Sinus Evaluation Necessary?

[albot]

In late November I started having pain in my upper right mouth towards the back teeth and gum area. After a week I went to the dentist who did digital x-rays and visual inspection and said my teeth looked healthy so he refered me to an endodontist. The endo did a single regular x-ray as well as tooth sensitivity tests and everything checked out fine. He said come back if the pain gets worse. A week later I start getting a headache behind the right eye as the oral pain gets worse. I go back to the endo and he does a second x-ray and everything is fine. He tapps the teeth and no pain. At this point it seems that when the oral pain gets worse, so does the headache. I decide to go see my wife's dentist(who I have known for years) and he inspects my mouth and says he sees a questionable spot on my gums and sends me to the oral surgeon. I go to the oral surgeon who looks at my x-rays, does more sensitivity tests and conculdes that it is my maxillary sinuses causing the issue and refering pain into my mouth. He gives me amoxycilin for 10 days. I am on day 10 and it has not made one difference. He did 1 panoramic x-ray which also looks at the sinuses and everything looks fine. I went back to my original dentist and he says that I do not have the definitive signs of a root canal issue yet. He is 80% sure but does not want to to mouth work unless he is absolutely sure it is my tooth. The only symptom I have is sensitivity to cold. I do have some bad facial pain and headaches due to this problem. He advised me to go to my primary doctor for a sinus eval and she does not think it is my sinuses but to be sure we will do a limited sinus CT so the dentist can then go forward and treat the mouth. Does the CT scan sound excessive? I have had several mouth x-rays in the last 3 months and now a CT scan and that worries me. Any opinions would be appreciated. I have had a number of x-rays including an abdominal CT scan in previous years.

[scottma]

If pain is associated with flossing, periodontal evaluation is advised. Symptomatology of temporomandibular disorder is not limited to joint pain itself. Headache, neck and upper shoulder pain, ear tinnitus , stuffy ear, tooth mobility, tooth sensitivy to cold or hot, tmj and orofacial pain, supraorbital pain, are related to tmd.

[almok]

The other symptom I have is a lot of pain when flossing in the area in question which then reffers a headache. I do not have any jaw discomfort. It just seems so obvious that is is dental related but it is very frustrating to say the least.

[scottma]

It appears your pain is referred pain from muscular origin based on the imformation provided. Dental origin is not likely. Sinus pathology needs to be ruled out by ENT doctor. If no sinus pathlogy identified, seeing a tmj specialist is advised.