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Sinus pressure with sensitive upper teeth

Client’s Description

People come in complaining of a toothache and infection in their upper teeth that 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.

This pattern occurs as mostly a feeling of infection and sensitivity in the upper premolars and first molar. In the picture below, 3 teeth are highlighted in red. The back tooth is the first molar and the two in front of that are called premolars or bicuspids. It is that yucky toothache feeling that  where it feels like it is infected into the root of the tooth.

I had this referral pattern several years ago. I had a pulp cap go bad in the first molar and there were some root fragments in the maxillary cavity that got infected. I started hunting for a good dentist but I went ahead and released the trigger points so that I didn’t have 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. Those teeth were not a problem when examined on the x-ray.

I had an extraction of the root fragments which is usually a fairly traumatic procedure that puts people down for a few days. It is a lot like having wisdom teeth extracted. Most of the post-procedure pain can be avoided if you can get the trigger points released. I had the roots extracted on a Thursday afternoon at 3:30. I was clear-headed and edited documents all evening for an upcoming seminar. I felt good and worked with clients all day Friday. I taught a seminar on Saturday. The only inconveniences that I had were around handling the surface of the extraction, like avoiding solid foods.

Most of the time when I see tooth pain that is generated by trigger points, it is because of the posturing and pressure created by the dental procedure. It can also be caused uneven chewing because of a fragile tooth or chewing on things like toothpicks, popcorn kernels. Sometimes it is caused by more laborious chewing of foods like taffy or bubble-gum.

Most tooth pain comes from trigger point referral. 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. The rest of those toothaches seem to be connected to trigger point referral. If your therapist is trained in the treatment of TMJ with neuromuscular or craniostructural techniques, they can help you avoid unnecessary pain and discomfort in your teeth. 


Self Care

The trigger points are just under the arch of the cheek bone. Pressing on this knotted muscle makes the sensation in the tooth and roots flare up with a little relief afterward. It is easy to aggravate the trigger point and the tooth infection this way. Try Ice and Stretch on your jaw and you’re more likely to get temporary relief.

See your neuromuscular therapist or craniostructural therapist for lasting relief.

This post is part of a series on trigger points that are connected with tooth pain. It is intended to help one to understand how tooth pain is generated by trigger points and how to relieve tooth pain by releasing trigger points. It is not intended to encourage anyone to avoid proper dental care. Even when the pain is generated by trigger points, the chemical irritants in the referral pattern impact the tooth and gums adversely and your teeth should be checked by a dentist.

Therapy Notes

muscle-o%2fi%2ftThe trigger points are in the superficial masseter just below the zygomatic arch and make area around the tooth feel even more sore. Ice-n-stretch helps to relieve local tenderness and make it easier to work here.

Masseter is thick and, pound for pound, one of the strongest muscles of the body. This is seldom released with lasting relief with direct work on the trigger points. Cranial work, upper cervical alignment and softer modalities like stretching and oral motor therapies make this work more tolerable to the client, easier on the therapist and support global changes that make for lasting relief.

Similar Patterns

tags-sinus tags-tmj tags-teeth



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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