Spring and Your Patients

Referred dental pain:

Inflammation in the maxillary sinuses can radiate to the upper molars and premolars. Patients may describe a dull, aching discomfort that is hard to localise. It may affect several teeth, worsen when bending forward, or fluctuate throughout the day. It’s a common complaint that can mimic pulpal or periodontal pain.

 

Medication effects:

Many patients manage seasonal allergies with antihistamines or nasal decongestants. These can reduce saliva flow, increasing the risk of caries, gum irritation, and oral discomfort. Dry mouth can make dental procedures less comfortable and oral hygiene more challenging.

 

Mouth breathing:

When nasal passages are congested, patients naturally breathe through their mouths. This further dries the oral tissues and can increase sensitivity to air from dental instruments. It can also make longer procedures challenging. Being aware of this, and adapting accordingly, makes a significant difference to patient comfort.

When assessing upper posterior discomfort, look for patterns rather than isolated findings:

• Diffuse facial pressure over the cheeks, often worse on leaning forward
• Upper posterior tooth discomfort that is not isolated to a single tooth
• Tenderness in the sinus area that does not match percussion or pulp testing
• Seasonal allergy symptoms: sneezing, itchy or watery eyes, nasal congestion
• Mouth breathing, dry mouth, or difficulty tolerating dental treatment
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When clinical testing and radiographs don’t reveal a clear dental cause, a sinus-related origin should be considered, and referral arranged where appropriate.

Take a thorough history:

Ask about the timing, severity, and pattern of symptoms. Does the discomfort worsen outdoors? Is it seasonal? Has the patient recently had a cold or sinus infection? Ask about allergy medication, mouth breathing, and dry mouth. You’re not being nosey, you’re building a clearer picture, and patients appreciate it when we look beyond their teeth to understand the broader context of their discomfort.

 

Adapt treatment for comfort:

Small adjustments can make a big difference.

• For mouth-breathing patients or those with dry mouth, consider deferring non-essential treatment, or arranging shorter/staged treatment sessions, and pause to offer water when needed.
• Offer dry mouth products in surgery, a rinse with TePe Hydrating Mouthwash, or a pea-sized amount of TePe Hydrating Mouth Gel before treatment, can instantly moisturise and offer comfort through treatment.
• Gentle suctioning and careful air management can reduce mucosal irritation.
• Arrange appointments flexibly to allow these adjustments without rushing treatment.
• Apply lip balm to prevent cracking and discomfort.

 

Support oral comfort at home:

Dry mouth is a common complaint during allergy season, offer practical, simple advice:

• Encourage frequent sips of water.
• Suggest sugar-free gum or lozenges to stimulate saliva flow.
• Recommend alcohol-free fluoride mouthrinses.
• Advise the use of high-fluoride toothpaste where appropriate.
• Consider saliva substitutes or oral moisturising gels for patients with persistent dryness. TePe Hydrating Mouthwash and TePe Hydrating Mouth Gel, come in flavoured and unflavoured varieties. The flavoured versions offer relief from dryness and stimulate saliva flow, while the unflavoured versions support patients with little to no salivary gland function.
• Reinforce gentle but thorough brushing and interdental cleaning.

 

Patients appreciate realistic suggestions that fit into daily life, rather than overwhelming instructions.

Dental causes:

If a dental origin is identified, such as periapical lesions, failed restorations, or post-extraction issues, treating the source is essential, in coordination with any medical management of sinus symptoms.

 

Non-dental sinus pain:

Advise patients to consult their GP or ENT for targeted therapy, which may include saline nasal irrigation, intranasal corticosteroids, antihistamines, or antibiotics if bacterial sinusitis is suspected. It is crucial to avoid irreversible dental procedures until a sinus cause is reasonably excluded.

 

Red flags for urgent referral:

These include unilateral severe swelling, fever, eye changes, or evidence of an oro-antral communication. Prompt referral can prevent serious complications.

Patients often find sinus-related “toothache” confusing or frustrating, as often there isn’t a “quick fix”.

 

Clear, empathetic communication is key:

• Explain that facial or tooth pain may be linked to sinus inflammation rather than dental disease.
• Reassure patients that you will carefully assess teeth before recommending irreversible treatment.
• Be honest if the cause appears non-dental.
• Offer practical advice for managing dry mouth and discomfort.
• Encourage patients to maintain brushing and flossing, even if their mouth is dry and uncomfortable.

 

Acknowledging a patients discomfort and offering practical support strengthens trust and helps them feel cared for, not just treated.

Spring allergies and rhinosinusitis can have a significant impact on oral health and patient comfort. Patients may experience facial pressure, toothache, or general oral discomfort, often feeling confused about the source of their pain.

Mouth breathing and dry mouth can further complicate treatment and make dental care more challenging. By recognising the effects of rhinosinusitis and seasonal allergies and supporting patients with practical interventions, dental teams can offer care that is both clinically effective and genuinely compassionate. Small adjustments in chairside technique, patient education, and diary planning can help patients navigate pollen season more comfortably, keeping their oral health and wellbeing on track.

Kimberley Lloyd-Rees RDH/RDT

TePe UK Clinical Education Specialist

October 2025