From the Guidelines
For pain in teeth and nose persisting after an upper respiratory infection, over-the-counter pain relievers like acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours can provide relief, as suggested by the American College of Physicians and the Centers for Disease Control and Prevention 1.
Key Considerations
- A saline nasal spray used 2-3 times daily can help reduce nasal congestion and discomfort.
- For sinus-related tooth pain, applying a warm compress to the face for 10-15 minutes several times daily may help.
- If symptoms are severe or include fever, green/yellow discharge, or severe facial pain, seek medical attention as you may have developed sinusitis requiring antibiotics, as indicated by the high-value care advice for acute rhinosinusitis 1.
Important Factors
- Dental pain could indicate a secondary infection requiring dental evaluation.
- These symptoms occur because the sinuses are located close to the upper teeth roots, and inflammation from an infection can put pressure on dental nerves.
- The diagnosis of sinusitis is based on a combination of clinical history, physical examination, imaging studies, and/or laboratory tests, as outlined in the practice parameter update for the diagnosis and management of sinusitis 1.
Recommendations
- If symptoms don't improve within 2-3 days with these measures or worsen at any point, consult a healthcare provider promptly.
- Clinicians should reserve antibiotic treatment for acute rhinosinusitis for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving (double sickening) 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment of Pain in Teeth and Nose
- The treatment of pain in teeth and nose after ten days of an upper respiratory infection is typically focused on relieving symptoms, as most upper respiratory infections are caused by viruses and do not require antibiotic treatment 2.
- For pain or fever, medications such as acetaminophen, ibuprofen, or naproxen may be recommended by a physician 2.
- In cases where the upper respiratory infection has developed into acute rhinosinusitis, antibiotics may be considered if symptoms are severe, worsen over time, or last for an extended period 3, 4.
- Supportive care, including saline irrigation, nasal steroids or antihistamines, and decongestants, may also help reduce the severity of symptoms 3.
Antibiotic Treatment
- Antibiotics such as amoxicillin or amoxicillin-clavulanate may be prescribed for acute bacterial rhinosinusitis, but only if symptoms are severe or last for an extended period 3, 4.
- The optimal duration of antibiotic therapy is unknown, but treatment may be continued until symptoms resolve and for an additional 7 days 4.
- It is essential to note that antibiotics are not effective against viral infections and should only be used when a bacterial infection is suspected or confirmed 2, 5.
Symptom Management
- For patients with acute rhinosinusitis, symptom management may include the use of pain relievers, decongestants, and nasal steroids or antihistamines 3.
- Saline irrigation may also be helpful in reducing the severity of symptoms 3.
- In cases where symptoms are severe or persistent, further evaluation and treatment by a healthcare professional may be necessary 3, 4.