How a dentist tells if your jaw pain is from TMJ, a tooth or a sinus infection

Your jaw or face hurts, but is it your jaw joint, a tooth or your sinuses acting up? It's a reasonable question, since all three can feel surprisingly similar. Your dental provider can tell the difference by looking at where your pain sits, what triggers it and how it behaves. They then confirm with a physical exam and targeted tests, like tapping a tooth or pressing along the jaw joint. Each cause leaves its own pattern of clues. 

What you will learn in this article: 

• Sinus pain affects several upper teeth at once. Tooth pain points to one tooth and spikes with hot or cold. 

• Jaw clicking or popping only points to TMD when pain comes with it. 

• A dental provider can often tell all three causes apart with simple hands-on tests with no scan needed. 

• A blocked nose or recent cold alongside tooth pain usually points to your sinus, not your tooth. 

If you're dealing with unexplained jaw, cheek or face pain, schedule an appointment with your Aspen Dental provider. They can evaluate all three causes and refer you to the right specialist if needed. 

Why upper-jaw and face pain is hard to figure out 

Your upper back teeth have long roots. Those roots sit right beneath the floor of the maxillary sinus. That's the sinus cavity inside each cheekbone. When that sinus swells, it can press on the roots. Your teeth may ache even though they're healthy. 

The temporomandibular joint (TMJ) sits just in front of your ear. This is where your lower jaw meets your skull. A problem with that joint is called a temporomandibular disorder (TMD). TMD pain can spread to the jaw, head, face and neck. That overlap makes it hard to know where the pain starts. 

What each cause tends to feel like 

Not all jaw and face pain feels the same. Here is how each cause tends to show up. 

Tooth pain 

A toothache typically hurts in one clear spot. It can feel sharp when you bite down or drink something cold. It may throb or linger after the trigger goes away. The American Dental Association (ADA) says jaw pain can include ear pain, tenderness of the jaw, pain when biting and headaches.¹ A cracked or infected upper back tooth can mimic sinus pressure on one side. 

TMD pain 

TMD tends to create a dull, achy feeling near the ear or cheekbone. The American Association of Oral and Maxillofacial Surgeons (AAOMS) lists earaches, headaches, jaw tiredness while eating and a clicking or popping in the jaw as common signs.² The pain can shift. It may feel worse in the morning if you grind your teeth at night. The ADA notes that teeth grinding is one possible cause of a TMJ disorder.³

Sinus pain 

Sinus pain often feels like pressure across both cheeks at once. It tends to come with a stuffy nose, thick discharge or a recent cold. It can get worse when you bend forward or lie down. Tooth pain from a sinus problem often affects several upper teeth at the same time, not just one. 

How a provider narrows it down 

The AAOMS says diagnosing a TMD involves a thorough history, a physical exam and diagnostic tests.² Here is what that visit can look like: 

• History: Your dental provider will ask when the pain started. They'll ask what makes it better or worse. They'll ask about recent illness, jaw habits and stress. 

• Palpation: The ADA says a dental exam includes checking the jaw joints and muscles for tenderness, clicking, popping and limited movement.³ Your provider presses gently on key spots to see where it hurts. 

• Percussion and thermal testing: Your dental provider may tap on teeth or apply a cold stimulus. A tooth with nerve damage tends to respond differently than a healthy one. 

• Imaging: The ADA says a thorough dental exam may include X-rays.¹ X-rays can show infection at a tooth root or bone changes near the joint. A provider may also order a sinus scan or a specialized jaw image if needed. 

If the cause turns out to be medical, such as a sinus infection, your dental provider can refer you to the right provider. 

Red flags to see someone soon 

See a dental provider promptly if you notice any of these: 

• Swelling in your face or jaw 

• Fever along with tooth or face pain 

• Trouble opening or closing your mouth 

• Pain that wakes you up or won't ease at all 

• Numbness in your face or teeth 

These signs may point to an infection or another issue that needs prompt care. 

What to bring to your appointment 

A few notes can help your dental provider a lot. Here is what you should write down: 

• When the pain started and how often it comes 

• What makes it better or worse (heat, cold, biting and lying down) 

• Any recent illness or sinus trouble 

• Any jaw sounds you've noticed 

• Medications you take 

You do not need to figure this out on your own. Contact your local dental provider, and they can walk through all three in a single visit.

How a dentist tells if your jaw pain is from TMJ, a tooth or a sinus infection FAQs 

These are the questions patients most often ask when they come in with this kind of pain. 

Can you have TMD and a sinus infection at the same time? 

Yes, you can. Two separate problems can be present at once. For example, a sinus infection can make upper teeth ache while TMD causes jaw and muscle pain at the same time. Your dental provider will work through each cause on its own. Tell them about all your symptoms so nothing gets missed. 

Can stress or grinding at night make jaw pain worse? 

It can. If stress or nighttime grinding seems to be a factor, mention it to your dental provider. A night guard or stress-management approach may help reduce the strain on your jaw, separate from treating whatever pain you're having right now. Your dental provider can also check for signs of grinding, like worn tooth surfaces, during your exam. 

Does this kind of pain ever go away on its own? 

It depends on the cause, but a tooth infection will not clear up without treatment. A sinus infection tied to a cold may settle on its own, though some need antibiotics. If your pain has lasted more than a few days or is getting worse, don't wait. Your dental provider can tell you whether it needs treatment or just monitoring. 

Sources 

¹ American Dental Association, MouthHealthy: “Jaw Pain.” https://www.mouthhealthy.org/all-topics-a-z/jaw-pain 

² American Association of Oral and Maxillofacial Surgeons: “What Causes TMJ Disorders?” https://myoms.org/what-we-do/tmj-and-facial-pain/tmj-disorders-causes/ 

³ American Dental Association, MouthHealthy: “Temporomandibular Joints (TMJ).” https://www.mouthhealthy.org/all-topics-a-z/tmj