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Sinus pressure with sensitive upper teeth

Your Pain Pattern,
What Aggravates It,

The Underlying Anatomy
How to Get relief,
and more…

Want to skip ahead?
Here’s a link to my post about
getting relief on your own.

How People Describe This Pain Pattern

People complain of a toothache and infection in their upper teeth. The sensation seems to extend up into the roots. They usually don’t expect the massage therapist to get rid of the pain, they are just complaining about their teeth. I get a little more of these cases as my clients know that I can get rid of most tooth pain.

In this picture, the three teeth are highlighted in red. The back tooth is the first molar, and the two in front of that are called premolars or bicuspids. 

Mainly, this pattern occurs as a feeling of infection and sensitivity in the upper premolars and first molar. It is that yucky toothache feeling where it feels infected into the tooth’s root.

My Personal Experience

I had this referral pattern several years ago. A pulp cap went bad in the first molar, and some root fragments in the maxillary cavity had an infection. I started the hunt for a good dentist. However, I went ahead and released the trigger points to relieve the pain while I was looking. The pain and infected feeling were almost exactly like this illustration. When I released those trigger points, the pain and infected feeling in the two premolars went away. Interestingly, those teeth were not a problem when examined on the x-ray.

The dentist extracted root fragments. Usually, it is a reasonably traumatic procedure that puts people down for a few days. You can avoid most of the post-procedure pain if you release the trigger points. I had the roots extracted on a Thursday afternoon at 3:30. Afterward, my head was clear. That evening, I edited documents for an upcoming seminar. The next day, I felt good and worked with clients all day Friday. I taught a workshop on Saturday. The only inconveniences that I had were around handling the surface of the extraction, like avoiding solid foods.

How You Activate and Intensify This Pain Pattern

Awkward Dental Work

When I see tooth pain from trigger points, it is because of the posturing and pressure created by the dental procedure. Sometimes it results from more laborious chewing of foods like taffy or bubble gum. Also, uneven chewing or chewing on things like toothpicks and popcorn kernels activate these trigger points.


Most tooth pain comes from trigger point referrals. When there is strong pain that occurs as something hot/cold hits the tooth, that’s usually pain from an exposed nerve and needs prompt dental care. Mostly, other toothaches seem associated with trigger point referrals. Still, even when trigger point work relieves the pain, see your dentist. Make sure that there is not an underlying tooth problem.

The Musculoskeletal Anatomy Behind Your Pain

Anatomy – Throacic Outlet

The anatomy of these structures is important to understand the syndrome. This post walks through the structures one at a time.

This is a strong, thick 3-bellied muscle that closes the jaw. You can read more about it in this post about the masseter muscle.

Getting Relief on Your Own

Clinically Proven
Self-Care Strategies

This post has strategies for getting relief on your own. Explore how to change your activities, stretch, and other strategies that relieve the pain associated with this trigger point.

Therapy Notes for Massage and Bodywork

Better Bodywork
Through Shared Expertise

This post has techniques, tips, treatment routines, and anatomy illustrations to improve the bodyworker’s approach.

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Tony Preston has a practice in Atlanta, Georgia, where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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*This site is undergoing significant changes. We are reformatting and expanding the posts to make them easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistencies in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.