Maxillary Sinusitis of Dental Origin: How to Treat It?

What is maxillary sinusitis?

Maxillary sinusitis is an inflammation of the maxillary sinuses, those cavities located in the upper part of the jaw, on either side of the nose.

These sinuses play a role in the drainage of mucus and the humidification of the air we breathe. During sinusitis, these cavities fill with mucus or pus, which causes extremely uncomfortable obstruction and pressure.

Sinusitis may be of viral or bacterial origin, or may also occur following a dental infection. In the rarest cases, maxillary sinusitis may also be caused by allergies or by the presence of polyps in the sinuses.

What is maxillary sinusitis of dental origin?

Maxillary sinusitis of dental origin is an inflammation of the maxillary sinuses caused by an infection at the level of the antral teeth, that is, the premolars and molars of the upper jaw.

When a dental infection spreads, it can reach the sinuses and lead to their inflammation. Dental sinusitis is less common than viral or allergic forms, but it must not be neglected: its bacterial origin may require a specific treatment.

How to know if the sinusitis is dental? What are the symptoms?

Identifying the dental origin of a sinusitis is not always obvious, since its symptoms may be close to those of a classic sinusitis. Certain signs and circumstances, however, point the diagnosis towards a sinusitis of dental origin:

• facial pain localised in the cheek region (notably when chewing);
• dental sensitivity with pain in one or more teeth of the upper jaw;
• unilateral nasal congestion: feeling of a blocked nose, sometimes accompanied by difficulty breathing normally;
• nasal discharge (thick mucus, often yellow or green), generally on one side only;
• bad breath (linked to the bacterial infection);
• fever and fatigue;
• a periodontal infection (bone and gum) of the tooth's supporting tissues spreading to the maxillary bone near the sinus.

If these symptoms appear, consult a healthcare professional.

Dental maxillary sinusitis can become chronic, which increases the risk of complications. Antibiotic therapy will then be prescribed to treat the underlying bacterial infection, combined with the treatment of the dental cause.

What are the causes of dental maxillary sinusitis?

Maxillary sinusitis of dental origin is most often caused by dental infections (deep cavity, pulpitis or abscess) or by traumas affecting the upper and posterior teeth — premolars and molars.

These infections can spread to the maxillary sinuses via the roots of the teeth and the bone surrounding the apex, in contact with the sinus floor, which triggers a sinusitis.

Another frequent cause is linked to tooth extraction, and more particularly that of the upper molars. Following an extraction, a passage may form between the oral cavity and the maxillary sinus, thus offering bacteria an entry point to the sinus. In the same way, the placement of dental implants in the upper jaw can be the cause of a sinusitis when the procedure is poorly performed or when the implant penetrates the sinus.

Endodontic treatments (root canal treatments) and orthodontic ones can also be involved when they are incomplete or when an accidental perforation of the sinus occurs. Cysts and apical granulomas can, in turn, exert pressure on the sinuses or become infected and cause inflammation.

Dental treatments constitute the response to the dental cause of sinusitis:

• extraction of the causal tooth;
• revision of a poorly performed root canal treatment in order to eliminate the infection;
• treatment of a periodontal cause.

How to treat dental maxillary sinusitis?

The pressure exerted by the accumulation of mucus on the nerves of the area can cause pain in different places, notably in the head and at the level of the teeth. Fortunately, several tips can help relieve dental pain linked to maxillary sinusitis.

Drink water

Stay well hydrated throughout the day in order to thin your mucus and promote its elimination.

Use a decongestant

Over-the-counter products are available in pharmacies that help soothe mucous membranes and facilitate the nasal drainage of mucus. Be sure to read the leaflet carefully before use to know the dosage and any contraindications of the medication.

Natural expectorants

Depending on the progression of the infection, certain home remedies — such as ginger infusions with honey or thyme tea — can prove useful. To effectively relieve pain and clear your nose naturally, carry out an inhalation with essential oils and take a good hot shower.

Sleep, but in an inclined position

Generally, quality sleep is essential to allow the immune defences to do their work. If you are in the habit of sleeping flat on your back, however, you have probably noticed that this position promotes obstruction of the airways. To help your sinuses unclog, use an extra pillow to slightly raise the upper body.

Spice up your meals

If you tolerate spicy food well, opt for hot dishes or for spices and foods with expectorant properties — such as black radish or turmeric — which temporarily soothe the pain linked to dental sinusitis.

Keep in mind that this advice helps reduce the dental pain caused by your sinusitis, but does not constitute a treatment for the infection itself. Above all, consult your dentist to make sure that your toothache is indeed due to a sinusitis and to rule out other possible causes. If the symptoms persist, make an appointment with your GP or ENT specialist.