Double Board Certified · Functional Sinus Care
Odontogenic Sinusitis — when the cause is dental, the cure is too.
Odontogenic sinusitis is sinus inflammation caused by dental infection or dental procedure. It accounts for a meaningful share of unilateral maxillary…
ABFPRS
Facial Plastic & Reconstructive Surgery
ABOto
Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
In Consultation
"Maxillary sinusitis that does not respond to standard treatment frequently has a dental cause that has been overlooked."
A Note from Dr. Mourad
"Odontogenic sinusitis is sinus inflammation caused by dental infection or dental procedure. It accounts for a meaningful share of unilateral maxillary sinusitis and is consistently under-diagnosed — because the dental and sinus evaluations are usually done by different specialists."
— Dr. Moustafa Mourad, MD
Overview
What is odontogenic sinusitis?
Odontogenic sinusitis is sinus inflammation caused by a dental source — most commonly an infected upper molar or premolar, a periapical abscess, a failed root canal, or a complication of dental implant or extraction. Because the roots of the upper back teeth sit immediately below the floor of the maxillary sinus, dental disease can extend into the sinus and produce chronic, often one-sided sinusitis.
It is frequently missed because the patient and the treating physician focus on sinus symptoms while the underlying dental cause goes unaddressed. Recurrent unilateral maxillary sinusitis, foul-smelling discharge, or sinusitis that does not respond to standard treatment should raise suspicion for a dental source.
Accurate diagnosis requires coordinated evaluation — nasal endoscopy plus imaging that includes the dental roots (CT or CBCT). Treatment is twofold: the dental source must be addressed by a dentist, oral surgeon, or endodontist, and persistent sinus disease is treated medically or surgically as appropriate.
An Established Academic Authority
Double board certification. Fellowship director. Published author. A surgeon's surgeon.
ABFPRS
Board Certified
American Board of Facial Plastic & Reconstructive Surgery
ABOto
Board Certified
American Board of Otolaryngology — Head & Neck Surgery
AAFPRS
Fellowship Director
American Academy of Facial Plastic and Reconstructive Surgery
Textbook
Published Author
Contributions to the academic literature of facial plastic surgery
Dual board certification in both Facial Plastic & Reconstructive Surgery and Otolaryngology — a combination held by a small number of physicians nationally.
02 · Symptoms
How this condition typically presents.
Three patterns are most common. Patients often recognise themselves in one or more of these.
I
Unilateral Maxillary Symptoms
One-sided cheek pain, pressure, and congestion that does not respond to standard sinus treatment.
II
Foul Odour or Taste
A characteristic foul smell or taste — often the strongest clue to a dental cause.
III
Recent Dental History
Recent dental work, tooth extraction, or known untreated dental infection on the affected side.
03 · Anatomy
Dental & sinus anatomy.
The upper molar roots sit immediately beneath the floor of the maxillary sinus. The proximity is what makes odontogenic sinusitis possible.
Anatomy
Root tips adjacent to the sinus floor
The roots of the upper molars frequently sit just below — sometimes within — the floor of the maxillary sinus. A periapical dental infection can extend directly into the sinus.
This anatomy is also why an upper tooth extraction can leave an oroantral communication — a small fistula between the mouth and the sinus.
Pathology
Sinus disease from a dental source
When a dental source produces sinus disease, the imaging characteristically shows unilateral maxillary opacification with identifiable dental pathology — periapical lucency, root canal failure, or oroantral fistula.
Sinus surgery alone does not cure the disease; the dental source must be addressed by a dental specialist, and the sinus drainage restored by an otolaryngologist.
Illustrative diagrams. Coordinated dental and sinus management is essential.
04 · Diagnosis
How the diagnosis is made.
Diagnosis is made by CT imaging — characteristic findings of unilateral maxillary disease with dental-root involvement.
Dental examination and assessment by a dental specialist is essential.
Endoscopic examination confirms the sinus findings and assesses the drainage pathway.
05 · Treatment Options
Treatments matched to the diagnosis.
Treatment is individual. The right answer ranges from optimised medical therapy to a focused procedure to definitive surgery.
Dental Source Management
Treatment of the underlying dental cause — extraction, root canal, or repair of an oroantral fistula.
Learn More
Endoscopic Sinus Surgery
Drainage and clearance of the affected sinus, typically performed after or with dental management.
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Medical Therapy
Targeted antibiotics, saline irrigation, and supportive care as part of combined management.
Learn More
01 · Why Dr. Mourad
Diagnosis first, treatment second.
Dr. Mourad coordinates evaluation with dental specialists when odontogenic sinusitis is suspected — both the sinus and the source must be addressed.
CT imaging is essential to identify dental pathology and to plan combined treatment.
Sinus surgery alone — without addressing the dental source — produces incomplete and short-lived improvement.
When to Seek Care
When to seek care promptly.
Severe facial pain, swelling, or fever — evaluate within days.
Significant facial swelling or redness around the eye — evaluate immediately.
Numbness of the cheek or upper teeth — evaluate promptly.
Persistent oroantral fistula after recent dental extraction — evaluate within days.
Outlook
What to expect.
When the diagnosis is correct and the right treatment is applied, the outlook is generally good. Most patients describe meaningful improvement in symptoms and day-to-day function.
When symptoms persist despite treatment, the workup is re-opened. Persistent symptoms with no answer almost always mean the diagnosis is incomplete.
Living Well
Day-to-day measures that help.
Daily saline irrigation, control of indoor allergens, and good sleep hygiene meaningfully reduce day-to-day symptoms for many patients.
Medical therapy, when prescribed, works best when used consistently rather than as needed — this is one of the most common reasons treatment seems to fail.
Frequently Asked
Patient questions, honestly answered.
Odontogenic sinusitis is maxillary sinus inflammation driven primarily by disease of a tooth or its supporting structures. Unlike viral or allergic sinusitis, it is often strictly one‑sided and associated with dental symptoms or recent dental work. Diagnosis depends on correlating nasal endoscopy, dental exam, and imaging such as periapical films or CBCT to demonstrate a dental source. Treatment requires addressing the dental nidus as well as sinus drainage; ENT and dental specialists commonly coordinate care.
The Most Important Step
Get an expert evaluation.
A careful evaluation by a double board-certified physician is the right first step. The conversation is unhurried, the diagnosis is honest, and treatment is matched to what you actually have.