Sometimes patient comes to the dental clinic with acute pain but when clinical examination is done with X-ray’s and all, there is no problem with the teeth. All the teeth appear healthy with excellent oral health. Only when you take the detailed history patient tells that the intensity of pain changes with the movement of head .You as a dentist are in fix. Patient is not lying. He had come to you as he had pain. At that time the dentist has to think about the sinus. Sinus infection can cause the tooth ache and that too very severe toothache. Now you must be wondering what are Sinuses?
Sinuses are hollow air filled cavities present in the upper jaw. When we breathe air travels through sinus and to the lungs. In sinus air gets warm and humid before going to the lungs. Sinuses are lined by the membrane. In case of some infection, allergy or pollution this membrane gets infected causing the sinus infection known as sinusitis.
If we see the X-ray we can see that how close the roots of the upper molars are to the sinus and only then one can appreciate the fact that infected sinus can cause the toothache.
We know that sinusitis can cause the pain in the otherwise healthy teeth. Now the question arises how to diagnose that particular toothache is because of sinusitis. For that we need a detailed history of the patient along with clinical examination and X-ray’s to rule out the pain because of some dental problem like decay of the tooth or trauma to the tooth or any infection in the gums and the surrounding structure of the tooth. We do certain test also like Electric pulp testing or the hot and cold tests to rule out the infection in the tooth. If all the tests are negative for tooth infection and patient is giving the history of change in the intensity of pain when head movement is there then one can say that pain is because of sinusitis. Further we can take history for the symptoms of sinusitis.
There are other sinuses also but for toothache we are concerned about the maxillary sinus as they can cause tooth ache. For maxillary sinusitis common causes are Infection, allergy or pollution. The common symptoms are like common cold . patient has stuff nose, cough ,headache, fever etc. Treatment of maxillary sinusitis is
1. One should drink lot of fluids
2. Can take steam
3. Can take decongestant nasal spray
4. Can take antihistamines or antibiotics
Treatment depends upon the cause. If the sinusitis is recurrent and chronic then the patient should be referred to Otolaryngologist.
Normally the tooth ache is caused by some problem in the tooth or the gums. But always remember that teeth have other neighboring structures which can influence the teeth like sinuses and any problem in them like infection can directly or indirectly can affect the teeth
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