My Sinuses Can Hurt My Teeth?

           Well, in a manner of speaking, yes. Congestion in the sinuses that are located on either side of your nose, underneath your eyes (called your maxillary sinuses) can affect your upper teeth. Your lower jaw contains no sinuses and so no sinus condition can cause primary tooth symptoms in the lower jaw.

           Congestion in your maxillary sinuses can bring acute pressure to bear on the roots of your teeth that project into the inferior borders of these sinuses. Your roots do not actually protrude into the sinus cavities, but rather their tips cause elevations in your sinus floors akin to poles supporting a tent leaving the sinus floors paper thin in these areas. This pressure, when it contacts the nerves leaving your teeth or the nerves in the ligaments that attach your roots to your jaw bone and sinus floor, can cause significant discomfort.


The arrow indicates where the sinus floor is being "tented" by the roots of the end tooth here.

           This discomfort, depending on the degree of your congestion and the intensity of the pressure, can range in severity from a vague irritation to a deep ache.  It can also take the form of sensitivity to temperature extremes (with cold usually being more of a problem than cold).   If the pressure is serious enough, it can cause extrusion of your affected upper teeth sufficient to create a bite so heavy as to make the lower teeth that normally meet them in your bite sore as well. Episodes such as this are uncommon, but when they do occur the tenderness associated with your upper teeth is usually considerably greater than that of your lowers. On your upper the pain may extend from your teeth up to your eyes or your temples and across your cheeks over to your ears. Except for these symptoms, you may be unaware that you have a sinus problem, especially if the congestion in your sinuses is so thick that your nose doesn't run and you have no post-nasal drip.

           The number of upper teeth involved can vary from person to person. In most cases all your upper molar teeth and one or both of your upper premolar teeth (the ones between your eye teeth and your molars) will be involved with your maxillary sinuses. More rarely, your eye teeth may be included and in extreme situations your sinuses can even encompass your incisors.


Congestion (arrow) in the right maxillary sinus affecting the upper molars.

           There are two possible reasons for your congestion - allergy or infection. While a dental x-ray can show the congestion in those portions of your sinuses that involve your upper teeth, it cannot be used to definitively diagnose the underlying problem. This is for your physician to do and he or she may order an additional x-ray image called a Waters view to aid in diagnosing your condition. If you are diagnosed with allergies, your physician may prescribe an antihistamine for you. If an infection is suspected, you may be put on a course of antibiotics.

           It is also possible for you to have a dental problem and sinus problem superimposed on each other. If medical treatment has cleared your sinuses, but some of your oral symptoms persist, please return to our office so that Dr. McArdle can reevaluate you dentally. It is often easier to ascertain the source of a dental problem when any obscuring medical questions have been eliminated.





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Dr. Barry F. McArdle, D.M.D. ~ 118 Maplewood Avenue, The Captain Moses House, Suite B-7, Portsmouth, NH 03801

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