People suffering from chronic sinus infections or inflammation are surprised to hear from a doctor or dentist that it could be related to their teeth. Both dental infections and dental treatments can affect the sinus cavities on certain teeth. We’ll explain that relationship here.
How are the Teeth Related to the Sinuses?
In general, the upper molars, and sometimes premolars, have roots that protrude upward into the maxillary sinus cavities. The maxillary sinus cavities are the large air spaces inside the skull just behind your cheekbones. They should be empty, but they fill with mucus and inflammation when irritated by allergies or infection.
The separation between the teeth roots and the air space of the sinus cavities is an extremely thin layer of bone. On the tooth side, this bone connects to the teeth via the periodontal ligament. On the sinus side, a thin layer of soft tissue membrane covers the thin layer of bone.
Teeth Infections Causing Sinus Symptoms
When a tooth in this relationship to the sinus cavity has an endodontic infection (originating inside the tooth), the bacteria spread through a tiny pore at the tip of each root into the tissues around the roots. Because the tissues separating the tooth and the sinus are so thin, it takes very little time for an infection to destroy it. Dental x-rays often show “holes” around the infected tooth’s root directly into the maxillary sinus cavity.
Sinus Infections/Inflammation Causing Teeth Symptoms
The connection can go both ways. When someone has perfectly healthy teeth, they can experience the symptoms of a toothache because of sinus problems. As infection or inflammation develops in the sinus cavities, the mucus and inflammatory matter settles in the “floor” of the sinus cavity due to gravity. This puts it directly on top of the teeth roots.
As pressure builds in the sinus cavity, it may put pressure on the roots of the teeth and the nerves around them. People with sinusitis-referred dental pain often experience tenderness on chewing, swelling in the gums above the roots, and sensitivity to cold.
How Could Extraction of a Tooth Affect the Sinus Cavity?
It is rare, but possible, for a tooth extraction to break healthy bone that separates that upper tooth from the sinus cavity. There are two reasons this is rare: 1) We are unlikely to extract a tooth that has perfectly healthy bone surrounding it. 2) The healthy bone is strong and will resist breaking.
It is far more common for a tooth extraction to lead to a “hole” or communication between the tooth socket and the sinuses when the tooth has an infection and significant bone loss already present. This also makes sense because we do tend to extract infected teeth. Since the infection has already broken down the bony barrier between the tooth and sinus, removing the tooth simply exposes that opening.
The good news is that removing the infected tooth will eliminate the source of infection spreading into the sinus cavities. The bad news is that the newly opened “hole” must be closed and sealed ASAP. This could involve a surgical procedure to replace missing bone (a bone graft), a small membrane to cover the bone, and stitches to close the gums together. This restoration of the bone is especially important if you desire to replace the missing tooth with a dental implant in the future.
More Questions about Teeth and Sinuses?
Luckily, we have all of the specialties that would deal with this scenario under one roof – Endodontics, and Oral Surgery. Call Empire Dental Specialty Group today to schedule a consultation with one or all of our experts! We can answer any question you have about the teeth and their relationships with sinuses. We will assess your individual situation and address any concerns we see.