Healthy Smile: Is it My Tooth or My Sinus?

by Jeffrey Gross, DDS, FAGD of The Healthy Smile

If I could rephrase the question I would say “what is the source of my discomfort?”  The answer to this question is a cause for much confusion. I want to shed some light on this subject and possibly clear up some of this puzzle.

We all have heard of sinus problems. What is a sinus, and why does it cause a problem? What does it have to do with my teeth? Will the Indians win their division? Okay, I can’t answer everything. Let’s focus on the first two.

A sinus is a hole in our head. The sinuses are connected throughout the skull. Why do we have these structures? There are several theories. Some of the more common thoughts are to help moisten or humidify the air that we breathe. Other ideas involve helping our voice. It doesn’t matter for our discussion as to why they are in our heads. They are a fact of life. Inflammation of the lining of the sinus can cause pain or impair our breathing.

The sinus that we deal with in dentistry in the called the “maxillary sinus.” As with all sinuses, there is a pair of them. One is on the right side and the other on the left side of the face. These are located right behind your cheekbones. Many times, you will find a physician tap in this area to see if it is painful or not. I also use this as an aid to locate and determine the cause of head pain.

Since these sinuses are in the cheek area, they are above and next to our upper teeth. The location of these sinuses is vital to remember. The teeth that are close to the sinus are the upper teeth, not the lower teeth. I often get a question as to whether a sore lower tooth is a sinus issue. We now know that lower teeth have nothing to do with the sinuses. Discomfort on the lower teeth needs another source for their uncomfortable feeling.

The patient I saw today had a swelling next to her upper tooth. She showed signs of infection and felt uncomfortable. She had a secondary complaint of sinus issues as this is allergy season in our area. I recommended that we take a closer look using 3-D imaging and find out if we could determine the source of her issues or issue.

The results showed that the tooth was hopeless. Although I am sorry that I need to remove the tooth, I was happy that we didn’t perform a heroic procedure to save the tooth. These techniques would not yield a successful result. The sinus is that area was not clear and possibly made worse by the infected tooth. The tooth infection may be impacting my patient’s sinus issue.

Pain in and around the head can be very complex and at times, a difficult puzzle to solve. Using modern technology and problem-solving skills, we can find answers that were difficult to find in the past.

If you have a nagging issue that needs to further investigation, please call Joyce at 440-892-1810. She will be happy to set up an appointment. I look forward to talking to you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile, 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com