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.
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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:
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.
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.
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