Are sinuses really to blame for this tooth pain?
August 2, 2015 9:18 AM Subscribe
I received a root canal 5 years ago and the tooth has been hurting/sensitive for weeks. Two dentists say it's sinus related, but it definitely feels like the tooth (x-ray inside).
5 years ago I had root canal surgery on my back two molars. Aside from the fact that I've broken the ceramic crown on my second molar three times through grinding my teeth at night, everything has been OK.
Last summer I had a metal crown placed on my second molar because I keep cracking the ceramic ones. A couple of months ago I started feeling some sensitivity in my second molar which concerned me since I've had root canals on both back teeth. How can it feel sensitivity?
I went to a dentist who said the x-rays appeared fine. She did find a small hole in the crown (yes, I managed to grind through metal in 9 months), but said that it wasn't significant enough to warrant another new crown.
Weeks have passed and the pain persists. It is VERY similar to a toothache. It reacts to hot and cold, not biting. It's just the inside of the tooth, not the whole tooth. If I touch it with my tongue, it's sensitive.
Around the same time that this has been going on, I've been having moderate sinus issues; pain in my cheekbones, slight runny nose as well as muscle tightness in my neck. Nothing worse than anything I've had before related to sinuses.
Last night when I laid down to sleep I felt a rush of sharp pain in the tooth. It was significantly worse when lying down. I couldn't sleep all night. I went to an emergency dentist today who took another x-ray and said that I'm fine and that it's a sinus issue.
The x-ray is here: http://i.imgur.com/UhcCkxX.jpg
Could what I'm feeling really be sinus related? It's only affecting ONE tooth, which makes me suspect that it's the tooth itself causing the issue.
5 years ago I had root canal surgery on my back two molars. Aside from the fact that I've broken the ceramic crown on my second molar three times through grinding my teeth at night, everything has been OK.
Last summer I had a metal crown placed on my second molar because I keep cracking the ceramic ones. A couple of months ago I started feeling some sensitivity in my second molar which concerned me since I've had root canals on both back teeth. How can it feel sensitivity?
I went to a dentist who said the x-rays appeared fine. She did find a small hole in the crown (yes, I managed to grind through metal in 9 months), but said that it wasn't significant enough to warrant another new crown.
Weeks have passed and the pain persists. It is VERY similar to a toothache. It reacts to hot and cold, not biting. It's just the inside of the tooth, not the whole tooth. If I touch it with my tongue, it's sensitive.
Around the same time that this has been going on, I've been having moderate sinus issues; pain in my cheekbones, slight runny nose as well as muscle tightness in my neck. Nothing worse than anything I've had before related to sinuses.
Last night when I laid down to sleep I felt a rush of sharp pain in the tooth. It was significantly worse when lying down. I couldn't sleep all night. I went to an emergency dentist today who took another x-ray and said that I'm fine and that it's a sinus issue.
The x-ray is here: http://i.imgur.com/UhcCkxX.jpg
Could what I'm feeling really be sinus related? It's only affecting ONE tooth, which makes me suspect that it's the tooth itself causing the issue.
This pretty much exact thing happened to me and it was clearly caused by a sinus infection, not a failed root canal. The nerves to your teeth go past your sinuses and anything that irritates the nerve up there will be interpreted by the brain as coming from the tooth, it can't tell the difference. I know it doesn't feel that way but nerves can be tricky like that.
For me, the original nerve root was close to the sinus cavity anyway and the root filling pushed up against it just a bit more. So any pressure or hot or cold or whatever on the tooth irritated the inflamed sinus tissue and my brain referred it back down into the tooth even though there is no nerve even there to feel anything. All this was clear on the x-ray image. I took antibiotics and got rid of the infection and the pain went away. I still can feel that tooth (and no others) if I push on it when I have allergies playing up, but it's still a trick, what I'm feeling comes from higher up and not the tooth itself.
So yes, this really can be sinus related even just for one tooth. The way to be sure is by having a good dentist do x-rays that include the very top of the root and double check. You've had two dentists look and both tell you the same thing, so you can probably believe them. So maybe look at addressing whatever is causing your sinuses to be irritated, that's quite likely to help.
posted by shelleycat at 9:31 AM on August 2, 2015
For me, the original nerve root was close to the sinus cavity anyway and the root filling pushed up against it just a bit more. So any pressure or hot or cold or whatever on the tooth irritated the inflamed sinus tissue and my brain referred it back down into the tooth even though there is no nerve even there to feel anything. All this was clear on the x-ray image. I took antibiotics and got rid of the infection and the pain went away. I still can feel that tooth (and no others) if I push on it when I have allergies playing up, but it's still a trick, what I'm feeling comes from higher up and not the tooth itself.
So yes, this really can be sinus related even just for one tooth. The way to be sure is by having a good dentist do x-rays that include the very top of the root and double check. You've had two dentists look and both tell you the same thing, so you can probably believe them. So maybe look at addressing whatever is causing your sinuses to be irritated, that's quite likely to help.
posted by shelleycat at 9:31 AM on August 2, 2015
Yes. Sinus pain can definitely cause tooth pain.
There is a lot packed inside our cranium, which can cause things like that to occur. However, I suspect you have more than just the sinus issue here. Specifically, you said you have chewed through a metal crown in nine months. Wow. You are either one heck of an intensive ice muncher or you are doing some serious grinding of your teeth. My recommendation would be to see a doctor about your sinus problem, and then maybe a dentist or orthodontist who can fit you with a bite plate.
posted by LilithSilver at 9:36 AM on August 2, 2015 [1 favorite]
There is a lot packed inside our cranium, which can cause things like that to occur. However, I suspect you have more than just the sinus issue here. Specifically, you said you have chewed through a metal crown in nine months. Wow. You are either one heck of an intensive ice muncher or you are doing some serious grinding of your teeth. My recommendation would be to see a doctor about your sinus problem, and then maybe a dentist or orthodontist who can fit you with a bite plate.
posted by LilithSilver at 9:36 AM on August 2, 2015 [1 favorite]
I once had a crown over a rotten root. It caused confusion, false parotiditis , a whole number of issues. I was out of town and on my way in to see an ENT when the crown fell off. The fetid, rotten state of my gum was a medical emergency in its self. When the dentist pulled out the root he ran from the room with it. I had an anaerobic infection in a top tooth root, near my brain. It was a bad thing. So if there is a hole in the crown, infection can be in the gum, and even with a root canal, that can be sensed.
posted by Oyéah at 9:45 AM on August 2, 2015
posted by Oyéah at 9:45 AM on August 2, 2015
So if there is a hole in the crown, infection can be in the gum, and even with a root canal, that can be sensed.
This is true. And the way it is diagnosed is with a dental examination and x-rays, which you've had done by two dentists. If you're not convinced for whatever reason then definitely follow up with an endodontist, but addressing the sinus issues still seems like a good idea. Worst case scenario it will make your face feel better at least, best case it will solve everything (since this is still possible based on the info you currently have).
posted by shelleycat at 10:07 AM on August 2, 2015
This is true. And the way it is diagnosed is with a dental examination and x-rays, which you've had done by two dentists. If you're not convinced for whatever reason then definitely follow up with an endodontist, but addressing the sinus issues still seems like a good idea. Worst case scenario it will make your face feel better at least, best case it will solve everything (since this is still possible based on the info you currently have).
posted by shelleycat at 10:07 AM on August 2, 2015
I am just going to weigh in with my own experience, which is that I went to the dentist not once but twice with what turned out to be sinus pain. Obviously, that's because the sinus pain felt as though it were centered in my teeth. (Not a specific tooth, but a specific area - maybe 2 teeth. And I think, but don't know for sure, that this only happens with upper teeth.)
The test that the dentist had me do was to bend over as if I were touching my toes. If the pain was affected, then it was my sinuses, not my teeth.
posted by sudo intellectual at 10:58 AM on August 2, 2015
The test that the dentist had me do was to bend over as if I were touching my toes. If the pain was affected, then it was my sinuses, not my teeth.
posted by sudo intellectual at 10:58 AM on August 2, 2015
Nthing try Sudafed (the good kind behind the counter), alternate warm and cold compresses, Neti pot, and some type of steroid Nasonex spray (OTC now). That should wipe out whatever is living in your sinuses; if not, then get to an Urgent Care and get antibiotics because it may be a bacterial sinus infection.
posted by kinetic at 12:04 PM on August 2, 2015
posted by kinetic at 12:04 PM on August 2, 2015
And I think, but don't know for sure, that this only happens with upper teeth.
When I had my Terrible Weekend, the worst pain was one upper tooth, but I had strange phantom pains coming and going all over my mouth, including one lower tooth I originally thought just decided to go rogue at the same time. I think beyond a certain point my nerves were just all "FUCK I DON'T KNOW ANYMORE".
posted by Lyn Never at 12:13 PM on August 2, 2015
When I had my Terrible Weekend, the worst pain was one upper tooth, but I had strange phantom pains coming and going all over my mouth, including one lower tooth I originally thought just decided to go rogue at the same time. I think beyond a certain point my nerves were just all "FUCK I DON'T KNOW ANYMORE".
posted by Lyn Never at 12:13 PM on August 2, 2015
The complete opposite has happened to me. I had a tooth infection (unknown at the time) with no tooth pain, which was causing me a lot of sinus pain. I pursued it as a sinus issue which I've had in the past even going as far as seeing a specialist to stick a scope up my nose. In the end it turned out that I needed a root canal.
posted by eatcake at 12:44 PM on August 2, 2015 [1 favorite]
posted by eatcake at 12:44 PM on August 2, 2015 [1 favorite]
I've had what you are describing including the shooting tooth pain (occasional) I had an ENT who prescribed a short course of prednisone to get rid of the sinus inflammation that seemed to be the culprit. Still not totally resolved (may need to get my deviated septum fixed) but on the mend I think. Best of luck with all this, it's so vexing. I agree, try Sudafed in the short term and see if you notice a difference. It may also be a TMJ type of thing. Do you have a bite guard? One of the things I found was that once my tooth nerve was inflamed it took a few days of really going easy on it for it to calm back down.
posted by jessamyn at 12:57 PM on August 2, 2015
posted by jessamyn at 12:57 PM on August 2, 2015
I had this issue for more than a year before a dentist took the tooth out for me and it was so rotted that it rather fell out and I needed two bone grafts before the implant could take. I had seen 4 other dentists, multiple other doctors including an ENT who all told me that it was sinuses even after an abscess developed on the gum (root canal specialist diagnosed it as gum disease!). One doctor even diagnosed migraines and prescribed epilepsy medicine and a neurologist! I think this must be tricky to diagnose. Look for new dentists that are not related to your current dentists in any way. Keep looking!
posted by RoadScholar at 1:22 PM on August 2, 2015
posted by RoadScholar at 1:22 PM on August 2, 2015
i'm with the dentists - this is sinus issues, or at least it always has been in my case when i've had very similar symptoms to yours.
posted by nadawi at 1:49 PM on August 2, 2015
posted by nadawi at 1:49 PM on August 2, 2015
On page 16 of this PDF (page 123 of the book), you can see how the very neatly organized cranial nerves of a shark turn into the HOT FUCKING MESS of hacked-together facial nerves in a human. (The whole chapter is very interesting for why your facial pain is never coming from where it actually hurts.) Pain that feels EXTREMELY SPECIFIC might be coming from somewhere else entirely in your head.
If you keep asking, you will eventually find a dentist willing to do unnecessary dental work on you for what is referred sinus pain, but do try some sinus remedies first. (My dentist has on occasion prescribed me sinus drugs because I get such terrible referred sinus pain to my teeth.) Sometimes I've had excruciating tooth pain because I recently had, like, a stuck popcorn kernel so the nerves along the gums were irritated, and then sinus swelling turned the already-irritated nerve into A MEGA CRISIS OF TOOTH PAIN, but it was really the sinus that was the problem. Also if your gums have started to recede even a little from the tooth (which it does in everyone after 30ish), you can have excruciating pain that feels like it's IN the tooth but is actually on the surface along the gums ... and again, this pain is a lot worse for me when my sinuses are being bad.
posted by Eyebrows McGee at 2:43 PM on August 2, 2015
If you keep asking, you will eventually find a dentist willing to do unnecessary dental work on you for what is referred sinus pain, but do try some sinus remedies first. (My dentist has on occasion prescribed me sinus drugs because I get such terrible referred sinus pain to my teeth.) Sometimes I've had excruciating tooth pain because I recently had, like, a stuck popcorn kernel so the nerves along the gums were irritated, and then sinus swelling turned the already-irritated nerve into A MEGA CRISIS OF TOOTH PAIN, but it was really the sinus that was the problem. Also if your gums have started to recede even a little from the tooth (which it does in everyone after 30ish), you can have excruciating pain that feels like it's IN the tooth but is actually on the surface along the gums ... and again, this pain is a lot worse for me when my sinuses are being bad.
posted by Eyebrows McGee at 2:43 PM on August 2, 2015
This is just from my personal experience, but I bet the fact that you're grinding your teeth at night has a lot to do with it!
I have had bad sinus issues in the past, and underwent surgery which fixed me up. A few years ago I started having sinus pain, just like I used to before my surgery. My ENT could find nothing wrong. My dentist gave me a nightguard and told me to try to avoid stress.
Turns out, the face pain and headaches I get from grinding my teeth feel almost exactly like sinus pain.
If you don't have a nightguard, you really should get one as soon as you can. Or if you have one, and you're still grinding through your crowns, maybe you should try a diferent kind. There are other things you can do to treat teeth grinding as well that can help allieviate the pain.
posted by inertia at 2:48 PM on August 2, 2015
I have had bad sinus issues in the past, and underwent surgery which fixed me up. A few years ago I started having sinus pain, just like I used to before my surgery. My ENT could find nothing wrong. My dentist gave me a nightguard and told me to try to avoid stress.
Turns out, the face pain and headaches I get from grinding my teeth feel almost exactly like sinus pain.
If you don't have a nightguard, you really should get one as soon as you can. Or if you have one, and you're still grinding through your crowns, maybe you should try a diferent kind. There are other things you can do to treat teeth grinding as well that can help allieviate the pain.
posted by inertia at 2:48 PM on August 2, 2015
I have had a root canal fail. The infection spread through the bone, eating a hole away in it. This was missed by two dentists and an endodontist. Apparently, it looked like an ambiguous shadow on the X-ray which diagnostically is NBD. I was in an incredible amount of pain and was told repeatedly that it was my sinuses. Antibiotics and NSAIDs did nothing, though. I thought that I was going to lose my mind. Finally, a fistula opened in my gum. An endodontist, still not seeing anything on the X-ray, opened the tooth. It wound up needing to be pulled. I also required bone grafts to replace the missing bone.
If treatment for sinus stuff doesn't work, having the dentist drill through the crown is not an unreasonable next step. Yours already has a hole in it. Once they open the tooth up, it will be easier to determine whether there's an infection. In my case, it stank when the tooth was opened.
Good luck. Dental pain is one of the worst things that I can think of. I hope that you find a resolution soon.
posted by batbat at 4:05 PM on August 2, 2015 [1 favorite]
If treatment for sinus stuff doesn't work, having the dentist drill through the crown is not an unreasonable next step. Yours already has a hole in it. Once they open the tooth up, it will be easier to determine whether there's an infection. In my case, it stank when the tooth was opened.
Good luck. Dental pain is one of the worst things that I can think of. I hope that you find a resolution soon.
posted by batbat at 4:05 PM on August 2, 2015 [1 favorite]
If it keeps hurting, keep asking. I spent *months* four years after a root canal with pain which came and went. every xray was fine and every dentist said "sinus". I also got the teeth grinding diagnosis. I finally went back to another doctor who sent me back to another dentist who opened the tooth up--
the smell nearly knocked us both out. The dentist who did the root canal had missed a root, and the tooth was abscessing in a way that was not visible on the damned xrays. The specialist told me that it's not uncommon, and very hard to see when the abscess happens this way.
I hope for your sake it is actually a sinus problem!
posted by frumiousb at 4:11 PM on August 2, 2015
the smell nearly knocked us both out. The dentist who did the root canal had missed a root, and the tooth was abscessing in a way that was not visible on the damned xrays. The specialist told me that it's not uncommon, and very hard to see when the abscess happens this way.
I hope for your sake it is actually a sinus problem!
posted by frumiousb at 4:11 PM on August 2, 2015
I had a similar experience several years ago. Neither dentist or GP were able to diagnose the issue. A friend suggested doing a daily nasal rinse (neti pot) and the pain resolved over the course of a couple of weeks.
posted by royboy at 1:15 PM on August 3, 2015
posted by royboy at 1:15 PM on August 3, 2015
This thread is closed to new comments.
I finally realized I had a little facial sinus pressure and took a Sudafed and had complete relief in about 2 hours.
So...if you haven't tried that, it might answer your question real fast.
posted by Lyn Never at 9:25 AM on August 2, 2015 [2 favorites]