Don’t ignore sinus and tooth pain

Everybody and his brother are reaching for tissues, eye drops and antihistamines to ward off the effects of pollen, mold and other seasonal allergy triggers.

Some of America’s 40 million sinusitis sufferers even have to resort to pain medicine to deal with headache and tooth pain.

‘This spring is a tough one for some people,’ says Dr Allan Melnick, a prominent clinical dentist in Encino, California, US. ‘While tree pollens are at moderate levels in California right now, wind, snow melt and rain have boosted airborne pollen and mold to astronomical levels in other areas of the country. Those with chronic bronchitis, allergies, asthma and chronic sinus problems are suffering big time.’

The socio-economic impact of sinusitis and related airway illnesses is huge.

Healthcare expenses for sinusitis and comorbid conditions top $6 billion annually in the US and affect more than 90 million people – or one-third of the population, according to The Journal of Allergy and Clinical Immunology.

Sinus symptoms include swollen or infected sinus cavities, leading to congestion for some and sneezing and drainage for others. Headache, watering eyes, itching, facial pressure, bad breath and aching teeth are often part of sinus attacks.

‘Lots of people don’t know that sinus problems can cause tooth pain,’ notes Dr Melnick, a former UCLA dental professor.

‘I think it’s important to educate the public, so they can get adequate relief. The maxillary sinus cavity sits right above the top molars. The teeth and sinuses are like neighbors in adjacent condos; they share a common wall. What impacts one, is likely to have repercussions with the other.’

Inner workings
Four pairs of sinuses comprise the hollow nasal pathways surrounding the eyes. Of the four, the maxillary sinus is closest to the upper teeth and often touching them. Viruses, bacteria, fungus, structural variations or immune system issues may lead to acute or chronic sinusitis. Inflammation reduces air and mucus flow and increases pressure within the cavities. Infection may set in.

Over time, these things can aggravate facial nerves and tooth roots, causing dental discomfort, facial neuralgia or worse.

Standard treatment for allergy and sinusitis include saline nasal washes, antihistamines, warm compresses to the face, analgesics, antibiotics, topical or oral decongestants, and steroids. Lifestyle modifications are encouraged.

A referral to an ear, nose and throat specialist or allergist may be necessary, and allergy shots may be prescribed. Surgery is considered as a last resort if other treatment fails to alleviate severe symptoms.

‘Don’t try to ride out the pain. Go see your doctor. Go see your dentist. Rule out an abscess, a cracked tooth, bruxism, TMJ or loose fillings. If it’s an allergy or an infection, let’s treat it. Get to the bottom of the pain, so you can live your life,’ says Dr Melnick.

Don’t ignore sinus and tooth pain
Determining the source of dental tooth pain in sinusitis patients involves completing a full medical history, tapping teeth with an instrument to test for sensitivity, and taking X-rays to rule out other problems.

Typically more than one tooth will be sensitive if dental pain is linked to sinus congestion, according to the Consumer Guide to Dentistry. In chronic cases of sinusitis, a nasal smear, CT scan or other diagnostics may be appropriate.

Foregoing treatment for sinus infections may lead to serious consequences, according to the Mayo Clinic.

    Bone, eye or brain infections
    Tooth loss or fracture
    Complications with impacted teeth
    Overlooked cancerous growths

Dr Melnick’s seasonal allergy tips
Limiting exposure to allergens is key when trying to get sinus attacks under control, says Dr. Melnick, the senior dentist for He offers these lifestyle tips to minimise sinusitis triggers.
    Limit outdoor time during allergy season
    Bathe indoor-outdoor pets frequently
    Use a saline nasal rinse daily
    Wash your face and hair, especially before bed
    Use the air-conditioner and change filters often
    Use a vacuum with a HEPA filter
    Keep outdoor clothes off bedding
    Hire someone to mow lawns and do landscaping
    Opt for wood or tile floors rather than carpet
    Keep indoor humidity between 40-60%
    Avoid cigarette smoke and other pollutants

‘Keep your windows and doors closed,’ says Dr Melnick. ‘Resist the spring fling – especially on beautiful mornings when allergens are at their highest. The pollen that’s mucking up your car is clogging your airways, too.’

About Allan Melnick, DDS
Born and raised in West Los Angeles. After graduation from U.S.C. School of Dentistry he moved to Encino where he resides today. Visit his blog at

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