Tooth Pain and Sinuses: Can A Sinus Infection Cause a Toothache?

Tooth Pain and Sinuses: Can A Sinus Infection Cause a Toothache?

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Tooth Pain and Sinus Infections
©Lightspring/Shutterstock.com

This past weekend, my wife told me that she was having the worst toothache of her life. When she came in for her checkup a few months ago, her teeth were in great shape.

Dental Sinus InfectionShe told me that the pain was constant and that it got worse when she stood up. I told her that I thought it was a sinus infection. She went to the doctor and found out that she did have a sinus infection.

Stories like my wife’s are fairly common — many people think that they have a problem with their teeth when they simply have sinusitis.

What Are Sinuses?

Each time you take a breath through your nose, air travels through your sinuses on its way down to your lungs.  Your sinuses are simply hollow, air-filled cavities in your upper jaw bone.  They are lined with a pink membrane that is similar to the pink lining on the inside of your mouth.

When the lining of your sinuses gets infected or inflamed, it is known as sinusitis.

Many people end up coming to the emergency room at our dental school with painful teeth.  Upon examination, we sometimes find that their teeth are healthy and that the real cause of their pain is a sinus infection or sinusitis.

How Your Sinuses Can Cause Tooth Pain

Below you’ll find a dental x-ray.  I outlined the floor of the maxillary sinus (the sinus located above your upper teeth) so that you can see how close it comes to the roots of your upper molars.

Maxillary Sinuses on a Dental X-Ray

On the left side, it looks like the sinus floor goes below the roots of the upper molars.  Usually this isn’t the case, and that illusion can be attributed to overlap as we are seeing a two dimensional image of a three dimensional object.  However, it does give you a pretty good idea of why sinus infections can make it seem like you have a toothache in your upper molars and premolars.

Want more details on how a tooth can cause a sinus infection? Then read this article: Can a Sinus Infection Be Caused by a Tooth?

How to Know If The Pain Is Coming From a Tooth or Your Sinuses

When a patient comes in with severe tooth pain, we normally take an x-ray of the offending tooth.  Tooth pain is usually caused by reversible and irreversible pulpitis.

We also do some tests on the tooth by feeling around it for an infection, tapping on it, and/or putting ice on it.  This allows us to better understand if the pain is coming from one tooth or not.

If the teeth don’t have any cavities in them and appear to be healthy, then we usually try to find another source of the pain, such as a sinus infection (sinusitis).

Symptoms of a Maxillary Sinus Infection

Although there are other sinuses, the main pair of sinuses that affect your upper teeth are the maxillary sinuses.  One of the main symptoms of maxillary sinusitis is continuous pain in your back upper teeth that changes (gets worse or better) when you move your head (such as lying down or standing up.)

Treatment of Maxillary Sinusitis

Maxillary sinusitis can be treated in a variety of ways.  Here are some common treatments for maxillary sinusitis:

  • Using a humidifier to moisten the air that you breathe in.  This helps to loosen any dried secretions that have accumulated in the sinuses.
  • Using nasal spray that contains phenylephrine or ephedrine.
  • Taking decongestants orally such as Sudafed (psedoephedrine)
  • Taking antibiotics if it is believed that the sinusitis is caused by bacteria.  Common antibiotics that are prescribed for sinusitis include amoxicillin, trimethoprimsulfamethoxazole, clavulanate with amoxicillin, azithromycin, and cefuroxime.

Conclusion

Although toothaches are generally caused by a problem with your tooth, it is important to understand that your teeth have neighbors, such as your sinuses, that can mimic a toothache.

Do you have any questions about sinusitis or sinus infections?  I’d love to hear what you have to say in the comments section below.  I’ll do my best to respond to your questions, comments, and/or concerns.  Thanks for reading!

226 COMMENTS

  1. Hi Tom,

    Thanks so much for this post. It has been a real help to me. For the last two days I have had a headache, pain in my jaw and a horrible throbbing pain, in my upper teeth. All this accompanied by a lovely nasal drip :( I was unsure if a sinus infection would include my teeth, so thanks for the helpful information. I will tough it out for a day of two with a salt water nasal spray and see how that goes, while fighting the urge to extract my teeth with a hammer.
    Kind regards,
    Michelle, Ireland.

    • Not dead, Bob! It came to a point with hundreds of posts receiving so many comments that I simply couldn’t keep up and respond to every comment. I do read them all though. Have a great day!

  2. They have been draining my sinus for 10 times or something. I am waiting for one more in 2 days.Meanwhile I visited a dentist ,she treated a tooth canal filling it with
    “calcium”and told me to come after 2 weeks.I learned that the medicine in the tooth canals is not antiseptic.I am afraid my third course of antibiotics is over before the tooth and sinus are treated.Shall I ask the dentist to do something before sinus drain in 2days and another due visit which is in 4 days? (I still have a slight pain,but use no relievers.)

    Sincerely,

    Gytis

  3. I wonder if sinus rinses can cause sinusitus? I’ve never had sinus pain to the degree I am having now. About a before week ago, I switched from the Neti-Pot irrigation sinus flow method to the Neil Med Sinus Rinse method that requires you to squeeze/force the saline solution up one nostril in order for it to flow out the other. I used the new prior to discovering I was coming down with the flu and acute bronchitus. I was treated with meds for those conditions and meantime, I used the sinus rinse (pressure) method every other day to help clear my congeseted nose and throat. A week later, I am pretty much over the flu; but I have the worst pain in my upper/lower jaw and teeth you can imagine! The pain comes and goes & it radiates from the front to rear of my upper and lower teeth. It is UNBEARABLE!! I went to see my PCP; and he suggested a naso-streriod medication to treat sinusitus like Nasonex or Flonase for a few days first. Then if the pain is not relieved start a treatment of penicilin. How long can this pain last? I’m on day two of treatment with no relief. This reallly sucks!

  4. hey like if you have a hole in one of your molars and then pain comes with it, when my mom went to the dentist they said its sinus related do you think she needs to take out the tooth ??

  5. Hi
    I have a good idea that i have a sinus infection but would like some input. I do get alot of stuffy noses and also sinus pressure above my eyes like on my eyebrow. I also had a rootcanal about two years ago and noticed somtimes ill get pain in that tooth when my nose is stuffy. So i recently have had a stuffy nose and had pretty bad pain bitting down on that same tooth. I woke up the next day and my upper cheek was swollen and my tooth hurt as well. When i take asprin the pain subsides in the tooth but not in my cheek now. I guess im jus looking for a lil advice i jus started a new job and i dont wana take the time off yet to go to a doctor will this go away on its own or should i jus go to the doc and have her look. Thanks Gary

  6. Have sinus problems for years, had been having severe pain in one side of face from my upper teeth to my temple and even my ear on that side. Had surgery month ago, had terrible fungus in that side of my face. the ear specialist said he got it all out. But im still having bad pain in that side of my face,from my teeth , temple and ear..I have been back several times to the doctor cannot find anything that could be causing this. Please advise.

  7. I have had two root canals, and two crowns put on tooth #13 over the past 1.5 years. Sometimes it is still slightly painful. Also, I had flap gum surgery 6 months ago between tooth #14 and tooth #15. I have a pretty big gap between 14 and 15 now, but it’s not really painful anymore.
    A couple of days ago the pain around #13 came back hardcore. Also, #14 hurt slightly. I went back to my dentist and endodontist, who have both treated me on #13. They did the usual hot/cold tests, tapping, etc.
    He even mentioned that tooth #14 may need a root canal, but he’s not sure. He takes xrays every time I go, and always says the root canal and crown look perfect. I have also had a bad sinus issue for the last two weeks, with lots of pressure and drainage. The endodontist prescribed antibiotics that I am currently on. He also wanted to give me vicodin, but I will not take narcotic drugs. I don’t like them.
    Anyway, this is the 4th time since my initial root canal that a similar issue has happened. The previous times I was also prescribed antibiotics. Eventually, the pain would subside and I’d be fine. Just when I start to feel normal again, here comes the pain again. I’ve (obviously) had quite a bit of work (and thousands of $’s) in that area of my mouth, and I’m growing increasingly frustrated because it’s never rectified.
    Based on my short description, can you shed any light on what may be going on? I seem to be getting thrown around the same circles every time by my endo and dentist.
    Thank you!

  8. Last September was my first ordeal with sinusitis and my teeth. I was in Las Vegas and at the dinner table, the pain was so intense it brought me to tears. The dry air of Las Vegas had sent my sinuses haywire. Hubs finally heeded my pleading and got some sinus meds which helped almost immediately. I’ve had sudden bursts of pain from time to time, primarily in the front, but at the moment, am experiencing a very tender and swollen area over my upper right molar. It feels like another tooth is about to pop thru, but I have taken my meds and hope that will alleviate it soon. I have to say, having a baby wasn’t as painful as sinusitis pain in the teeth!!!

  9. Hey!

    Last week I went to the dentist for filling some cavities. I had 6, so he did, they are still painful when cold touches it. Now my problem is this. My front teeth hurts a little bit. When I push it, it hurts a bit. I also have this weird feeling in my upper gums. Every time my teeth touch each other, my upper gums get this kind of a pulling feeling, more like a stretch. I don’t know how to describe it.

    When the dentist was done last week, he told me I am good, that I have no other issues. So I assume my gums are good.

    I do have a cold and cough at the moment so is it my sinus or should I make an appointment? Perhaps it is my wisdom tooth? I only have 1 on the upper right side, growing vertically.

    Thanks in advance!

  10. I am battling a sickness right now for about a week that the doctor has not yet stated is an actual sinus infection but my sinuses are plugged. I’ve been on sudafed and I’m doing flonase. Today my upper and lower jaw and teeth are throbbing. Not just one tooth all of my teeth are throbbing. Could this mean that I actually have a sinus infection now? I took some ibuprofen and I got no relief. Is there anything else I could do to help relieve the pain so I could actually sleep and be comfortable without being in constant pain?

    • I experienced something of the sort last year & it was HORRIBLE.. It was the worst pain I’d ever experienced in my life.. It felt like every tooth in my mouth was throbbing, stabbing.. It was just an excruciating pain. I went to an Allergy specialist here in Texas.. Rewind, first I went to the Dentist.. He took ex rays, which showed a lot of sinus pressure. He gave me a prescription for sinus medication & pain meds.. None of which worked, or should I say they wasn’t working fast enough . I gave it three days.. The pain was so unbearable.. I called my Allergy Specialist.. Went in to see him..By the time I left his office, I was given a steroid shot, an allergy shot, prescriptions for naproxen, antibiotics & sudafed.. It’s took a few days but eventually the pain subsided.. Thankfully, it wasn’t a constant pain.. It would strike once every 10 to 20 mins or when I would switch positions. I also had a Nasal Steroid pump. I found that a heating pad sometimes gave me relief.. I would wet a towel, place it in a zip lock bag & in the microwave for a minute or so.. Then hold it to my face..I would cry every time the pain struck. Then I realized that crying for whatever reason made it worst.. Hope you feel better. If it’s anything like I experienced, my prayers are with you.

  11. Hi,

    I’m in a bad way.
    Hoping you can shed light.
    A couple of yrs ago tooth # 13 filling fell out, then broke off near gumline.
    Dentist recommended extraction. Well, I didn’t. Mostly because I had about 6 other crisis looming in my mouth requiring major work. It got neglected. Now I have infection in there. Called my old dentist who prescribed Amoxicillin. Was out of town. Consulted a holistic dentist who switched me to Clindamycin 150mg every 8 hrs.
    Told me problem in Tooth # 11 ( pain ) is being caused by # 13 draining into left nasal cavity and that I needed to have # 13 extracted after 7-10 days of his homeopathic and protocol and the Clindamycin.
    Well, I didn’t. The oral surgeon he referred to was horrible and me being terrified of the whole thing anyway decided to try and find an oral surgeon I feel good about. But I waited too long and now I’m in trouble.
    Now I am very sick all over. Went back on second round of Amoxicillin (which I had here ) but it’s not helping. I have a sore lump above gumline up high above #11 could it be a cyst? ( as far as the gum goes )and I am sick as. dog. It’s the weekend of course. I’m embarrassed to call either dentist, ( my old dentist is in NYC – I trust him but he doesn’t do extractions and anyone he would refer me to is out of pocket and I cant afford that.)

    I do have insurance where I live in MA but so far haven’t found an oral surgeon who takes it.

    Can’t find an oral surgeon open on Saturday, am now sufficiently scared and don’t know what to do.

    Any ideas?

    Thank you.

  12. Hi, I have been having sinus issues he past two years (21 years old). I recently was getting jaw and head pain with the sinus pain and went to the dentist to get it checked. My wisdom teeth are still impacted but are coming up straight and should come through if there is enough room. with prednisone and other treatments (nose sprays and allergy meds) the pain was much better. Now i suddenly have pain to the touch of my upper right gum in conjunction with bad sinus pressure. I do not want to get the wisdom teeth removed unless necessary (my dentist believes it is best everyone does it at a young age whether there are problems or not). Do you think the pain is a problem with the wisdom tooth? I have no pain when i bite or am not touching it but if i touch with my finger or tongue i have a lot of pain in the gums (no swelling or sight of the tooth breaking through) thanks!

    • I do not have an answer for your query, but I would like to mention that I had my wisdom teeth removed just a few years ago (I was 22) and it was fine. You have to treat it the same as if you got them removed at any other age, but they healed fine. My teeth were severely impacted (growing sideways!)

  13. I had been having an awful toothache on my left side for about a month.It seems the ache got worse when I would lay my head down.It started to ache so badly, sometimes it would hurt my left nostril when I would breathe.Today, I went to the dentist and they discovered three cavities needed to be filled on the top left side.They filled them and after the numbness began to ware off, my filled teeth began to ache much like they did before.It is so unbearable.Please help me.

  14. My regular dentist had said a few months ago that it had a small crack and will need a crown on 2nd molar from back on left upper side. I had tooth pain start up about 3 weeks ago and they wanted me to go to a specialist, thought I might need a root canal. I could not afford the specialist and went to a dentist here that was recommended and he took xrays. He said that I do not have root canal symptoms (tapping tooth does not hurt) etc., cracks are small and do not go all the way down tooth, just hairline) and looks like a sinus infection (pain started when sinus infection started) is causing problems. I have developed a small lump (hurts when push on it and aches) above the tooth. He changed me from Amox. to Clindamycin, 300 mg every 6 hrs. He said that is will eventually drain, or should and if it does not, will have to have it done. My daughter is an RN and says that I should go to emergency clinic as it could go septic and have them drain right away, but dentist said to wait and see if new antibiotic works and to come back in 6 days to re-check tooth. What are your thoughts on this?

    • Hi KC – There are different philosophies on this, and you’ll get different opinions with different dentists and doctors. I will usually try a strong antibiotic and if that doesn’t help, then refer to an ENT.

      A lump right above the tooth does seem suspicious. Did both dentists test the teeth to see if the nerve was alive? This usually involves putting ice on the tooth or sending electrical pulses through it to see how long it takes for you to feel it.

      I hope that helps!

  15. Its really hard when sinus infection cause a toothache particularly in the upper rear teeth that are close to sinuses. Mostly pain in the upper teeth is a common symptom regards with sinus conditions.

  16. Hi there,

    So I am only having sensitivity in particular with one molar, second from the back (I dont have wisdom teeth). I am 25yrs old and have had upper jaw pain before after having a sinus infection. When I tap on the tooth itself it doesnt bother me or when I brush and floss. Its a numbing pain that only goes away when I clenched my teeth together or eat something, I have taken advil but that barely relieves the pain. I dont want to go to the dentist for an xray if I dont have to. When I tap on my cheek its sore and sensitive, I know that will go away after the sinus infection has cleared, I just want to make sure there isnt any cause for concern. The molar that is bugging me is also the most crowded from when my final molar came in at the back and its the only one not properly leveled with my other molars…

    Hope you can help,

    Krystle

  17. I went to a dentist for severe tooth pain and he didn’t find anything wrong with the teeth that were hurting, however he did find some other dental work that needed done and that has since been taken care of. However the tooth pain has come and gone over this time. When the dentist x-rayed my teeth before performing the above mentioned work he noticed a half-moon shape in my sinus above the teeth and he attributed the pain to my sinuses, as this article says is possible. I’m wondering what the half-moon shape could be? I haven’t yet had a chance to see an ear, nose and throat specialist, but I have been googling my fingers off and I can’t find anything related to give me a hint? The shape is perfectly formed like a bubble, or a circle cut in half. Looking at the x-ray from the side, my teeth forming a horizontal line, the shape is flat also, along the bottom edge of the sinus, following my teeth, with the curve of the half-moon going upward towards the top-side. My dentist said he had seen it before in other patients, but didn’t know what it was, since he’s a dentist, not a sinus specialist. Any clues to help?

  18. Hi – I have had sinusitis before and regularly get it which usually generates into a cold, however sometimes I have pain in what feels like my upper teeth when I am eating but I feel around my mouth and put pressure on my teeth but it doesn’t hurt – so could this just be problems with my sinuses when I am eating? Or will you only get sinus pain during a cold or flu?

    • My experience only. For years I had different pains. Had X-rays but nothing showed up. Tapped on my teeth and no pain with this. Then after much prayer I felt something in my mouth and my filling had fallen out. The new dentist that examined this pulled it for me because it was split up the middle. All pains stopped. Note my wife says all this time my breath smelled bad. Xrays one year earlier showed nothing but one year more and the pulled tooth relieved the problems completely. And the smell went away. Just my experience.

      • This was meant for Martin but one of the pains I had was when eating also. I never got an answer from this blog but I found the answer through prayer during much pain. How could a tooth which was causing me three different type pains, be split down the middle when it never showed up on X-rays a year earlier. But now all pain is gone. By the way I found that smiling helped with one of the pains in my jaws. The other pain was like sinuses but terrible and worse when talking or eating.

  19. Am a 21 year old boy.About 2 weeks ago, I felt a severe pain in my ear(right).I went to see the doctor and had it examined but nothing was found.I now feel the pain in my tooth (upper-right corner),accompanied with headache and “runny-nose”-(i think it has bad odour)

    • My experience only. For years I had different pains. Had X-rays but nothing showed up. Tapped on my teeth and no pain with this. Then after much prayer I felt something in my mouth and my filling had fallen out. The new dentist that examined this pulled it for me because it was split up the middle. All pains stopped. Note my wife says all this time my breath smelled bad. Xrays one year earlier showed nothing but one year more and the pulled tooth relieved the problems completely. And the smell went away. Just my experience.

  20. 5 Month ago i feel a pain in my right cheek and after sometime in my right side jaw .i go to my dentist . He say my lower 6 no teeth of right side is crack so he done rct of that teeth then after some time i feel my jaw is irritating me and congestion in my throat i go to a ent doctor he gave me some steroids pain killers and antibiotics which normalise my throat but pain is still remaining in jaw then i go to dentist and remove the filling which give me some relax but now the pain start in left side jaw cheek and teeth i again go to my dentist now this time he say infection in left upper 6 no teeth he done start its rct but its taking more time in healing and a burning sensation in left side start and inner mucas redness etching on inner and outside on lips burning start than i change my dentist and go to another dentist he say that a rct file is broken in the root he tried to remove it but its not coming out finally he say its not harmful and gave me some antioxident and power capsules after some medicine treatment he completed the rct of both teeths but problem is still remaining . OPD of my teeth according to doctor is good. than i go to a neuro physician but the ptoblem is not remove after that i go to a new dentist he gave me some vitamin tablets which give me some relief but problem of pain still remaining. I am also a patient of rhinitis please help me if u can.

  21. Hello,
    Not sure if anyone checks this page anymore but worth a try. I had major sinus/ear infection which since ENT has cleared it up. I do have a front filling on a molar on that side that does not hurt but yes looks like possible staining or needing to be filled more around it (expanding). He has brought up TMJ numerous times but I have not jaw pain at all. Yes it does pop occasionally but my dentist has never questioned possible TMJ. Is it a possiblity the cavity filling may need to be retouched not hurting but causing ear pain? No jaw or joint pain. The dentist or oral surgeon doesn’t accept medicare and are very expensive and trying to decide which one I need to go to first. ENT for 6 months has been costly enough and all tests come back normal on them now

  22. Hello,
    I don’t know if anyone checks this anymore, but a couple of weeks ago I began having symptoms of a sinus infection. It’s more in the left side of my head. I’ve had pain in my top molars on the left side, before the sinus problems my teeth felt fine, all of a sudden though the pain hit and it wasn’t horrible, but it was there. Now my jaw on the left side feels weird. I don’t know, would this be a tooth problem or just sinuses?

    • Tamara,
      I mentioned my story in a comment. I can relate to your pain. I have learned to live with it and use the nasal spray I mentioned. I learned that our sinus runs on the upper level of our gums and makes the molar teeth feel like they are going to pop out of my mouth. With extreme pain in teeth and jaw. I cannot sit or lie down. I cannot eat or even drink. I get some relief from the spray that my husband uses. I have never had this issue before I got new crowns. I am sorry for your pain and I hope you can find some relief like I have.

  23. I started having severe teeth pain after the dentist put in 4 crowns in upper and lower molars. He suggested to take out the old silver fillings and replace with cerec. I took his advice. I only went in for one filling since it had fallen out.
    Then I started having teeth pain. I was told I was a grinder and fitted for a mouth piece that cost $500. I never had this issue in my life.
    I faithfully wore the mouth guard with no results. I hurt severely. My dentist brushed me off and would not do another exam. He told me I had nerve damage due to my age.
    I got 2nd and 3rd opinions. I do not have nerve damage but was told the crowns did not fit my mouth properly. My mouth was having a fit to adjust the teeth.
    It has been several years now and the teeth adjusted best they could but I now get sinusitis. I never had this issue before the new crowns. I use FLUTICASONE PROPIONATE nasal spray and get relief. I never know when the pain will come on since I get no warning signs. I have no cold or congestion. I have no other symptoms whatsoever.
    I have healthy teeth and always have. The dentist made a lot of money off me and I regret going to him.

  24. Hello!
    I am trying to figure out if my wisdom tooth, that is protruding up into my sinuses – much like the picture- could be causing issues, or if this is normal? I spent a few years rather lightheaded before having a deviated septum surgery that took care of sinus infections and has made me feel a million times better. However, I recently have been feeling a bit worse- lightheaded- again and was wondering if my teeth could be to blame? My wisdom teeth are not causing any other problems as far as pain or crowding, so I had put them on the back burner. Thanks for your advice!

    T

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