The Specialist

Sinus infections often cause toothaches that can lead to sinus infections

Tooth pain is a common symptom of sinusitis or sinus infection. The opposite is also true; a true toothache in an upper posterior region can cause a sinus infection.

In this column, we will discuss the inter-relationship of sinus infections and toothaches.

Toothaches are common occurrences. When they happen to the upper posterior teeth (premolars and molars) because of a dental infection, we must also consider the possibility that the sinuses may become infected. Also, when the sinus is infected, the pain may be referred to a tooth causing what appears to be a toothache. This unique relationship occurs because of the close proximity between the upper back teeth and the sinuses.

Sinusitis, commonly called a sinus infection, is an uncomfortable inflammation of your paranasal sinuses, the air cavities located in the face. In this area, mucus is built up and becomes thick, encouraging bacterial or viral infection. Swelling of the maxillary sinuses is typically what causes sinus toothaches, as these are located in the cheek and nose area right above your top teeth. Some of the symptoms include fever, constant nasal discharge that is often yellow or green, post-nasal drip, puffy eyes and bad breath. Sinusitis can be caused by anything that could inflame the sensitive tissues of the sinuses, including:

• Viral infections like the common cold.

• Respiratory infections.

• Allergies to pollen and other agents.

• Structural abnormalities and growths, like a deviated septum or nasal polyps.

• Pollutants like cigarette smoke.

• Complications with asthma.

Determining the original source of the infection, whether it is the sinus or a toothache, begins with a proper diagnosis.

If you’re having pain in a number of teeth, it’s likely that your toothache is due to a sinus infection. You may also feel a bit under the weather or have a fever. This is what’s known as referred pain, when the discomfort spreads to several teeth, even sometimes your lower teeth. The sinus usually swells and there is mucus buildup, which puts pressure on the nerves that run to the roots of your top teeth. In other words, this isn’t a tooth issue – your toothache is merely an uncomfortable symptom of sinusitis.

A localized dental tooth infection can also cause your sinuses to get infected. It is estimated that as much as 40 percent of chronic maxillary sinus infections are due to dental infections. In these cases, there is usually a history of current dental infections or periodontal diseases, and recent tooth extractions.

A sinus infection caused by dental concerns will likely be the only source of pain, and it could be more intense and focused. A sinus pain from an infected tooth will intensify with certain types of movement. Jumping up or bending over may make the pain worse. This is because the sinus pressure shifts as you move and is felt more in your teeth. If an infected tooth is not treated, the infection could spread elsewhere in your body, which is potentially life-threatening. Some signs that the original infection came from your tooth pain are the following:

• Pain when eating or drinking something cold or hot.

• Facial swelling.

• Gum swelling near the tooth.

• Pain near a tooth that has or requires dental work.

• Imaging studies with a CT scan can indicate underlying problems with a tooth or teeth.

See your dentist if the pain becomes more severe or it doesn’t go away after your sinus infection is gone. Your dentist will determine whether it’s being caused by periodontal disease, cavities, or dental abscesses. It would be important for your dentist to take a CT scan of the area to make an accurate diagnosis. The infected tooth can either be removed or the infection treated by a root canal. Following treatment, the patient is prescribed the necessary medications to relieve pain and sinus pressure.

See your medical doctor if your dentist doesn’t find a dental cause for your toothache. They can assess whether a sinus condition or another medical condition is the cause. Also, see your medical doctor if your sinus infection doesn’t get better after dental treatment. It’s important to rule out any structural issues, such as narrow drainage passages, tumors or a shifted nasal septum.

Because of the challenges in pinpointing what came first sinusitis or the toothache, an experienced dentist and a medical doctor should be consulted. Using a dental CT scan is a valuable asset in determining the cause. Professional collaboration between your dentist and physician is the prescribed standard of care to relieve you of pain while advancing your total health and wellness.

 • Dr. Kendal V.O. Major is the founder and CEO of the Center for Specialized Dentistry, which is a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified fast braces provider. His practice is located at 89 Collins Avenue, New Providence. He can be contacted at (242) 325-5165 or  

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