Sinus infection and tooth pain: What is the connection?

Sinus infections, also known as sinusitis, commonly cause facial pressure, congestion, headaches, and nasal drainage. Less commonly—but often more confusing for patients—they can also cause tooth pain. Understanding why this happens can help distinguish sinus-related discomfort from a true dental problem.

How Sinuses and Teeth Are Connected

The sinuses are air-filled cavities within the bones of the face and skull. The maxillary sinuses, located behind the cheeks and above the upper teeth, are the sinuses most closely associated with dental pain.

The roots of the upper premolars and molars often sit very close to the floor of the maxillary sinuses. In some individuals, the roots are separated from the sinus cavity by only a thin layer of bone or tissue. Because of this close anatomical relationship, inflammation or pressure within the maxillary sinus can be perceived as pain in the upper teeth.

The sinuses, teeth, and surrounding facial structures also share common nerve pathways. When the sinus lining becomes inflamed or swollen during an infection, pressure can be transmitted through these shared nerves, creating pain that feels dental in origin even when the teeth themselves are healthy.

Why Sinus Infections Can Cause Tooth Pain

During a sinus infection, the sinus lining becomes inflamed and swollen, and normal drainage of mucus is impaired. As pressure builds within the maxillary sinuses, it can compress nearby nerves and tissues.

This pressure most often presents as:
• A dull, aching pain in the upper back teeth
• Pain affecting multiple teeth on one side
• Discomfort that worsens when bending forward or lying down
• Tooth pain accompanied by congestion, facial pressure, or headache

Unlike dental pain caused by decay or infection, sinus-related tooth pain is usually not triggered by chewing, temperature changes, or biting pressure.

Can Tooth Problems Cause Sinus Infections?

The relationship between teeth and sinuses can also work in the opposite direction. Infections of the upper teeth—particularly abscesses involving the molars—can sometimes spread into the maxillary sinuses. This is known as odontogenic sinusitis and requires treatment of the underlying dental source in addition to managing sinus inflammation.

Because symptoms can overlap, distinguishing between a sinus infection and a dental problem often requires a clinical examination and, in some cases, dental imaging.

When to See a Dentist vs. a Physician

Dental evaluation is recommended if:
• Tooth pain is localized to a single tooth
• Pain worsens with chewing or biting
• There is swelling of the gums or face
• Symptoms persist after sinus symptoms improve

Medical evaluation is appropriate if:
• Tooth pain is accompanied by congestion, nasal discharge, or facial pressure
• Pain affects multiple upper teeth
• Symptoms worsen when bending forward
• There is a recent history of sinus infection or upper respiratory illness

In some cases, both dental and sinus evaluations are necessary to identify the true source of discomfort.

Getting an Accurate Diagnosis

Because sinus infections and dental problems can mimic each other, self-diagnosis is unreliable. A thorough dental examination allows evaluation of the teeth, gums, and surrounding structures to determine whether pain is dental in origin or referred from the sinuses. When dental causes are ruled out, appropriate medical treatment can be pursued with confidence.

If you are experiencing persistent tooth pain or facial discomfort, professional evaluation is the best way to identify the cause and guide proper treatment.