Sinusitis and Toothache Guide: When Upper Tooth Pain Comes From the Sinus and When From the Tooth

When sinusitis is present, sinus toothache, in which the upper teeth feel painful, can occur. In that case the sinus inflammation, not the tooth, has to be treated for the pain to go away. Conversely, inflammation at the root of an upper tooth can spread to the sinus and cause sinusitis, so both dental and otolaryngology care may be needed.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Sinus toothache	Referred pain in the upper teeth when there is sinusitis or rhinitis (source: Korea Disease Control and Prevention Agency (KDCA, 질병관리청) National Health Information Portal)
Pain features	Tender to tapping, worse when bending the head or walking heavily on the heels, pressure between the eyes (source: Korea Disease Control and Prevention Agency (KDCA) National Health Information Portal)
Acute versus chronic	Acute within 12 weeks of symptoms; chronic if not fully resolved and lasting 12 weeks or more (source: Korea Disease Control and Prevention Agency (KDCA) National Health Information Portal)
When a tooth is the cause	If a dental lesion is the main cause, it is classified as secondary chronic rhinosinusitis (2020 European guideline) (source: Korea Disease Control and Prevention Agency (KDCA) National Health Information Portal)
Environments to avoid during treatment	Low-pressure environments such as air travel and scuba diving (source: Korea Disease Control and Prevention Agency (KDCA) National Health Information Portal)

Why does sinusitis cause upper tooth pain?

The sinuses are air pockets inside the facial bones, connected to the nose by small passages. Inflammation of the lining of these spaces is sinusitis, which often appears together with rhinitis and is also called rhinosinusitis.

The sinus of the upper jaw lies close to the roots of the upper molars. The KDCA National Health Information Portal describes referred pain felt in the upper teeth when there is sinusitis or rhinitis as sinus toothache. It is a type of non-odontogenic toothache, in which the teeth are fine but feel painful.

Sinus toothache is often felt as an ache in several upper teeth together, and whether a stuffy nose, runny nose or facial pain appear at the same time is an important clue.

How does sinus toothache differ from pain from a tooth problem?

The features of sinus toothache the KDCA introduces are as follows. Being tender to tapping resembles tooth inflammation, so it can be confusing by symptoms alone.

On the other hand, if it twinges briefly with cold and stops, if only one tooth hurts exactly, or if there is a sharp twinge on biting, a problem with the tooth itself, such as dentin hypersensitivity, inflammation at the root tip or a cracked tooth, is considered first.

Pain gets worse when you bend your head down or walk heavily on your heels.
There is a feeling of pressure between the eyes.
Pressing the sinus area, such as around the cheekbone, increases the pain.
A stuffy nose, runny nose, facial pain and reduced sense of smell may be present together.

Can teeth cause sinusitis?

Yes. KDCA material on rhinosinusitis cites the 2020 European guideline on rhinosinusitis and explains that cases in which another problem, such as a dental lesion, a fungus ball or a tumor, is the main cause are classified as secondary chronic rhinosinusitis. Inflammation at the root tip of an upper tooth spreading to the sinus falls here.

In this case, treating only the sinus can lead to recurrence, so dental treatment such as root canal treatment or extraction of the causative tooth must be received together. If nose symptoms on one side last long and the upper teeth on the same side have an old cavity or a root-canal-treated tooth, be sure to mention it at the visit.

Sinusitis is classified as acute if within 12 weeks of the onset of symptoms, and chronic if not fully resolved and lasting 12 weeks or more. If chronic sinusitis recurs on only one side, it is worth checking for a dental cause too.

Which department should I visit first?

If a stuffy nose, yellow nasal discharge and facial pain are clear and several upper teeth ache together, you can first receive sinusitis care from an otolaryngologist. Sinus toothache disappears when sinusitis or rhinitis is treated.

If there are hardly any nose symptoms and one tooth hurts intensely or the gum is swollen, the dentist comes first. In either case, if the cause is not confirmed in one place, receive care in the other department so that both the teeth and the sinuses are checked.

The dentist looks at inflammation at the root tip with X-rays. The KDCA explains that rhinosinusitis is diagnosed by combining symptoms and history, nasal endoscopy and imaging, and that CT is the recommended standard test for diagnosing chronic rhinosinusitis. Looking at the results from both departments together lets the cause be sorted out more accurately.

What should I watch out for during treatment?

The KDCA advises avoiding low-pressure environments such as air travel and scuba diving during treatment of sinus toothache, because pressure changes can increase sinus and upper tooth pain.

When taking a painkiller for toothache, check that ingredients do not overlap, because cold medicines can also contain acetaminophen. Take the prescribed sinusitis medicine for the set period even if symptoms improve, and if tooth pain remains, continue dental care.

The KDCA explains that treatment of rhinosinusitis is based on medication according to symptoms, and that surgery may be needed if there is no improvement or it is severe. Recording how the upper tooth pain changes during sinus treatment helps sort out a tooth cause from a sinus cause.

Common myths and facts

Myth: If an upper tooth hurts, it is always a cavity.

If sinusitis or rhinitis is present, sinus toothache can occur in which an upper tooth hurts even though the tooth is fine.

Myth: Toothache caused by sinusitis is cured by treating the tooth.

Sinus toothache disappears only when sinusitis or rhinitis is treated, and dental treatment is not needed.

Myth: Sinusitis is a nose problem and has nothing to do with the dentist.

There is also secondary chronic rhinosinusitis in which a dental lesion is the main cause, so in some cases dental treatment must be received together.

Frequently asked questions

All my upper teeth ache after a cold. Should I go to the dentist?

If a stuffy nose and facial pain come with it, it may be sinus toothache from sinusitis, so you can first receive otolaryngology care. If pain in a particular tooth remains after the sinusitis has improved, have the dentist check for a dental cause.

Is there a way to check at home whether it is sinus toothache?

You can see whether the upper tooth pain gets worse when you bend your head or come down stairs heavily, and whether the area between your eyes feels pressed. However, tooth inflammation can also be tender to tapping and feel similar, so the final judgment is made by examination.

My lower tooth hurts. Is it related to sinusitis?

The KDCA describes sinus toothache as referred pain appearing in the upper teeth. For pain in a lower tooth, it is generally better to consider other causes first, such as the tooth, gum or jaw muscles.

Can I fly while being treated for sinusitis?

The KDCA advises avoiding low-pressure environments such as air travel and scuba diving during treatment of sinus toothache. If you must fly, discuss it in advance with the doctor treating you.

Can I take sinusitis medicine and a toothache painkiller together?

Cold medicines and prescription drugs may also contain pain-relieving ingredients. The MFDS advises taking only one medicine containing acetaminophen at a time, so show the pharmacist the prescribed medicine bag, check that ingredients do not overlap, and then choose the painkiller.

References

Korean version →