How To Treat Unbearable Sinus Tooth Pain

Written & Reviewed by Dr David Chen

The source of an unbearable sinus tooth pain originates from an inflamed sinus that refers pain to the teeth. Therefore, treatment for this condition is focused on the sinus inflammation (sinusitis) and not on the dentition.

pano x-ray of max sinus close to root tips

The correct terminology for the condition is acute rhinosinusitis (ARS) because the sinusitis is rarely inflamed in isolation. The symptoms are typically concurrent with inflammation of the nose, which is why it is prefixed by “rhino”.

What treatment entails:

  • The bad news is that there is no cure to lessen the duration of ARS so treatment is aimed at reducing the severity of symptoms.
  • The good news is that it is self-limiting and will go away on its own within 7-10 days.
  • However, if symptoms persist longer than the 7-10 days, antibiotics may be beneficial.

Well without further ado, let’s get you some pain relief from that excruciating sinus toothache.

How to relieve tooth pain from sinus pressure

Treatment for an unbearable sinus toothache is limited to lessening the symptoms because there is no permanent cure. It is predominantly of viral origins so taking antibiotics are ineffective since it isn’t bacterial.

Despite your doctor not being able to cure you, there are home remedies that can make the referred tooth pain feel better.

How to relieve sinus pressure in teeth:

  • Take NSAIDs. A non-steroidal anti-inflammatory drug (NSAID) like ibuprofen can reduce the pain and inflammation.
  • Saline irrigation. Flush out your nostrils with saline. It may provide possible benefits of symptoms relief.
  • Intranasal glucocorticoids. Research has shown minor benefits by decreasing inflammation and allowing nasal drainage.

Other alleged home remedies but not as beneficial:

  • Oral decongestants. Phenylephedrine, phenylephrine, and oxymetazoline are common oral decongestants. They dry up the mucous membrane in the nose and cause inflammation.
  • Intranasal decongestants. Oxymetazoline (Afrin) to decongest the nose but it ends up drying up the nose and provoking inflammation. There is currently no evidence to support its use although patients think it makes them feel better.
  • Antihistamines. Similar to the decongestants, antihistamines end up over-drying the nose thus provoking inflammation and making symptoms worse.
  • Mucolytics. Commonly available as guaifenesin (mucinex) also has a drying effect.
  • Steam inhalation. Inhaling warm or humidified steam may provide a temporary feeling of relief from congestion but there is no evidence that it shortens duration of symptoms.


Unbearable sinus tooth pain stems from an inflamed sinus which refers pain to the teeth. The reason the teeth feel it is because the root tips of upper back molars are often close to the floor of the maxillary sinus.

When there is inflammation with the sinus floor, your body may think that it’s coming from the teeth since the apex of the roots are close to it. However if you see a dentist, they will tell you that the teeth don’t have any problems because they don’t. That is one way to rule out a tooth problem and to suspect it may be sinus origins.

We’ve provided a series of 3 periapical x-rays above to show you the proximity of the upper molars to the sinus. The root tips can sometimes be very close to the floor of the sinus. If your anatomy is as such you may be more prone a severe sinus toothache. However if your root tips are not close to the sinus, you’re less likely to experience this condition.

Originates from sinus

The vast majority of sinusitis or acute rhinosinusitis which results in a sinus toothache are due to viral infections. Therefore the tooth pain that you’re feeling is most likely from acute viral rhinosinusitis (AVRS).

However in about .5-2% of cases, it may be from bacterial origins instead of viral. If that is the case it would make it acute bacterial rhinosinusitis (ABRS).

How long can sinus tooth pain last?

The sinus tooth pain should resolve on its own within 7-10 days or at least show signs of improvement. That is because AVRS is self-limiting.

If it does not resolve within that time frame, it may not be of viral origins but of bacterial, which means you have ABRS instead.

Once the inflammation from the sinus resolves, your teeth should stop hurting.

When should I see a doctor?

If you think you’ve tooth pain coming from your sinus, you should seek medical help immediately. Even though there may not be a cure, you should still get a diagnosis so that you know you actually have a sinus toothache.

How to tell that you have it

Your dentist will be able to diagnosis the condition for you and it involves ruling out tooth conditions. The tooth pain is being referred from the sinus so all tests on the teeth should return negative.

  • No cavities
  • No tooth nerve pain
  • No dental abscesses
  • No impacted wisdom teeth
  • Dental x-rays are within normal limits


  • Generalized pain and tenderness around the sinus/cheek bones
  • Headache
  • Tooth pain or aching in the teeth
  • Congestion and stuffiness in the nose
  • Pressure that feels worse when bending over

One week follow up

If your toothache does not improve or resolve within the 7-10 day time frame, the sinusitis may be of bacterial origin. That means you have acute bacterial rhinosinusitis (ABRS) but the good news is that taking antibiotics will have an effect.

In other words, you should follow up with your dentist after about a week if there are no signs of improvement. You may be eligible to get antibiotics to help the condition resolve a little quicker.


If you’re having unbearable sinus tooth pain, it is from an inflamed sinus but the good news is that it will self-resolve. Give it about 2 weeks or so for it to go away. If it doesn’t, it may not be from the usual viral infection but could be from bacteria. If that is the case, you may benefit from antibiotics.

Nonetheless, we do still recommend seeing the dentist as soon as you suspect having it. You do want to make sure it is a sinus problem and not an actual tooth problem. Only way to tell would be to get a diagnosis by your dentist.


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