Sinus Infection or Toothache? How Canadians Can Tell
That throbbing upper-tooth pain might be a cavity—or it might be your sinuses acting up. Because the roots of upper back teeth sit near the maxillary sinuses, sinus pressure can mimic a toothache. Here’s how Canadians can tell the difference and what to do next.
Is my toothache a sinus infection or a dental problem?
If multiple upper back teeth ache on one side, worsen when you bend over, and you also have nasal congestion or facial pressure, it’s often sinus-related. A sharp, pinpoint tooth pain triggered by cold or biting—especially with a swollen gum spot—usually means a dental issue.
Why sinus problems can feel like a toothache
Your maxillary sinuses sit directly above your upper premolars and molars. When you have a cold, allergies, or sinusitis, swollen sinus linings and trapped fluid can increase pressure. That pressure irritates the nerves shared near tooth roots, making several upper teeth feel sore or achy even if those teeth are perfectly healthy.
Common sinus-related tooth pain clues
– Several upper back teeth on one side feel dull or achy (not just one tooth).
– Pain and facial pressure get worse when you lean forward, go up stairs, or fly.
– Cheeks, under-eye area, or forehead feel tender to touch.
– You also have a stuffy or runny nose, post-nasal drip, or you recently had a cold/allergy flare.
– The pain may improve after a hot shower, saline rinse, or decongestant.
Signs it’s likely a dental issue (see a dentist promptly)
– Pinpoint pain in a single tooth, especially when you bite or chew on it.
– Sudden, sharp sensitivity to cold that lingers after the cold is gone.
– A pimple-like bump on the gum, bad taste, fever, or swelling in the jaw/face—possible signs of an infection or dental abscess.
– Pain that worsens when you lie down and throbs without relief.
– A cracked tooth feeling (sharp zaps with pressure or cold).
– Recent deep filling, crown, or trauma on that tooth.
Quick at-home checks before you pick up the phone
These simple steps may help you narrow it down while you arrange care in Canada:
– Try a saline nasal rinse or a warm shower. If tooth pain eases as nasal pressure reduces, sinus involvement is likely.
– Gently tap the chewing surface of the painful tooth with a clean spoon handle. If one specific tooth sends a sharper pain signal than its neighbours, that’s more dental than sinus.
– Note triggers. Biting or cold sensitivity that lingers suggests a tooth problem, while bending and head movement sensitivity suggests sinus pressure.
– Speak with your pharmacist about short-term decongestant options and saline sprays if you suspect sinusitis. If you take blood pressure meds or have heart issues, ask specifically which decongestants are safe for you.
Important: Avoid placing aspirin directly on the gums (it can burn tissue), and don’t use leftover antibiotics. If pain is severe, swelling is spreading, or you have fever, call a dentist urgently or seek emergency care.
When to call a dentist vs your family doctor (Canada)
– Call a dentist first when the pain is sharp, localized, triggered by biting or cold, or there’s gum swelling, a bad taste, or facial swelling. Dentists can assess teeth, gums, and the bite, and start definitive care. If a true dental infection is present, antibiotics alone won’t fix it—source control (e.g., drainage, root canal, or extraction) is key.
– Call your family doctor or a walk-in clinic when your main symptoms are sinus pressure, congestion, post-nasal drip, and discomfort across several upper back teeth. Many sinus cases improve with supportive care (saline rinses, rest, fluids) and time; your physician can advise if and when antibiotics are appropriate.
“Oral health is a key indicator of overall health, wellbeing and quality of life.” — World Health Organization (WHO)
How dentists figure it out (and why X‑rays matter)
Your dentist will take a careful history, then perform tests that tease apart tooth vs sinus sources:
– Percussion test: gentle tapping on teeth to spot a single tender culprit.
– Cold test: how long a tooth reacts helps reveal pulp (nerve) health.
– Bite test: identifies cracked-tooth pain patterns.
– Gum evaluation: pockets or drainage pathways may signal infection.
– Imaging: Bitewing or periapical X‑rays look for decay, deep fillings, abscesses, and bone changes. For complex cases, a panoramic image or CBCT may be used. Learn what dentists look for in imaging in this step‑by‑step guide to dental X‑rays.
Treatment paths: sinus vs dental
If it’s sinus related: Most viral sinus infections improve within 7–10 days with rest, fluids, humidification, saline rinses, and decongestants (when safe). Allergy care (e.g., antihistamines or steroid sprays as directed) can help prevent recurrent episodes. Your family doctor will decide if antibiotics are appropriate for bacterial cases.
If it’s dental: Your dentist will treat the source—removing decay and placing a filling, smoothing a cracked cusp, adjusting the bite, placing a crown, or performing a root canal if the nerve is infected. For true infections, source control is critical. For urgent first-aid steps while you’re on the way to care, review our Canadian overview of what to do in common dental emergencies.
Red flags that need urgent dental or medical attention
– Facial swelling that’s spreading toward the eye or down the neck
– Fever, chills, or feeling unwell
– Trouble swallowing, speaking, or breathing
– Severe pain that doesn’t respond to over-the-counter pain relievers
These signs can indicate a severe dental infection, such as an abscess. If you notice them, seek urgent care. You can also learn the warning signs in our Canadian abscess guide.
Smart pain control while you arrange care
– Over-the-counter pain relief: Many Canadians do well with ibuprofen or acetaminophen (follow label directions; ask your pharmacist about safe dosing and drug interactions). If you have kidney, stomach, or heart conditions—or take blood thinners—consult a professional before using NSAIDs.
– Gentle self-care: Warm compresses for sinus pressure, cold compresses for dental swelling; soft foods; avoid extreme hot/cold drinks; sip water often to stay hydrated and thin mucus.
How to prevent confusing sinus vs tooth pain
– Manage allergies well: Daily saline rinses in season, HEPA filtration at home, and prescribed sprays help keep nasal inflammation down.
– Humidify Canadian winters: Dry indoor air can aggravate sinuses and sensitive teeth—aim for 40–50% indoor humidity.
– Prioritize daily oral care: Brush with fluoride toothpaste twice a day and clean between teeth once daily; keep up with regular checkups to catch small problems before they hurt.
– Address grinding and bite issues: A custom night guard can reduce biting pain and cracked-tooth issues.
– Treat colds early: Rest, fluids, and nasal saline at the first signs may reduce sinus pressure before it reaches your teeth.
Conclusion
Sinus pressure often makes several upper teeth ache, while true dental problems usually act up in one specific tooth—especially with biting or cold triggers. When in doubt, call your dentist first. They can test teeth and review X‑rays, then coordinate with your family doctor if a sinus issue is likely. Acting early saves pain, cost, and time—and protects your smile.
FAQ
1) Can a sinus infection really make my back teeth hurt?
Yes. Swollen maxillary sinuses sit just above upper molars and premolars. Pressure can irritate nearby nerves and make several upper teeth feel sore—even if the teeth are healthy.
2) How do I know it’s a tooth problem, not my sinuses?
If pain is pinpointed to one tooth, worsens when you bite, or lingers after cold, it’s usually dental. If several upper teeth ache and the pain increases when you bend forward, it’s more likely sinus-related.
3) Will antibiotics fix a dental infection?
Antibiotics may help in select cases, but they don’t remove the source. Dental infections need definitive treatment (e.g., drainage, root canal, or extraction). Your dentist will guide you on the safest, most effective plan.
4) What can I do at home if I think it’s sinus-related?
Use saline rinses, rest, hydrate, and consider a short-term decongestant if safe for you (ask a pharmacist). Warm showers and humidified air can reduce pressure. If symptoms persist or worsen, see your family doctor.
5) What over-the-counter pain relievers are best?
Many adults find relief with ibuprofen or acetaminophen. Always follow label directions and ask a pharmacist about drug interactions or medical conditions that affect what’s safe for you.
6) When should I see a dentist urgently?
Seek same-day dental care if pain is severe and localized, a gum pimple appears, there’s facial swelling, fever, or pain on biting that’s getting worse. These can be signs of an abscess or cracked tooth and need prompt attention.
