Chronic sinus issues are incredibly common, affecting more than 28.9 million adults in the United States every year. Sinus infections can cause pressure, congestion, headaches, and even tooth pain. But what many people don’t realize is that dental problems are often a hidden cause of chronic sinus symptoms.
Because the upper teeth sit directly below the maxillary sinuses, issues such as tooth infections, gum disease, or complications from previous dental work can spread upward, creating inflammation, pressure, and repeated infections that don’t seem to go away.
In this article, we’ll break down how oral health and sinus problems are related, which dental issues can trigger sinus infections, how to tell the difference between sinus pain and dental pain, and what treatment options are available. If you’ve been dealing with sinus pressure that never seems to improve, your teeth may be part of the problem.
A sinus infection—also called sinusitis—occurs when the tissue lining the sinuses becomes inflamed or infected. The sinuses are four small air-filled spaces in your skull that help filter air, produce mucus, and keep your nasal passages moist.
When these spaces become blocked, bacteria can grow, leading to infection.
Acute sinusitis: Lasts less than 4 weeks
Subacute sinusitis: Lasts 4–12 weeks
Chronic sinusitis: Lasts longer than 12 weeks
Recurrent sinusitis: Several episodes throughout the year
Chronic sinusitis is the type most likely to be linked to dental problems.
Sinus infections can range from inconvenient to debilitating. Common symptoms include:
Facial pain and pressure
Nasal congestion
Post-nasal drip
Tooth pain, usually in the upper back molars
Headaches
Thick yellow or green mucus
Reduced sense of smell
Fever (less common in chronic cases)
One important thing to note: tooth pain caused by sinus infections typically affects more than one tooth and often gets worse when you bend over. This is because the pressure in the maxillary sinus shifts.
The roots of the upper back teeth, especially the premolars and molars, are separated from the maxillary sinus by only a thin layer of bone. In some people, the roots even extend into the sinus cavity.
Because of this close anatomical relationship, problems in one area can directly affect the other.
Odontogenic sinusitis refers to sinus infections that originate from a dental issue. Research shows that up to 40% of chronic maxillary sinusitis cases are caused by dental problems.
Often, patients don’t suspect a dental source because sinus symptoms seem unrelated to their teeth. Yet resolving the dental issue frequently leads to relief.
Several oral health issues can contribute to chronic sinus infections. Understanding these helps explain why sinus symptoms sometimes persist until dental treatment is completed.
A tooth infection occurs when bacteria reach the inner pulp of a tooth. If left untreated, the infection can spread from the tooth root into the maxillary sinus.
Throbbing or persistent tooth pain
Sensitivity to hot or cold
Gum swelling
A bad taste or smell
Pain radiating to the ear, jaw, or sinuses
The Journal of Endodontics reports that dental infections are one of the most common causes of one-sided sinusitis.
Gum disease is a bacterial infection of the tissues surrounding the teeth. Severe periodontitis can cause inflammation around the roots of the upper teeth, which can irritate the sinus lining.
The CDC estimates that nearly 47% of adults over age 30 have some form of gum disease, making it a widespread contributor to sinus problems.
When cavities reach deep into a tooth, bacteria and inflammation can spread toward the sinus cavity. This is particularly common in teeth with:
Old fillings
Large restorations
Cracks or fractures
Even if the cavity hasn’t yet caused a full infection, the inflammation alone can irritate the sinus.
Removing an upper molar can sometimes create a small opening between the mouth and the sinus called an oroantral communication (OAC). If it doesn’t heal properly, bacteria can pass into the sinus cavity.
Signs of this complication include:
Air escaping through the extraction site
Fluid leaking between the mouth and nose
Persistent congestion
Dentists can repair this with a minor surgical procedure.
Persistent infection beneath a previously treated tooth can spread upward into the sinus. This may occur if:
A root canal was incomplete
A crown leaks
A filling cracks
A tooth fractures under an old restoration
A study found that failed dental procedures contribute to around 20% of odontogenic sinusitis cases.
Dental implants placed in the upper jaw must be carefully positioned to avoid compromising the sinus cavity. Problems can occur if:
There isn’t enough bone beneath the sinus
The sinus membrane is perforated
Infection develops around the implant
This is why many patients require a sinus lift before getting implants, especially in the upper back jaw.
Because sinus pressure often radiates downward, it can mimic dental pain.
Pain affects multiple upper teeth
Pain worsens when bending over
Congestion, drainage, or pressure is present
Teeth feel “achy” instead of sharp
Pain is centered on one specific tooth
Sensitivity to hot, cold, or biting pressure
Pain continues even after sinus symptoms improve
Gum swelling or an abscess is visible
A dental exam with X-rays or a CBCT scan is the fastest way to determine the cause.
If a dental issue is causing sinus infections, treating the sinus alone won’t solve the problem. Instead, the underlying oral health condition must be addressed.
Treatment may include:
Root canal therapy
Antibiotics (in specific cases)
Extraction of a non-salvageable tooth
Abscess drainage
Once the infected tooth is treated, sinus symptoms often improve quickly.
Periodontal therapy may involve:
Scaling and root planing (deep cleaning)
Antibacterial medications
Laser treatment
Gum surgery (for advanced cases)
Improving gum health reduces bacterial spread to the sinus.
Small surgical procedures can correct openings between the mouth and sinus, preventing further infections.
This may include:
Retreatment of a root canal
Replacement of old crowns or fillings
Extraction of compromised teeth
Correcting the source of infection allows the sinus to heal.
If there is insufficient bone beneath the sinus, a sinus lift can create the ideal foundation for an implant.
You should visit a dentist if:
Your sinus symptoms affect only one side
You have repeated sinus infections
Tooth pain doesn’t go away after sinus treatment
You notice swelling around a single tooth
You’ve had recent dental work near the upper molars
You have untreated cavities or gum disease
Dentists and ENT doctors often collaborate, but a dental evaluation is essential when sinus issues may be odontogenic.
You can protect both your oral and sinus health by:
Brushing twice daily
Flossing once a day
Maintaining regular dental cleanings
Treating cavities early
Replacing failing restorations
Seeking dental care at the first sign of pain
Healthy teeth are a strong defense against chronic sinus issues.
Sinus infections are frustrating, especially when they keep returning. If you’ve tried traditional sinus treatments without success, your teeth may be the underlying cause. Dental infections, gum disease, or complications from past dental work can all trigger chronic sinus problems, and addressing the oral health issue is often the key to long-term relief.
At Stubbs Dental, our team uses advanced imaging and expert diagnostics to uncover the true source of your symptoms and create a personalized treatment plan just for you. If you’re experiencing persistent sinus pressure, upper tooth pain, or ongoing congestion, schedule a consultation today! We’re here to help you feel better, breathe easier, and enjoy a healthier smile.