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Maxillary sinus cyst & dental pain
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Maxillary sinus cyst & dental pain

I have been having pain and pressure in my right upper teeth starting at the canine and going back 3 teeth (#6, #5, #4, #3) for over 3 months.   I have seen a dentist who ruled out any problems with the teeth (by visual exam and x-ray), a periodontist who ruled out any problems with the gums and an endodontist who ruled out the need for a root canal.     I have been treated for a sinus infection by my primary care physician and ENT.    I have been prescribed antiobiotics (amoxycillin for 20 days and azithromycin 250mg for 7 days), prednisone for 5 days, flonase, nasonex and daily sinus rinses.    Nothing has helped.    The pain and pressure never goes away, but is definitely less intense in the morning.   The pain increases throughout the day.   The tooth pain also moves around between the 4 teeth depending on the position of my head.   I also have headaches behind my eyes, across my forehead and right cheek.

A CT scan of my sinsuses shows a 1.4 cm cyst in the maxillary sinus.    The cyst is sitting right on the bottom of the maxillary sinus above my teeth.    On the CT scan you can actually see the teeth making contact with the cyst.    My ENT is recommending surgery to remove the cyst.    However, he is not certain the cyst is the culprit causing my pain as he claims they are normally asymptomatic.

Has anyone had a personal experience with a cyst in the maxillary sinus that caused dental pain?   If so, did you have it removed and was the pain resolved?    Or if you are reading this and you are a medical expert, have you ever treated a patient with symptoms like mine and was a cyst in the maxillary sinus the cause of the pain?

Thank you.
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Avatar_dr_f_tn
Hello and hope you are doing well.

Understand your predicament.
But it’s unlikely that the cyst can cause compressive symptoms on the teeth. Maxillary sinusitis can cause referred pain to the teeth and vice versa. If it is a chronic sinus infection, 4-6 weeks of antibiotics are pretty standard in addition to nasal steroid sprays, oral steroids, and salt water irrigations of the sinuses.  If this fails to solve the problem, sinus surgery is usually recommended.

Hope this helped and do keep us posted.
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Avatar_n_tn
Update**  A different dentist and endodontist diagnosed both me with cracked tooth syndrome.    The crack is in one of the right upper molars.    A dome x-ray done at the endodontists office shows that the cyst in my sinus is DIRECTLY above the cracked tooth.    The endodontist believes my body created the cyst in response to the cracked tooth.     He explained the cyst is like a callus my body formed to contain anything bad that was pushing or leaking up from the cracked tooth.    He recommends a root canal and crown.
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Avatar_dr_f_tn
Hello and hope you are doing well.

Good to see the root cause for your symptoms was detected. Infected tooth roots from the upper teeth can go inside the maxillary sinus and cause sinusitis. As you have an infected tooth, you will still need to have this addressed as dental infections can be potentially life-threatening. Good luck.
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Avatar_n_tn
I am scheduled for a root canal in a few days to repair the cracked tooth.    After that, a crown will be put on to protect the tooth.    Thank you again for all of your input.
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