People frequently present to the dentist complaining of pain or hypersensitivity in their upper back teeth. This may be due to a variety of causes - decay, fractures, gum infections, etc. Occasionally the dentist cannot place the blame on any of these factors, and the teeth may appear normal both visually and on x-rays. The situation can be a diagnostic dilemma for the doctor and the patient. The patient needs relief, yet the dentist would be reluctant to initiate an irreversible procedure (i.e., root canal or extraction) without convincing evidence that a particular tooth is at fault.

The answer is often found to be a sinus infection. This can be explained by noting that the roots of the upper molar and bicuspids are usually located adjacent to the maxillary sinus. When the sinuses are infected or inflamed, such as can occur with seasonal allergies or colds, the symptoms may perfectly mimic a toothache. The reason is that the nerves which supply these teeth course through the membrane which lines the sinus. Therefore the brain receives a misleading message that something is amiss with the teeth.

There are telltale symptoms which are a giveaway that the teeth may be innocent. A sudden change in posture or rapid movement of the head may produce pain, as the fluid sloshes around the sinus, which is nothing more than a hollow chamber in the skull located between the eye socket and the roof of the mouth. Also, if the patient acknowledges that the onset of the symptoms coincides with a cold or sinus problem, one can expect the teeth to feel normal after the ailment subsides.

Relief may be obtained by taking over-the-counter decongestants or antihistamines. In severe cases antibiotics or even surgery may be necessary. In such cases a dentist will refer the patient to their family physician or an ear, nose and throat specialist. Proper diagnosis will prevent the unnecessary compromise or loss of innocent teeth.

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