Can Tooth Pain Be a Symptom of Sinusitis?

Toothaches can occur for many reasons, most commonly tooth decay and gum disease. But one cause you may not expect is the inflammation of the sinuses, known as sinusitis.

A condition commonly associated with allergic rhinitis (hay fever) and upper respiratory infections, sinusitis can trigger "classic" symptoms affecting the nasal passages and sinuses. It can also cause pain in the upper teeth and jaw that some people mistake for toothache.

For this reason, sinus-associated tooth pain is sometimes referred to as a "sinus toothache." It may be relieved by home remedies, or, if it's persistent or severe, it may require treatment from your healthcare provider.

This article looks at the causes of toothache in people with sinusitis. It also explains how sinusitis is diagnosed and treated so that you can get fast relief.

Symptoms of Sinusitis

The sinuses are a connected system of hollow cavities in the skull located near your eyes, nose, cheeks, and forehead. The sinuses are lined with membranes that secrete mucus to trap debris that you either breathe in or enter the nostrils on their own.

Sinusitis causes the sinuses and nasal passages to swell, narrow, and secrete excess mucus. Depending on the underlying cause, this can lead to:

• Nasal congestion or blockage
• Runny nose
• A thick nasal discharge
• Drainage down the back of the throat (postnasal drip)
• Pain, tenderness, and swelling around the eyes, cheeks, nose, or forehead
• Coughing or throat clearing
• Reduced smell and taste
• Headache
  
• Ear ache
• Dental pain
  
• Sore throat
• Bad breath
• Fatigue

Causes of a Sinus Toothache

The tooth pain caused by sinusitis is not related to any injury or disease affecting the teeth. Rather, it is the result of a combination of nerve pain triggered by the compression of nerve roots near the sinuses and referred pain. Referred pain means it's felt at a location other than where the pain started.

In certain cases, the pain may extend to the lower teeth and jaw. That's because of the network of nerves that connect the upper jaw to the lower jaw. The referred pain is often described as "shooting" and can mimic the pain caused by a tooth abscess.

How to Treat a Sinus Toothache

If you have a sinus toothache, you don't need to treat your teeth. You need to treat underlying sinus inflammation. By relieving the pressure placed on the nerve roots of the upper jaw and teeth, the tooth pain will quickly ease.

Home Remedies

Most cases of sinusitis can be treated at home, particularly those associated with allergic rhinitis and seasonal allergies.

These home remedies may include:

• Hydration: Drinking plenty of fluids can help keep the sinus membranes well hydrated and help thin the nasal mucus.
• Warm face cloth: Applying a warm, damp cloth over your nose and eyes for 10 to 20 minutes several times a day can help ease sinus pain.
• Humidifiers: The moist air from a humidifier (or even steam from a shower or bath) can help to loosen nasal secretions and unblock the nasal passage.
  

Medications

Certain over-the-counter (OTC) and prescription drugs can help ease sinus symptoms as well as the underlying conditions that lead to sinus inflammation.

OTC medication options include:

• Antihistamines: Drugs like Claritin (loratadine) and Allegra (fexofenadine) block the action of a substance called histamine that triggers allergy symptoms.
• Anti-inflammatory drugs: OTC painkillers like Advil (ibuprofen) and Aleve (naproxen) not only help reduce swollen sinus tissues but function separately as an analgesic (pain reliever).
• Decongestants: Nasal sprays, drops, or tablets can help open blocked nasal passages by restricting the blood flow that contributes to swelling.
• Saline nasal irrigation: Saltwater treatments help relieve swelling by drawing water out of inflamed tissues. The saline solution can be delivered by an aerosol spray, squirt bottle, or neti pot.

Prescription drug options include:

• Antibiotics: These drugs may be prescribed if a bacterial infection is the cause of sinusitis. However, most people with a sinus infection will improve within two weeks without the need for antibiotics.
• Immunotherapy: This is a treatment in which you are exposed to gradually increasing amounts of allergy-causing substances (allergens) to reduce your sensitivity to them. The substances can be delivered by injection or with sublingual (under the tongue) drops or dissolving films.

Are There Tests to Check for Sinusitis?

People with a sinus toothache will sometimes go to a dentist thinking they have a dental problem. When their dentist is unable to find one, they may be referred back to their primary care provider for further examination.

In addition to a physical exam and a review of your medical history, your healthcare provider may perform tests to determine the underlying cause of the inflammation. This is particularly true if your symptoms are severe, recurrent, or resistant to OTC treatments.

Tests and procedures include:

• Nasal or sinus swab: The sample of mucus from deep inside the nose can be sent to a lab to check for bacterial, fungal, or viral infections.
• Nasal endoscopy: This involves the insertion of a thin, flexible tube with a fiber-optic camera (called an endoscope) into your nose to view the sinuses.
• Computed tomography (CT): This is an imaging technique that composites multiple X-ray images to create three-dimensional "slices" of the sinuses.
• Allergy testing: If an allergy is suspected but the cause is unknown, allergy tests (like a skin prick test) may be used to help identify the allergens.

When to Call a Healthcare Provider

As aggravating and debilitating as sinusitis can be, it generally does not require urgent medical care. However, there are exceptions, particularly with regard to a severe sinus infection.

See your healthcare provider immediately if:

• Your sinus symptoms are accompanied by a high fever and chills.
• The sinus pain is severe and spreading.
• Your symptoms persist for more than 10 days despite appropriate treatment.

Summary

Sinusitis is the inflammation of the sinuses typically caused by an infection or allergic rhinitis (hay fever). While sinusitis is readily recognized by sinus pain and congestion, it can also cause tooth pain (sometimes referred to as a "sinus toothache").

Sinusitis-associated tooth pain is caused by the compression of nerve roots situated near the sinuses that affect the upper jaw and teeth. On occasion, the compression can also trigger referred nerve pain in the lower jaw and teeth.

Treating the underlying cause of sinusitis will almost always resolve the tooth pain. If sinusitis is affecting your ability to function normally, ask your healthcare provider for a referral to an ear, nose, and throat specialist known as an otolaryngologist. If all other treatments fail, the specialist may recommend functional endoscopic sinus surgery (FESS) to remove obstructions and improve mucus clearance and breathing.