How is sinus pressure and tooth pain related? Do you have an occasional cold or the nasal congestion that comes with suffering from a seasonal allergy? This is the time of year that many allergy sufferers begin to get some of the stuffiness they may not have had to deal with since the autumn. Think of where your sinus is located. There are actually several "sinuses" located in the skull. Most people never have to be concerned about any of them except the maxillary sinus which is connected to your nose. From time to time, most people get congestion and a buildup of pressure in the maxillary sinus. This pressure is usually a passing thing and presents the sufferer with no more than an irritating inconvenience. However, for some people, pressure in the maxillary sinus leads to pain in the upper posterior (back) teeth. After early adulthood, the maxillary sinuses begin to enlarge. The sinus is like a little empty room divided by a wall down the center of your face behind your nose. After about 35 or 40 years old, most people's sinuses have enlarged enough to encroach on the roots of the upper posterior (back) teeth. Every tooth has a nerve and blood vessels (and other items) that enter into it through the tips of its roots. If the sinus has enlarged to the point that the roots of some of the teeth jut into it, then the nerves leaving the ends of the roots lay across the floor of the sinus unprotected by the bony covering that used to encircle them before the person's sinuses started to enlarge. The nerves of the teeth lay across the floor of the sinus much like an extension cord lays across the floor in someone's house. When the sinus has pressure built up in it, the pressure is also being applied to the unprotected nerves of the teeth and the teeth have a dull constant ache. Usually the pain is diffuse involving several posterior teeth. It can be on one side or both sides. In fact, if the pain persists more than a couple of days, it can even seem to travel to the lower teeth of the affected side. (This is called referred pain.) It is usually persistent and recurrent, and can also cause the affected teeth to be more sensitive to hot or cold. This is not a toothache, but is annoying. Treatment is best accomplished by preventing the pressure from developing. Some people can't prevent it, but most of us can by taking over the counter decongestants (cold preparations) like otravin tablets. A person who has had pressure build up enough to make the teeth hurt knows that even after they have begun to take a medication to relieve the pressure the pressure dissipates only after several days. Some people also find relief using a decongestant spray. A dentist should be contacted if the pain persists even after the sinus pressure subsides or if the pain is sharp, keeps you up at night, or is not spread over several teeth, but seems more confined to one tooth. Pain of these types is usually caused by something other that sinus pressure and will likely need more extensive treatment to cause it to subside. People who suffer from the condition described do not need to just "tough out" a cold or allergy outbreak. Relief can be significant especially if decongestants (or in the case of allergy, antihistamines) are sought before the pain starts or just after it has begun. Ask your dentist if you have questions about how a cold or allergies can affect your teeth.
Dr. James L. Johnson