What is it?

For the last three months I have had at least weekly pain and aching in my upper right molars. This pain then radiates up into my head and it is hard to differentiate between a headache or toothache. At the same time, I have stuffiness and other sinus symptoms. Allergy testing was normal about a year ago. I saw a neurologist who attributed it to migraine and put me on Topamax. So far it is not working, but I am on a low dose of 25 mgs for now. I just don't buy the migraine theory. I really believe it's my sinuses, but my internist does not believe it's sinusitis and did not want to treat with antibiotics. Insurance denied a sinus cat scan without antibiotic course first :0 Could you please offer some insight as to what this could be and what else I can look into? I saw a dentist and endodontist and ruled out any teeth problems. Thanks!

[National Jewish Health]

You are caught in a dilemma, pitting an insurance reality against the judgment of your physician.  It is possible that this is a sinus infection and also possible that it is not.  It sounds like you need to have a course of antibiotic therapy before getting a CT scan.  That is unfortunate, but a fact.  You will need to speak with your physician about the best way to proceed.