Is it sinusitis or a dental infection?

Tooth pain and sinus pressure can feel surprisingly similar. Pain in the upper teeth, especially the back teeth, often raises a question: Is this a dental problem, or is it coming from my sinuses?

Understanding the source of tooth pain is essential. That’s why patients benefit from the expertise of Nikita B. Ruparel, DDS, MS, PhD, a board-certified endodontist and leader in advanced dental pain diagnosis and treatment. Dr. Ruparel serves as director of the Advanced Education Program in Endodontics and clinic director of the Endodontics Clinic at the UT San Antonio School of Dentistry.

With advanced training in both dentistry and research, Dr. Ruparel specializes in modern endodontic care, including root canal therapy, regenerative endodontics and the management of dental trauma. She also frequently shares her expertise at national and international scientific meetings.

According to Dr. Ruparel, the roots of the upper premolars and molars sit very close to the maxillary sinuses. Because of this proximity, inflammation or infection in one area can easily affect the other. Recognizing how symptoms typically present can help you decide whether to see your dentist or a medical provider.

When pain is caused by a sinus infection (rhinosinusitis)

Sinus-related tooth pain usually results from pressure and inflammation in the sinus cavities, rather than a problem with a single tooth. Common features include:

• Diffuse, poorly localized pain that may feel like several upper teeth hurt at once
• A pressure-like, heavy or aching sensation affecting premolars and molars
• Pain that worsens with head position changes, such as bending forward or lying down
• Symptoms that are felt on both sides of the face when both sinuses are involved
• Nasal congestion, facial fullness or sinus pressure
• Sinus pain is not resolved with dental treatment

Patients often describe this discomfort as a general ache across the upper jaw rather than pain from a specific tooth.

When pain is caused by a tooth infection

Dental infections typically begin in a single tooth and may later spread to nearby bone or the sinus. Signs that point to a tooth-related source include:

• Pain localized to one tooth, especially in the early stages
• A sharp, throbbing or deep, persistent ache
• Pain that worsens with biting, chewing or tapping on the tooth
• Discomfort that may wake you from sleep
• Facial or sinus pressure developing on the same side
• Tooth pain and sinus pain resulting from tooth infection both resolve with dental treatment

If left untreated, a tooth infection can extend beyond the tooth and affect surrounding structures, including the sinuses.

Why an accurate diagnosis matters

Treating sinus-related tooth pain with dental procedures or treating a tooth infection with only sinus medication can delay relief and allow the underlying problem to worsen. A careful evaluation, which may include imaging and collaboration between dental and medical providers, is often the best way to identify the true cause.

“If pain is persistent, worsening or interfering with daily activities or sleep, it’s important not to ignore it,” emphasized Dr. Ruparel.

Dr. Ruparel encourages patients to seek a diagnosis based on the pain they are experiencing. If a patient doesn’t know where to start, visiting an endodontist is often a good first step. Endodontists specialize in the management of tooth pain and its neighboring facial structures. They can use 3D imaging and numerous clinical tools to pinpoint the true source of discomfort and determine whether it is dental or sinus-related. An accurate diagnosis is the first step toward effective treatment

Unsure what is causing your pain

The dentists and specialists at UT Dentistry can help determine the cause of your symptoms and guide you to the right care. Visit UTDentistry.org to learn more about the comprehensive and specialty dental services offered, or call the Endodontics Clinic at210-450-3636 to schedule an evaluation.