Sinus Pain or a Toothache?

This is the time of year when many people experience tenderness or pressure in their sinus cavities due to colds, flu, allergies or sinus infections. Sometimes this pressure and tenderness affects not only the sinuses, but also the teeth! Many people come to the dentist, assuming they have a tooth problem, only to find out their teeth are perfectly healthy.

Why Does Sinus Pressure Refer to the Teeth?

And x-ray showing the teeth and sinus cavity
This x-ray shows the close proximity of the teeth to the sinus cavity.

Location, location, location.

The maxillary sinus cavities (the biggest ones you have) are open air spaces contained in your skull, and they rest right on top of the upper jaw. In some people, there is not much bone between the teeth and the sinus cavity. In many others, the roots of the upper back teeth stick up into the sinus cavity, with only a thin shell of bone separating them.

The sinuses should be empty, containing only air. However, they often fill up with mucus, nasal drainage, and inflammation in response to allergens and bacterial or viral infections. The same buildup of pressure that causes tenderness behind your cheekbones can also cause tenderness on your upper back teeth.

What do Sinus-Referred Pain and a True Toothache Have in Common?

The reason these two can be confusing is that they cause many of the same symptoms. “Dental pain can mimic many conditions and vice versa,” including sinus pain, headache and TMD (Temporomandibular joints disorder) according to a report by the British Journal of General Practice.

Woman with toothache after eating popsicle
Both sinus pain and toothache share the symptom of sensitivity to cold.

Both sinus-referred pain and an actual toothache can cause one or more of these things:

  • Tenderness when chewing – Both sinus-referred pain and toothaches can include inflammation around the roots of the teeth. This causes tenderness of chewing or even just tapping the side of the tooth.
  • Sensitivity to cold – The nerve that supplies sensation to a tooth, the ability to feel hot, cold, and pressure, enters into the tooth through a tiny hole at the tip of the roots. When there is inflammation in the sinus cavity, it can put pressure on these tiny nerves and make them hypersensitive.
  • Dull ache or throbbing pain around the tooth – When inflammation causes swelling within an enclosed space, like the bone around a tooth, it hurts. This inflammation can be just a low, dull ache, or can turn into throbbing pain.
  • Tender swelling inside the mouth, under the cheeks – This inflammation can extend outside the sinus cavity into the soft tissue inside your cheeks. Both tooth infections and sinus inflammation can cause this kind of swelling, so it is very important to see your dentist as soon as possible if any swelling is present.

How Can You Tell the Difference?

Woman with cold
If you are experiencing congestion and allergies, it could indicate sinus pain rather than a toothache.

It is very simple for a dentist to distinguish between a sinus-referred pain and an actual tooth problem. The process typically involves one or two x-rays and some minor testing of the tooth. The most important part of this dental evaluation is ruling out dental disease.

If you come in for an appointment, we will closely evaluate your teeth in the area of pain for any cavities, gum disease, or tooth fractures. An x-ray of the entire root will show how close it is to your sinus cavity. Some testing confirms the health of the nerve inside the tooth.

If your tooth and its surrounding tissues are healthy, and your sinus cavity is close to the roots, it is safe to assume that sinus pressure is the culprit.

A few symptoms that are specific to sinus-referred pain are pressure or pain that intensifies with any impact or change in pressure. For instance, if your dull ache hurts more when your feet hit the ground during jogging, it is more likely to be sinus pain. Or if you bend forward with your head between your knees, and the pain worsens, it is probably related to your sinuses.

How to Alleviate Sinus-Referred Tooth Pain

If you have not seen a dentist within the past six months, please stop reading now and call one to schedule an appointment. Tooth infections can become very dangerous, so you must first rule out a serious dental problem as the cause of pain.

If you do see your dentist regularly, and you know you do not have any new dental problems, you can keep reading.

There are two main causes of the tenderness you feel when sinus inflammation refers its pain to a tooth. One is congestion in the sinus cavity. The buildup of mucus from nasal drainage and allergies can quickly fill up the sinus space. For this, you can take an over-the-counter decongestant, like Sudafed. This medication will break up the congestion, reducing the pressure in the sinus cavity.

The other cause is inflammation of the tissues in the sinus cavity and in the structures surrounding the tooth. For this, we recommend taking an over-the-counter anti-inflammatory medication like Advil or Motrin. This helps reduce the inflammation in the sinus cavity and around the tooth, relieving some of the tenderness.

More Questions about Sinus Pain and Toothaches?

It is important to know the difference! Call today to schedule an appointment at our dental office in downtown Pensacola, and we can quickly tell you which you are dealing with.