Sinus Tooth Pain: Is It Your Sinuses or Your Teeth?

Why sinuses and teeth are so closely linked

Your maxillary sinuses are two air spaces in the cheekbones, just above the upper back teeth. In many people, the roots of the upper molars and premolars sit right under the sinus floor, sometimes separated by only a thin layer of bone. They also share some of the same nerve pathways, which is one reason your teeth hurt when sick with a cold.

So when the sinus lining swells and fills with mucus during a cold, allergy flare or sinus infection, that pressure can be felt in the teeth below. The brain can't always tell whether the signal is coming from the sinus or the tooth. The opposite can happen too: an infection at the tip of an upper tooth root can irritate the sinus.

Why your teeth hurt when sick

Sinus pressure is the most common reason, but it is not the only one. Being sick can affect your mouth in other ways:

• Breathing through your mouth because your nose is blocked dries the mouth, which can make teeth and gums feel tender.
• Coughing, sneezing and a sore throat strain the jaw and face muscles.
• Fever and body aches can make you notice small aches you would usually ignore.
• Some people clench their teeth more when they feel unwell or stressed.
• Frequent cough drops, sweet drinks or sugary syrups can add to cavity risk if you're sick for a while.

Signs it's likely sinus tooth pain

• The ache is in the upper back teeth, often on both sides or across several teeth
• You also have a blocked or runny nose, thick mucus, a reduced sense of smell, or pressure in your cheeks, forehead or around the eyes
• Pain gets worse when you bend forward, lie down, jump or walk down stairs
• It started with or after a cold or allergy flare
• It fades as your congestion clears

Signs the problem may be a tooth

• Pain is in just one tooth and you can point to it
• It's a lower tooth, which sinuses don't affect
• Strong or lingering pain with hot or cold, or sharp pain when you bite
• Swelling of the gum or face, a bump on the gum, or a bad taste
• Pain that stays after your cold or sinusitis has gone
• Sinus symptoms on only one side that keep coming back, which can sometimes come from an upper tooth infection

Easing sinusitis teeth pain at home

Most sinusitis is caused by a virus and clears up on its own within a few weeks. Easing the congestion usually eases sinusitis teeth pain too.

Rest and drink plenty of fluids. A saline nose rinse or spray can help clear mucus. Breathing steam from a warm shower may feel soothing. An over-the-counter pain reliever can help; take it only as directed on the package. Your pharmacist can suggest decongestants or nasal sprays and tell you whether they are safe with your other medicines and health conditions.

Antibiotics don't help viral sinusitis. Only take them if a doctor or nurse practitioner has assessed you and prescribed them. Keep brushing twice a day with fluoride toothpaste, and rinse with water after cough syrup or lozenges.

Who to see: a doctor or a dentist?

If you have clear cold or sinus symptoms and the tooth ache is mild and spread out, start with your pharmacist or family doctor. See a doctor or nurse practitioner if symptoms are not improving after a week or so of self-care, get worse after starting to get better, or keep coming back.

See a dentist if the pain points to a single tooth, if there's swelling in your gum, or if the ache is still there after your sinuses clear. A dentist can test the tooth, check your bite and take an X-ray to look at the roots and the sinus floor. If you're in Aurora or nearby, Aurora Gateway Dental Care can help you sort out whether a tooth is involved. Call 289-475-5497.

When it's an emergency

Go to the emergency department or call 911 if you have any of the following with sinus or tooth pain:

• Swelling or redness around the eye, or the eye is hard to open
• Changes in vision, such as double vision
• A severe headache, a stiff neck, confusion or unusual drowsiness
• Swelling of the face or neck that makes it hard to breathe or swallow

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