Which teeth are connected to the sinuses?

Your oral health and sinus health are closely intertwined. Several of your upper back teeth sit right below your maxillary sinuses and their roots extend up into the sinus floor. Any issues with these “sinus teeth” can impact the sinuses, and vice versa.

Rather, issues in either area can affect the other, leading to a range of complications. Sinus infections can spread to teeth, causing abscesses, while dental infections can trigger sinusitis. Furthermore, post-nasal drip from sinus issues can erode tooth enamel, leading to decay.

Maintaining the health of both areas is crucial for overall well-being. Effective oral hygiene practices, such as brushing, flossing, and using antiseptic mouthwash, are vital. While regular dental check-ups are essential not only for detecting tooth decay and gum disease but also for identifying signs of sinus-related dental problems.

Additionally, managing allergies and sinus conditions with appropriate medical guidance can minimize post-nasal drip, reducing the risk of tooth decay.

Understanding the link between your teeth and sinuses will help you maintain the health of both critical areas.

Which teeth are connected to the sinuses

Anatomy of the Maxillary Sinuses

The maxillary sinuses are air-filled cavities within the bones of your cheeks directly above your upper teeth. There are a pair of maxillary sinuses, one located on each side of your nose. These hollow spaces help warm and humidify airflow.

The maxillary sinuses extend close to the roots of the upper back teeth, especially the molars and premolars. They also connect to the nasal cavity through small channels that allow mucus drainage. Any blockages can lead to sinusitis.

Which Teeth Are Connected to the Sinuses? 

Your upper premolars and molars share the closest relationship with the maxillary sinuses due to their proximity and root length. The tooth roots of the following may protrude into the sinus floor:

  • First and second molars – These double-rooted back teeth extend to connect with sinus membranes.
  • First and second premolars – The roots of these single-rooted teeth can reach near or into sinus space.
  • Second bicuspid – This sets medial to the first molar with shorter roots but possible sinus involvement.

Issues with these posterior maxillary teeth pose highest risk for interaction with the sinuses that can lead to complications. But other upper teeth may potentially interact as well.

Problems that Can Arise with Sinus Teeth

Some common issues that can occur when the upper back teeth interact with the sinuses include:

1. Tooth Infection and Sinusitis

When a tooth infection occurs, especially in the upper back teeth close to the sinuses, bacteria from a sinus tooth abscess can spread to the sinuses. This can lead to sinusitis, an inflammation or infection of the sinuses. Sinusitis can cause facial pain, congestion, and other uncomfortable symptoms, further complicating dental issues.

2. Sinus Infections and Referred Tooth Pain

When the maxillary sinuses become infected (sinusitis), the proximity to the roots of your upper back teeth can cause referred pain. This happens when congestion and swelling puts pressure on the sinus teeth. Conversely, a dental infection or abscess in these teeth can create pressure and pain in the sinus area.

3. Cysts and Maxillary Sinus

An infected tooth, if left untreated, can lead to the development of a cyst in the maxillary sinus. These cysts can grow slowly and may not cause noticeable symptoms in the early stages. However, if they enlarge, they can cause pain, pressure, and may require surgical intervention to remove.

4. Extraction complication

Removing sinus teeth risks puncturing or displacing the sinus membrane: Tooth extractions, especially in the upper back region, can sometimes perforate the sinus floor. Proper care during extractions is crucial to prevent complications. If a perforation occurs, it can lead to sinus infections if not managed correctly.

5. Post-Nasal Drip and Tooth Decay

Sinus discharge due to conditions like sinusitis or allergies can irritate the throat, leading to frequent swallowing and subsequent reduction of saliva in the mouth. This constant exposure to acidic substances can erode tooth enamel, causing tooth decay. The acid weakens the enamel, making teeth more susceptible to cavities.

6. Impact on Dental Procedures

Dental procedures involving the maxillary molars, such as root canals or implants, require careful consideration due to their proximity to the sinuses. Infections or complications in these procedures can affect sinus health.

7. Chronic Sinusitis and Dental Issues

Chronic sinusitis can lead to nasal congestion and mouth breathing, which can, in turn, affect oral health. Dry mouth caused by mouth breathing can increase the risk of cavities and gum disease.

Careful diagnosis and coordinated dental and medical treatment is required to properly manage issues involving the sinus teeth. Be alert for any symptoms of an oral-sinus connection.

Final note

The top back teeth play an important role in sinus health due to their direct anatomical connection to the maxillary sinuses. Problems with sinus teeth can trigger secondary issues for the sinuses, and vice versa. Being aware of this relationship allows for faster diagnosis and treatment when complications arise involving your molars, premolars and sinuses.

Keep in mind that your dentist and ENT specialists may need to collaborate, which is quite common in cases where symptoms overlap. Proper communication between these healthcare professionals ensures comprehensive care for issues involving both the oral cavity and sinuses.


  • Editorial team

    A team comprising oral health care professionals, researchers, and professional Writers, striving to impart you with the knowledge to improve your oral health, and that of your loved ones. 

  • Lilly

    Lilly, aka, Liza Lee, is a passionate community oral health officer and our lead writer. She's not only well-versed in performing a multitude of dental procedures, including preventive, restorative, and cosmetic, but also an avid writer. Driven by the significant oral health burden all around her, Lilly strives to build capacity and promote oral health. She envisions making a lasting impact by advancing research, prevention, and promotion efforts to alleviate oral health disparities. Please share your views and opinions on my posts.

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