One-sided sinus pressure with tooth pain can feel like a weird coincidence. Your cheek hurts, a few upper teeth ache, and you can’t tell if you’re getting sick or if something’s wrong with a tooth.

Here’s the tricky part: the maxillary sinuses (in your cheek area) sit very close to the roots of the upper back teeth. When the sinus lining swells or mucus gets trapped, it can feel like a toothache.

This post covers likely causes, how to tell sinus pain from dental pain, and when to get checked.

Why one-sided sinus pressure can cause tooth pain

Pain doesn’t always come from where you feel it. With sinus pressure and tooth pain, the culprit is often referred pain, when irritated tissue sends signals through shared nerves and your brain “mislabels” the source.

The maxillary sinus sits above the upper molars and premolars. In some people, tooth roots sit extremely close to the sinus floor. When the sinus is inflamed, that swelling and pressure can irritate nearby nerve branches (the same network that serves the upper teeth). The result is a dull, heavy ache that feels dental, even when the teeth are fine.

It can be one-sided if only one sinus is blocked or inflamed, which is common with uneven congestion. Many people notice it doesn’t feel like one tooth, it feels like several upper back teeth on the same side are sore.

Common sinus triggers, colds, allergies, and sinus infections

The usual triggers are simple:

• A viral cold that swells the nasal and sinus lining
• Allergies that cause congestion and trapped mucus
• Blocked drainage that builds pressure in one maxillary sinus

Most acute sinus infections improve in 7 to 10 days and don’t always need antibiotics, since many start as viral.

Sinus pain vs a real toothache, signs that help you tell the difference

Patterns matter. Use these at-home clues to decide what’s more likely.

More likely sinus pressure

• Pain gets worse when bending over or lying down
• Pressure in the cheek or under the eye on one side
• Stuffy or runny nose (sometimes only one side)
• Postnasal drip, bad breath, or a bad taste
• Headache or ear pressure
• Several upper back teeth aching at once
• Little or no sharp reaction to hot or cold

More likely a tooth problem

• Pain stays in one specific tooth
• Sharp pain when chewing, or when tapping that tooth
• Swollen gum, or a pimple-like bump on the gum
• Strong hot or cold sensitivity
• Pain that wakes you up at night

Can a tooth infection cause sinus problems too

Yes. An infection in an upper tooth can sometimes spread into the nearby maxillary sinus (often called odontogenic sinusitis). That can cause one-sided congestion, facial pressure, and foul drainage.

Don’t assume it’s “just sinus” if one tooth is clearly the problem, or if you notice gum swelling, pus, or a persistent bad taste.

When to get checked, and who to see first

Start with the provider that best matches your symptoms.

Choose a dentist first if it feels like one tooth, chewing hurts, you see gum swelling, or you don’t have cold or allergy symptoms. A dental exam and X-ray can spot cavities, cracks, or an abscess.

Choose primary care or urgent care if sinus symptoms are strong (congestion, facial pressure, thick discharge), or if a dentist rules out teeth. They may do an exam and, if symptoms keep going, consider imaging or referral.

Get checked if symptoms:

• last more than 10 days
• get worse after you started improving
• keep coming back on the same side

Red flags that need urgent care today

Seek urgent care (or emergency care) for:

• Fever around 101°F or higher, or severe illness
• Severe headache, stiff neck, confusion
• Swelling around the eye or face
• Vision changes
• Severe facial pain, or symptoms after a head injury

If these happen, don’t wait.

Conclusion

One-sided sinus pressure can feel exactly like tooth pain because the maxillary sinus and upper teeth share nerve pathways. Still, a true dental problem won’t resolve without dental treatment, even if it “feels like sinus.”

Use the symptom clues above, watch the timeline, and don’t ignore red flags. If you’re unsure, start with a dentist, then follow up with a doctor if sinus symptoms are driving it.