Sinus Toothache and Dental Toothache – How to Tell the Difference

It is difficult to tell whether a toothache in the upper jaw comes from a sinus infection or from a dental problem.


Because many of their symptoms overlap:

  1. The roots of the upper back molars extend into the maxillary sinus cavities. This means that when the maxillary sinuses are infected, the increased pressure caused by trapped mucous, pushes down on the roots thereby displacing them slightly. This causes the upper jaw to ache, followed by a throbbing toothache. Other symptoms of maxillary sinus infection are facial tenderness and swelling in the cheek area. This particular pain is not dental related.
  2. On the other hand, if the toothache is caused by tooth decay or other dental problems, ‘referred’ pain will extend up the U shaped root cavity (called the alveolar), into the maxillary sinus. This will also cause facial tenderness and swelling in the cheek area.

It is also worth mentioning that the maxillary sinuses are the most commonly infected sinuses. This is because drainage from these cavities is not assisted by gravity.

In other words, drainage is difficult because the lowest pockets of these cavities where mucus tends to accumulate, are below nostril level during waking hours. Mucous must therefore travel upwards while the body is erect.

Since sinus infection is commonly caused by bacteria multiplying in pockets of stagnant mucous, sinusitis induced toothache is a relatively common complaint.

How to tell the difference

  • Sinus toothache usually accompanies sinus infection in the maxillary sinuses.
  • Sinus toothache occurs when pressure build-up from maxillary sinus infection presses down on the exposed roots of the upper back molars. Even experienced dentists sometime have difficulty in differentiating between sinus toothache and dental toothache.

Apart from a throbbing toothache, symptoms of sinus toothache include:

  1. Facial swelling.
  2. Swollen gums.
  3. Facial tenderness in the cheek area.
  4. Fever.
  5. Sinus headache.
  6. General feeling of malaise.
  7. Prolific nasal discharge and/or postnasal drip.

Dental Toothache:

  • Dental toothache is caused by tooth or gum disease and can be identified by the absence of sinus infection.
  • Dental toothache can affect any of your teeth, both in the upper and lower jaw. If toothache occurs in the lower set of teeth, it is almost certainly caused by one or more dental problem.
  • Dental toothache symptoms include:
    • *Facial swelling
    • *Swollen gums
    • *Facial tenderness

Can Dental Disease Cause Sinusitis?

If the rear upper molars become infected, the answer is yes. As mentioned above, the Maxillary sinuses and the mouth (oral cavity) are connected by a U shaped opening called the alveolar. This cavity is occupied by the roots of the upper back molars.

If you suffer from periodontal disease (gingivitis) or develop an abscess below the gum line, bacteria will tend to migrate up the alveolar and invade the maxillary sinuses, thereby causing sinus infection.