It was somewhat of a mystery at first.
I once had this patient who had chronic/repeated pain in his upper teeth (basically the premolars and molars on his upper right side). He had been to two different dentists, who did an exam and took X-rays, but really couldn't find anything wrong with the teeth. But he still had pain. This went on for a year or two.
So one day, he ended up in my chair. And like the dentists before, I took some X-rays, but couldn't find anything wrong with the teeth themselves. In fact, they were in spectacular shape. So I asked him if there were any other issues he may be experiencing -- headaches, jaw pain, etc? He said no -- he felt fine, except for the teeth hurting, and the pressure...
Wait... the pressure? He said yes, the pressure. Besides the teeth hurting, there was pressure in and above the gums (he had a hard time describing this). So I asked a few more questions. In asking and listening to his answers, I discovered he had very small nasal passages. (He had X-rays and cat scans done a few years back, and the doctor had told him this.) I asked him if he got frequent sinus infections. He said he didn't know.
I was thoroughly satisfied that his teeth were indeed ok, but I didn't want to send him on his way without some type of suggestion, so I recommended he try a natural saline nasal spray the next time his teeth hurt, and to see if that did anything. I also told him he may want to make an appointment with an ears, nose, and throat specialist (after all, I'm a NYC Cosmetic Dentist, and while dentistry is my thing, doing anything beyond recommending a nose spray is something I would rather leave to a specialist.)
I am happy to report that yes, the saline spray did work to a degree (at least according to my patient), and he mentioned he was going to see a specialist at some point in the future. Which is great. But this got me to thinking about sinuses and teeth.
We dentists have always known sinuses can affect your teeth. But we don't really get too involved with this, because it's not really our area of expertise. In fact, in my research, I see that "sinuses affecting teeth" is really nobody's area of expertise. Not that this is stated, obviously, but there is shockingly little mentioned about it. For example, in symptoms for sinusitis (aka your basic sinus infection), The Mayo Clinic lists "Aching in your upper jaw and teeth" in the middle of the list. Teeth don't even get their own bullet point, and get pushed behind jaw. The U.S. National Library of Medicine is even a little more dismissive.
Now, maybe this is the dentist in me feeling scorned (I'm kidding), but it's definitely not really discussed much. I then searched the Mayo Clinic for a direct answer to the question as to whether sinuses can affect your teeth, and got this short answer from a dentist. Again, nothing that really punctuates and definitively gives anyone a concrete answer.
I guess this is to be expected with things like this -- dentists don't like getting involved in other professionals' territory, and I'm sure the ears, nose, and throat doctor doesn't want to make a tooth diagnosis. And like I mentioned earlier, this is one of those "tweener" type issues, and falls into a gray area neither side feels very comfortable discussing.
Hopefully, this post will shed a little light on the subject, however. Because it is indeed true that a sinus infection can affect your teeth (this much is clear from the symptoms listed, even if they are not prominent). This is because your sinuses and your teeth are are so close together -- your upper teeth sit right under major sinus cavities, and when they get swollen, well, they have to swell into something. And that something can be your teeth, depending the individual (a mere fraction of an inch can make a big difference here).
Sinus infections can be tricky. Like almost any other illness, not everyone experiences them exactly the same way. Some people get the classic symptoms. Some people, probably like my patient, may not. But since his sinus cavities were so small, perhaps any swelling was indeed prominent. (This part is just an educated guess on my part -- an ears, nose, and throat specialist can better make that judgment.)
But what we do know is swelling of your sinuses can affect your upper teeth. It can make them hurt, and from all indications, it will feel like a toothache. So if this happens to you, and your dentist cannot find anything wrong, at the very least, ask about the sinus-tooth connection. Because there very well may be something going on there.
Until next time, keep smiling!
For more by Thomas P. Connelly, D.D.S., click here.
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