January 25, 2017
by Helen Sanders, Health Ambition
Many people have experienced sinusitis at some point in their life and are familiar with the headaches, inflamed and tender skin and even fever associated with the infection. However, most are not aware that sinusitis, specifically maxillary sinusitis can be caused by a trip to the dentist.
Sinusitis is a common disease affecting more than 35 million people the US each year. Even though it is incredibly common, sinus infections are still among the most frequently misdiagnosed diseases in clinical practice.
Sinusitis is inflammation of the paranasal air sinuses caused by infection. Maxillary sinusitis is therefore an inflammation of the maxillary sinus.
The maxillary sinus (or antrum of Highmore) is the largest of your sinuses. Once your maxillary sinus is inflamed, it is possible for the infection to then spread to the orbit or to the ethmoid sinus.
The maxillary sinus is incredibly close to the maxillary teeth. In fact, it can often be seen on a dental x-ray situated above the molar and pre-molar teeth in the upper jaw. Because of this, it allows for easy spread of infection.
An odontogenic infection is an infection that originates within a tooth. The term is derived from odonto- (from ancient Greek odous – “tooth”) and –genic (from Greek genos – “birth”).
Odontogenic sinusitis was previously thought to account for up to 10% of all maxillary sinusitis cases. However, most recent studies have shown that it is actually closer to a much higher figure of 40% of chronic bacterial maxillary sinus infections are attributed to a dental source.
Odontogenic sinusitis has been a well-recognized condition for over 100 years. If a dental infection or dental/oral surgery ruptures the schneiderian membrane, it can often lead to sinusitis.
RELATED ARTICLE: Temporal Space Abscess Misdiagnosed As Temporal Arteritis: A Case Report
Symptoms of Maxillary Sinusitis
The symptoms of maxillary sinusitis, whether it be of dental origin or otherwise, are often the same. In most cases, symptoms will include headaches (in the sinus areas), pharyngeal or nasal discharge which is usually foul smelling, as well as normal signs of infection such as a fever.
Also, the sinus areas can be particularly tender to touch and feel hot as well as appearing red and swollen. Moreover, due to its close proximity to the maxillary teeth, there can be pain which feels dentally related regardless of whether it originated there or not.
In terms of odontogenic sinusitis, the most common symptom found is Unilateral purulent nasal discharge according to a recent clinical study.
Determining Dental Origin for Sinusitis
If someone has had a history of jaw pain, odontogenic infection or has recently undergone any form of oral surgery and are experiencing symptoms of maxillary sinusitis, then an odontogenic source should be considered.
Odontogenic sinusitis is completely different from sinusitis of other causes in terms of its pathophysiology, microbiology, diagnostics and management. Therefore, if it is failed to be appropriately identified patients can end up with prolonged symptoms as well as failed surgical and medical therapies.
Previously, dental films and dental evaluations were most commonly used for diagnosing odontogenic sinusitis. However, these methods frequently fail to detect maxillary dental infection that can be causing odontogenic sinusitis.
This is why it is now thought better to use sinus computed tomography (CT) or Cone Beam Volumetric CT (CBVCT) as these techniques are far superior in terms of accurately detecting dental diseases that can cause odontogenic sinusitis.
Most Common Causes of Odontogenic Sinusitis
Most commonly, a periodontal disease or dental abscess is the cause of odontogenic sinusitis. These often perforate the Schneiderian membrane and lead to infection.
Another incredibly common cause is perforations of the maxillary sinus during tooth extractions. This is why you should consider ruling out odontogenic sinusitis if you experience symptoms after recently having a tooth removed.
Furthermore, in a recent study of 27 patients with odontogenic sinusitis, over 35% contracted the infection due to dental implant related complications. Making this another common cause.
Treatment of Sinusitis
Treatment for any form of sinusitis should be sought as soon as possible in order to prevent more sinister complications such as the development of chronic sinus disease.
Traditionally for maxillary sinusitis treatment consists of a broad spectrum antibiotic which is prescribed for up to 10 days.
For odontogenic sinusitis, often medical treatment of antibacterials is required for up to four weeks. In some instances, management may require surgical drainage as well as treatment to remove the dental cause such as dental abscesses. In some cases, dental treatment alone will resolve the issue.
There are also a number of home remedies which offer immediate relief from symptoms of sinusitis. These can be used to relieve pain and discomfort whilst waiting medical or surgical assistance.
One home remedy is the use of essential oils. Through steam inhalation, oils like eucalyptus, thyme, peppermint and rosemary can be incredibly effective especially in reducing sinus headaches and congestion.
About the Author
Helen Sanders is chief editor at HealthAmbition.com. Established in 2012, Health Ambition has grown rapidly in recent years. Our goal is to provide easy-to-understand health and nutrition advice that makes a real impact. We pride ourselves on making sure our actionable advice can be followed by regular people with busy lives.
To read more about essential oils that deal with sinus infections, visit Health Amibition’s website.
Interested in contributing to Oral Health Group’s dental blog? Email email@example.com for more information!
Awesome blog. It sound’s quite interesting to read this post.
Thanks a lot for sharing this wonderful post.
It is great to see odontogenic sinusitis / Maxillary sinusitis of endodontic origin (MSEO) is getting more recognition. 40% of chronic sinus congestion is related to odontogenic sources. For those wishing to do more in depth reading I would suggest the following links : https://www.aae.org/specialty/wp-content/uploads/sites/2/2018/04/AAE_PositionStatement_MaxillarySinusitis.pdf
For those looking for an easier read:
Interesting article. I suspected a tooth entering the sinus when I Hydro-flossed my #15 and the water poured from the left nostril. And the smell is the same as the crap you dig out of a horse’s hoof. Not good. I’ll be irrigating it daily, salt-water rinsing, and peroxide…see if it heals.
Thanks for the article. I had a chronic sinus infection that was possibly going on for years. My only symptom was pressure in my head on the right. It was finally determined to be related to an old RCT on #2 when I got a cbct at work. I had the tooth removed instead of getting an apico because I went through so much hell for so long and I was just done. Finally getting treatment for it gave me my life back. I am considering an implant but I’m scared the same thing could happen with an implant and it’s not worth the risk to me.
Thanks so much for Links, and sharing your input. Only another person that’s gone through misdiagnosed problems, endless antibiotics, countless Specialist & ENT Revolving doors. Best I have been able to accomplish….Is of my on accord , lots of reading & asking other, just everyday people having been through, or going through awful pain, frustration, depression. Thanks again, Penney C.
I went in to try a new dental office in 2010 specifically for a cracked upper right side tooth. They took panoramic x rays and the gum gap measurements and came back to say I needed a root plaining and scaling before anything else. I reluctantly agreed and I also mentioned to them that there was kind of a tingly pain upper left area sometimes too. After scaling I got a bad infection up there a week or two after. I have had 2 extractions and 2 implants but still have on and off pain and facial swelling left cheek and sometimes left temple headaches. It hurts even now as I am typing this. I never went back to that dentist because they drained my insurance quick ! No other dentist, periodontitis, endodontist I have seen know that the issue is but I plan to see an oral surgeon soon. Maybe they can help. This has really messed up my quality of life.
I had a dental procedure done over a 2 wk period, the first where the hygenist took x rays of each side of my mouth and followed that with a really painful clean under the gums ,all the while conveying to the dental nurse a series of measurements to be entered onto my dental records.
One week later I had a clean and polish which was the most painful I have ever had in 67yrs. Since then I have had constant facial pain and extremely severe headaches, my face is swollen and my eyes look tiny in this face. I do suffer from chronic sinusitus but this has left me feeling miserable with pain and discomfort, and almost totally dysfunctional. I did ask the dentist to look at my mouth again and he said all was fine, he dismissed the possibility of any link with Sinus issues.
Thank you for being available. I am experiencing a foul odor from the drip coming from my sinus area. I have had oral surgery, small portion of bone removed and wear an opterator.
other than washing w/ medi-pod, what can I do to elevate the foul smell? Thank you. Ms. Dee
I had a n upper tooth removed and had a 4 tooth bridge put in which includes my two front teeth. I have a problem with my sinuses when I am having a lengthy conversation. My head gets congested and I whistle through the bridge. Any suggestions on what dentist can do to fix this?
Thanks for your article.
I had one eye tooth which broke off. I went to a new dentist and they told me a bridge would be the best remedy. I didn’t really understand that a bridge meant that they would file down 4 of my front teeth. The bridge was made& this was the end of my life as I knew it. They did not fit properly way too big and too rounded. I could it move my bottom jaw, lost my lower lip, & cried day & night. Finally after several attempts to fix, I said I wanted them remade. Problem was, the original mold was no longer available so the impression was made from what was in my mouth. Junk in equals junk out. The dentist did shorten the two front teeth making it possible for me to move my jaw. Therefore 50% better. However, right after this second attempt, I had constant phlegm in my throat and a sinus infection. At the time I didn’t attribute it to the bridge work & went to my physician who prescribed an antibiotic. ThIs didn’t work so we tried 2 different allergy medications which also didn’t work. That’s when I went on line to research causes and it was then that I realized that when the second procedure was done that everything that was placed up in the gums for the 1st procedure had been removed & put in a second time. My belief is that was the cause of my sinus issue. I went to both an oral surgeon(his answer was to have them straighten my teeth or get a. Ew dentist) and then a prothodontist who said he didn’t work on fixed bridges. So here I am chewing gum 24/7 since moisture helps, sleeping sitting up, which helps and totally stressed out as my life is not worth living. If anyone out there has any information which could be useful to me, please share….I am desperate
Hello Nancy. I know your pain! Around 8 years ago I had an upper molar extraction that I now know should not have been extracted. They should have put a post in the root and a crown. Instead, the tooth was so healthy they struggled for 45 minutes to rip it from my mouth! The next day I was on a plane to Europe. I developed an infection. Super painful and unpleasant. Came home a week later and antibiotics for the tooth area infection. Later I had terrible symptoms. Headache pain, pressure, I felt fatigued. I would take a shower and my lymphnodes would hurt from the water hitting my skin. I had no idea what was going on. Symptoms I was having were like leukemia! I was freaked out. Went to a bunch of doctors. No one could figure out what I had. All they could do was rule out cancer. (A big relief after weeks of freaking out.) No one ever mentioned puncturing of my sinus could cause this and that there is even a name for this condition! I wonder what the consequences are now that I’ve been living with this for 8 years. Pressure and pain in my head, constant, day after day year after year phlem in my through. Waking up in the morning congested and sometimes even pain my throat from this. Now that I know what this is I will be contacting doctors and …….
During the tooth extraction my sinus cavety expose and damage ?now i have a lot of problems when I know about the problem I visit my dentist and also blaming her about the problem he did a surgery and I don’t know what he did . After sometime atleast 3 or 4 week I have problems again like running rose fever headaches blocked nose .
I am worried about suggest me something sir
Is it a serious problem
Thanks for your article, I need your advice, I had dental scalling and polishing, during the procedure some dental polish powder and water got into my sinuses, now I have serious sinusitis pus and water droping into my mouth with unpleasant smell. However I saw the mmed sugeon did ct scan then prescribed some antibiotics and nostil spray still no good. can you tell something on this please!
Hi my name is stacey I am 35 ,I had my two front teeth extraction due to abscess and they cod not do a root canal as I had them ,so they said teeth have to come out ,and since they have took them out I suffered with sinus problems for 12 year now it as gone could this be due to the faild root canal and bacteria building up ,and now that it’s gone, and the teeth have gone could that have been the problem all along ,and I have a denture, I am not doing to well ,with it but its onley tempery the dentist said ,so hopefully I will get a new one soon I am they 9/02/2021 so will update you all ,thank you
I am 78 years old. When I was 15 years old, I had a painful and major sinus infection that swelled my entire face. I fainted from the pain. I did not have a tooth cavity or tooth infection. My parents took me to our dear neighbor and family dentist on a Sunday morning. He opened the office and took XRays and said that he could drill a hole in the back of my front tooth immediately and let this infection drain. It did and it smelled horrible. My sinus infection swelling and pain went away soon after most of the infection drained. There was a continuous drain for at least a few months. My parents took me to my pediatrician and I remember that the discussion in the his office. The inflammation was so close to my brain. The pediatrician said that the dentist saved my life. Eventually, my tooth turned gray. The dentist chose the front tooth as an emergency drainage. I’ve never had a sinus infection since.
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