Dental Sinusitis: When Toothache and Sinus Pain Are Connected
Short answer: Dental sinusitis, also called odontogenic sinusitis (ODS), occurs when inflammation or infection in the maxillary sinus is linked to a dental source. It often affects one side and may be associated with an upper tooth infection, previous dental treatment, extraction or another problem close to the sinus.
If you have one-sided sinus pressure together with upper-tooth pain, pain when chewing, an unpleasant smell or taste, nasal discharge, or symptoms that keep returning despite ordinary sinus treatment, a dental assessment may be appropriate.
Important: Dental sinusitis does not always cause obvious toothache. Some people mainly notice one-sided nasal blockage, cheek pressure, unpleasant smell or discharge. The absence of dental pain does not by itself rule out a dental source.
The roots of the upper molars and premolars can lie very close to the maxillary sinus. Deep decay, infection around a tooth root, periodontal disease, previous root canal treatment, an extraction complication or another dental procedure can sometimes affect this area.
At Gloss & Floss Dental Care® in Södermalm, Stockholm, we assess the teeth, gums, dental history, symptoms and appropriate dental X-rays when needed. If the findings suggest that further imaging or assessment by an ear, nose and throat (ENT) specialist is appropriate, we explain the next step.
If you already suspect a sinus opening after an upper-tooth extraction or another dental procedure, read more about our dental sinusitis and sinus perforation assessment.
Last updated: August 2026
Toothache or one-sided sinus pressure?
Book a dental assessment if symptoms are linked to an upper tooth, keep returning, are mainly one-sided, or are accompanied by pain when chewing, swelling, bad taste or an unpleasant smell.
Dental sinusitis: quick overview
- Dental sinusitis can resemble ordinary sinusitis, but the underlying source is dental.
- Upper molars and premolars are particularly relevant because of their relationship to the maxillary sinus.
- Symptoms are often more pronounced on one side, although symptom patterns vary.
- Obvious toothache may be absent, especially when sinonasal symptoms dominate.
- Medication alone may not resolve the problem if an active dental source remains untreated.
- Treatment depends on the cause and may involve endodontic treatment, extraction, oral surgery or ENT collaboration.
What is dental sinusitis?
Dental sinusitis, or odontogenic sinusitis, is sinusitis associated with a dental source or complication from dental treatment. It is different from the more common forms of rhinosinusitis that may follow a viral upper-respiratory infection or arise from other nasal and sinus conditions.
The maxillary sinuses are located above the upper back teeth. In some people, the roots of these teeth are separated from the sinus by only a small amount of bone and soft tissue. Infection or inflammation around an upper tooth can therefore affect structures close to the sinus.
Possible dental sources include deep decay that has reached the dental pulp, infection around a root tip, unsuccessful or previously treated root canals, periodontal disease, an opening between the mouth and sinus after an extraction, or complications related to dental procedures near the sinus.
The relationship works in both directions: a dental problem can cause sinus symptoms, while non-dental sinus inflammation can make several upper teeth feel painful or sensitive. That overlap is one reason careful diagnosis is important.
Is it sinus pain or tooth pain?
Sinus pain and dental pain can overlap, and it is not always possible to distinguish them at home. The pattern of symptoms can, however, provide useful clues.
| Symptom pattern | Possible explanation | Recommended next step |
|---|---|---|
| One-sided cheek or sinus pressure with pain from an upper tooth | A dental infection or other odontogenic source may be affecting the maxillary sinus. | Book a dental assessment. Dental imaging may be needed. |
| One-sided nasal symptoms, foul smell or unpleasant discharge without obvious toothache | Dental sinusitis can occur even when dental pain is mild or absent. | Dental assessment is appropriate, particularly if symptoms are persistent or recurrent. |
| Pain when biting on one upper molar | A cracked tooth, deep decay, inflammation around the root or another dental problem may be present. | Book a dentist visit. If the dental pulp or root system is infected, root canal treatment may be considered. |
| Sinus symptoms after a recent upper-tooth extraction | An oroantral communication — an opening between the mouth and maxillary sinus — may occasionally occur. | Contact the treating clinic promptly. Read more about sinus perforation management. |
| Several upper teeth feel sore during a cold or sinus infection | Pressure from the sinus may be referring pain to the upper teeth rather than a single tooth being infected. | Monitor the overall illness, but seek dental assessment if pain becomes localised, persistent or worsens. |
| Bad taste, pus, swelling or fever together with dental pain | A dental infection or abscess may be present. | Contact emergency dental care promptly. |
| Persistent or recurrent one-sided sinus symptoms despite treatment | A dental source is one of the possibilities that may need to be excluded. | Consider dental assessment and, depending on the findings, further medical or ENT evaluation. |
Signs and symptoms of dental sinusitis
Symptoms vary, and no single symptom proves that the sinus problem comes from a tooth. Features that can raise suspicion of a dental source include:
- Sinus pressure, congestion or pain that is mainly on one side
- Upper molar or premolar pain
- Pain or tenderness when biting or chewing
- One-sided nasal blockage or discharge
- Unpleasant smell or taste
- Purulent or foul-smelling nasal discharge
- Cheek pressure or facial discomfort
- Swollen or tender gum around an upper tooth
- Sensitivity of a tooth to temperature or pressure
- Sinus symptoms beginning after an upper-tooth extraction or dental procedure
- Symptoms that repeatedly return despite conventional sinus treatment
Remember: A dental source can sometimes be present even without clear toothache. Conversely, sinus inflammation from a non-dental cause can make healthy upper teeth feel sore.
Common dental causes
If a dental source is identified, treating that source is an important part of management. The appropriate treatment depends on the diagnosis and prognosis of the affected tooth or area.
| Dental source | How it may affect the sinus | Possible treatment route |
|---|---|---|
| Deep decay in an upper tooth | Bacteria can reach the dental pulp and eventually the tissues around the root, which may lie close to the sinus. | Depending on severity: restorative treatment, root canal treatment or extraction. |
| Root infection or persistent disease around a previously root-filled tooth | Inflammation around the root tip of an upper tooth may involve tissues adjacent to the maxillary sinus. | Root canal treatment, retreatment or apical surgery in selected cases. |
| Periodontal disease or a deep periodontal defect | Loss of supporting tissue and infection around an upper tooth may extend toward structures close to the sinus. | Periodontal assessment and treatment according to the clinical findings. |
| Recent extraction of an upper molar or premolar | An opening can occasionally develop between the extraction site and the maxillary sinus. | Clinical assessment, sinus precautions, suturing or oral-surgical management depending on the size and persistence of the communication. |
| Implant-, graft- or procedure-related complication near the sinus | Infection, displacement of material or a communication involving the sinus may occasionally contribute to sinonasal inflammation. | Dental and oral-surgical assessment, with ENT collaboration where appropriate. |
How suspected dental sinusitis is assessed
Assessment involves determining whether there is a dental condition capable of causing or contributing to the sinus symptoms. Because odontogenic sinusitis involves both the dental and sinonasal regions, some cases require input from both dental and ENT clinicians.
-
Symptom and dental-history review.
We consider when the symptoms started, whether they are mainly one-sided, whether a specific tooth hurts, previous root canal treatment, extractions, implants or other treatment close to the sinus. -
Clinical dental examination.
Relevant upper teeth, gums, biting tenderness, dental pulp response and surrounding tissues are assessed according to the clinical situation. -
Dental imaging when indicated.
Intraoral dental X-rays and/or panoramic imaging may be used to assess the teeth, root areas, bone and their relationship to the maxillary sinus. -
Further investigation when necessary.
If ordinary dental imaging does not adequately answer the clinical question, or if the sinus itself requires more detailed assessment, additional imaging or ENT evaluation may be appropriate.
Dental assessment and ENT assessment have different roles
A dentist can identify or exclude many of the dental conditions that may cause odontogenic sinusitis. In persistent, complex or uncertain cases, an ENT specialist may also need to confirm the sinonasal component of the condition, for example through ENT examination and appropriate imaging.
A normal-looking tooth or an inconclusive basic X-ray does not always explain persistent one-sided sinus symptoms. If clinical suspicion remains, the appropriate next investigation depends on the individual case.
For general patient information about non-dental sinusitis, you can also read the NHS guide to sinusitis.
Treatment options for dental sinusitis
Treatment depends on the underlying cause. When a dental source is confirmed, addressing that source is a central part of management. Some patients may also require treatment directed at the sinus itself.
Root canal treatment or retreatment
If the tooth can be preserved and infection involves the dental pulp or root canal system, root canal treatment may be recommended. A previously root-filled tooth may occasionally require retreatment or, in selected circumstances, apical surgery.
Extraction when a tooth cannot be predictably saved
If the affected tooth has a poor prognosis, extraction may be appropriate. Upper posterior teeth can lie close to the sinus, so the anatomical relationship and appropriate aftercare need to be considered.
Management of an oroantral communication or sinus perforation
If an opening develops between the mouth and maxillary sinus after extraction or surgery, prompt assessment is important. Management depends on the size, timing, symptoms and clinical findings. Some small communications can heal with appropriate management, while larger or persistent openings may require surgical closure.
Read more about dental sinusitis and sinus perforation treatment.
Medication
Medication may sometimes form part of treatment depending on the diagnosis, symptoms and clinical findings. However, medication alone may not provide a definitive solution when an active dental source remains untreated.
ENT collaboration and sinus-directed treatment
Some patients benefit from coordinated care between dental and ENT clinicians. Persistent or more extensive sinus disease may require ENT-directed treatment, and selected cases may require endoscopic sinus surgery. The appropriate sequence of dental and ENT treatment depends on the individual diagnosis and severity.
Suspect a tooth-related sinus problem?
A dental assessment can help determine whether an upper tooth, root infection, periodontal problem or previous dental procedure may be contributing to your symptoms.
What you can do while waiting for your appointment
Self-care may reduce discomfort temporarily, but it should not replace dental assessment when symptoms are persistent, recurrent, worsening or linked to a particular upper tooth.
- Avoid chewing on a painful tooth or the affected side.
- Continue gentle toothbrushing and appropriate interdental cleaning.
- Use over-the-counter pain relief according to the package instructions if it is suitable for you.
- Do not place aspirin, alcohol or other strong substances directly against the tooth or gum.
- Do not delay assessment if swelling, fever, pus, increasing pain or difficulty opening the mouth develops.
After an upper-tooth extraction: If you suspect an opening into the sinus — for example because fluid or air seems to pass between the mouth and nose — contact the treating clinic promptly. Avoid forcefully blowing your nose or deliberately creating pressure in the area until you have received professional advice.
When is it urgent?
Suspected dental sinusitis is not always an emergency, but certain symptoms require faster assessment.
Contact dental or medical care urgently if you have:
- Facial swelling or rapidly increasing swelling
- Fever or feeling significantly unwell together with dental or facial pain
- Pus, significant drainage or a pronounced bad taste associated with dental swelling
- Severe or rapidly worsening pain
- Difficulty opening your mouth
- Fluid or air passing between your mouth and nose after an upper-tooth extraction
- Swelling around the eye, visual disturbance or other new eye symptoms
- Difficulty breathing or swallowing — seek emergency medical help immediately
How to reduce the risk of dental sinusitis
Not every case is preventable, but reducing untreated dental infection and identifying problems early can lower the risk of complications involving the sinus.
- Attend regular dental examinations according to your individual needs.
- Treat significant decay before infection progresses toward the dental pulp and root.
- Seek assessment for persistent pain from an upper molar or premolar.
- Maintain healthy gums through effective home care and professional treatment when needed.
- Follow aftercare instructions carefully following upper-tooth extractions or surgery.
- Plan upper-jaw implant and bone procedures with appropriate assessment of the available bone and sinus anatomy.
Why choose Gloss & Floss for dental sinusitis assessment?
Tooth-related sinus symptoms can sit at the interface between dentistry and ENT care. Our role is to assess whether a dental condition is present, explain the findings clearly and establish an appropriate pathway for treatment or further investigation.
Frequently asked questions about dental sinusitis
What is dental sinusitis?
Dental sinusitis, also called odontogenic sinusitis, is sinusitis linked to a dental source or complication from dental treatment involving the area close to the maxillary sinus.
Can a tooth infection cause sinus pain?
Yes. Infection involving an upper molar or premolar can affect tissues close to the maxillary sinus and may contribute to cheek pressure, nasal symptoms or sinus pain.
Does dental sinusitis always cause toothache?
No. Some patients with odontogenic sinusitis do not have obvious dental pain. One-sided nasal symptoms, unpleasant smell or discharge, cheek pressure or recurrent sinus symptoms may be more noticeable than toothache.
How do I know if my sinus pain is coming from a tooth?
A dental source may be more likely when symptoms are mainly one-sided or occur together with a specific upper-tooth problem, pain when biting, dental swelling, unpleasant taste or smell, or a history of dental treatment near the sinus. Examination is needed to determine the cause.
Can ordinary sinusitis make my teeth hurt?
Yes. Pressure from the maxillary sinus can make several upper back teeth feel sore even when those teeth are not infected. Pain that becomes localised to one tooth, persists or worsens should be assessed by a dentist.
Does dental sinusitis go away with antibiotics?
Medication may sometimes reduce symptoms, but it may not provide a definitive solution if an active dental source remains untreated. Treatment should be based on the underlying diagnosis.
How is dental sinusitis diagnosed?
Dental assessment can identify dental conditions capable of causing sinus disease through clinical examination and dental imaging. Persistent or complex cases may also require additional imaging and ENT assessment to evaluate and confirm the sinus component.
What treatment is needed for dental sinusitis?
Treatment depends on the cause and may include root canal treatment, retreatment, extraction, management of an oroantral communication, oral surgery or ENT-directed treatment. Some cases require coordinated dental and ENT care.
What is sinus perforation after tooth extraction?
A sinus perforation or oroantral communication is an opening between the mouth and the maxillary sinus that can occasionally occur after extraction of an upper tooth. It should be assessed promptly so that appropriate aftercare or treatment can be provided.
Can I get a dental implant after dental sinusitis?
Implant treatment may often be considered once active infection and relevant sinus problems have been appropriately managed. Upper-jaw implant planning may also require assessment of bone volume and sinus anatomy, and some cases may require bone augmentation or sinus-lift treatment.
When should I seek urgent care?
Seek urgent care for rapidly increasing facial swelling, fever with significant dental or facial pain, severe worsening pain, difficulty opening the mouth, eye swelling or visual symptoms, or difficulty breathing or swallowing. Fluid or air passing between the mouth and nose after an upper-tooth extraction should also be assessed promptly.
Can Gloss & Floss assess suspected dental sinusitis without CBCT?
Yes. We can perform a clinical dental assessment and use appropriate dental X-rays or panoramic imaging when indicated. If the clinical question requires advanced imaging or ENT evaluation, we explain the next step and arrange or recommend appropriate further assessment.
Medical references
This patient information has been prepared with reference to current multidisciplinary literature on odontogenic sinusitis.
- Craig JR, Poetker DM, Aksoy U, et al. Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement. International Forum of Allergy & Rhinology. 2021. PubMed
- Craig JR, Tataryn RW, Aghaloo TL, et al. Management of odontogenic sinusitis: multidisciplinary consensus statement. International Forum of Allergy & Rhinology. 2020. PubMed
- Craig JR. Odontogenic sinusitis: A state-of-the-art review. World Journal of Otorhinolaryngology – Head and Neck Surgery. 2022. PubMed
Book a dental assessment in Stockholm
If you have persistent upper-tooth symptoms together with sinus pressure, recurrent one-sided sinus symptoms, or a problem that started after treatment of an upper tooth, a dental assessment can help determine whether a dental source is present.
Book help for toothache and sinus symptoms
At Gloss & Floss Dental Care® in Södermalm, we assess relevant upper teeth, gums, dental history and imaging needs and explain the appropriate next step.
This page provides general patient information and does not replace an individual diagnosis or assessment by a dentist, physician or ENT specialist.
