What is Sinusitis and Why Can it Cause Toothache?

The sinuses are naturally occurring, air-filled spaces that connect to the nasal cavity (inside area of the nose). Sinusitis the term given when there is inflammation of these spaces. This is common with a cold/flu or other upper respiratory infections. The spaces can also become inflamed as a result of allergies and obstructions to fluid flow within them. Inflammation associated with a sinus infection can cause pain, caused by a build-up of pressure.

There are several spaces, including the maxillary sinus which lies behind your cheekbones. Very often, roots of the top back teeth lie very close to the sinuses. Fluid build-up here can put pressure on the nerves that enter the roots of these teeth. Therefore a sinus infection can make you feel like you have toothache. It can be very difficult for your brain to tell the difference between a sinus headache and toothache!

Why sinus pain causes toothache graphic

The tips of the upper back teeth lie very close to the lining of the sinuses


“How do I Know if I Have Sinus Trouble and not Toothache?”

As explained, this can be difficult. Do attend your dentist for a proper diagnosis. Some of the following symptoms can help identify sinusitis.

sinusitis blowing nose

Can sinusitis lead to toothache?

  • If you have a cold/flu, your nose feels blocked or you have a runny nose (or discharge down your throat) you may have a sinus infection. Other symptoms like a cough, sore throat and fever may be present.
  • Throbbing pain or ‘heaviness’ behind the cheek bones is a sign of sinus inflammation. The cheek areas may feel tender to touch.
  • You may have a headache. Pain can also spread to cause earache.
  • With sinusitis, the pain is often made worse by nodding your head up and down or, for example, going up and down stairs.
  • If you have a history of getting this problem in the past, this may help with the diagnosis.
  • If you attend the dentist, he can check the teeth to rule out them out as the source of pain. If several upper back teeth are tender when the dentist taps them, this can point to sinusitis as the cause of pain. S/he may take X-rays to help rule out dental disease as the problem.
  • If there is any doubt as to the source of the pain (i.e. a dental problem or not) the dentist may give medication to treat sinusitis. If the problem is actually from a tooth then there will be no improvement after a few days.


Sinus infection treatment

Acute (short-term) sinusitis is treated with antibiotic therapy (e.g. amoxicillin) and decongestants (in the form of tablets such as Sudafed and/or drops). Nasal drops/sprays should only be used as a remedy for short periods of time, as they can lead to “rebound” sinusitis. Anti-allergy medicines (anti-histamines) may be prescribed if there is a suspected allergy at play.

Anti-inflammatories such as Ibuprofen can help relieve pain and reduce inflammation. As always, only take any medication if you know it is safe for you to do so.

Long-term (chronic) infections may require further treatment including surgery if there is a blockage or a source of infection present in the space.


Nasal sprays should only be used for short periods of time



Sinusitis is a common problem and an unpleasant one. It can often lead to confusion in those that suffer with it, as it can manifest as toothache.

It is not uncommon for sinus problems to manifest as pain in the back teeth. There are several clues that can help you distinguish between this pain and toothache.  As always, contact your dentist for advice.


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