Pain in the upper back teeth doesn’t always come from the teeth themselves. In some cases, the cause is maxillary sinusitis, an inflammation or infection of the sinus cavity located just above the upper teeth.
Because the roots of the upper molar and premolar teeth sit very close to the sinus, sinus problems can often feel like dental pain.
What is Maxillary Sinusitis?
The maxillary sinuses are air-filled spaces located in the cheekbones, above the upper jaw. When these sinuses become inflamed or blocked, they can fill with fluid and become infected or irritated. This condition is called maxillary sinusitis.
What Causes It?
Common causes include:
- Viral infections such as the common cold
- Bacterial sinus infections
- Allergies (hay fever)
- Nasal congestion or chronic sinus blockage
- Dental infections that spread into the sinus (less common but important)
- Anatomical issues such as a deviated septum or narrow sinus drainage pathways
How Does It Affect the Teeth and Mouth?
Because the sinus sits so close to the upper teeth, inflammation can create pressure that feels like toothache. This is often mistaken for a dental problem.
You may notice:
- Aching or pressure in the upper back teeth
- Pain that affects several teeth at once rather than one specific tooth
- Pain that worsens when bending forward or lying down
- A feeling of fullness in the cheek
In some cases, there may be an actual dental cause contributing to the sinus infection, such as an infected upper tooth.
Other Common Symptoms
Maxillary sinusitis can also cause:
- Nasal congestion or blockage
- Thick nasal discharge (yellow or green in bacterial cases)
- Facial pressure or tenderness in the cheeks
- Headache, especially around the eyes or forehead
- Reduced sense of smell or taste
- Mild fever or fatigue in acute infections
How Is It Diagnosed?
Your dentist will assess whether the pain is coming from the teeth or the sinus. This may include:
- Clinical examination of the teeth and gums
- Testing individual teeth for sensitivity
- X-rays if a dental cause is suspected
If a sinus cause is more likely, you may be referred to your GP or an ENT specialist for further assessment.
How Is It Treated?
Treatment depends on the cause:
- Viral sinusitis usually improves on its own with rest, hydration, and symptom relief
- Bacterial sinusitis may require antibiotics prescribed by a doctor
- Allergy-related sinusitis may be managed with antihistamines or nasal sprays
- Dental-related sinusitis requires treatment of the underlying tooth problem, such as root canal therapy or extraction
Decongestants, saline nasal sprays, and steam inhalation may also help relieve symptoms in some cases.
The Bottom Line
Maxillary sinusitis can closely mimic toothache, especially in the upper back teeth. The key difference is that sinus pain often affects multiple teeth and is linked with nasal and facial symptoms.
At Dural Dental Practice, we carefully assess whether upper tooth pain is dental or sinus-related so you receive the right treatment quickly. If sinusitis is suspected, we can guide you toward the appropriate medical care while ensuring no dental problems are missed.
