be very grateful. Thanks

  24. hi im indian has came au in Nov.2014.-Before coming to australia I had a part dental fixure (failed)which were removed a few days earler to visit au. However my uper last molr start bleeding ocasionaly or when I press it it release pus type blood.After cominng to au I started nalal as well as cough mucus contineously.3 months has elapsed no relief inspite of amoxil 1000 mg.I have headache nasal congession phelgem without stop head sinus congession.It does not effect at sleeping time.Ultimately returning india.Any suggession pl.

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