Sinus eval for probable root canal issue
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 says that it might be my maxillary sinuses causing the issue and refering pain to upper back molars. He gives me 500 MG amoxycilin for 10 days. It did not make a difference. He did 1 panoramic x-ray which also looks at the sinuses(I assume in a limited fashion?) and everything looks fine. I went back to my original dentist and he says that I do not have the absolute signs of a root canal issue yet, but I do have some gingival recession. He is 85% sure it is a dental issue but does not want to do mouth work unless he is absolutely sure it is my tooth. My gut feeling is that it is my second rear molar. One year earlier I had amalgams removed on this tooth and the one behind it and my teeth never seemed right after that. Some moderate pain for a few months then it went away until November came and the intense pain showed up that I have now. The only symptom I have is sensitivity to cold and irritation when flossing. I do have some uncomfortable facial pain and headaches due to this problem. He advised me to go to my primary doctor for a sinus eval and after listening to my history she does not think it is my sinuses but to be sure we will do a sinus CT so the dentist can then go forward and treat the mouth. Does the CT scan sound excessive and necessary in my situation and based on my history? I do appreciate my dentist being conservative but it really seems like it is my teeth. 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/pelvic CT scan in previous years so I am concerned about any additional radiation exposure to my head if it is not necessary.
Last edited by almok; 03-04-2008 at 06:14 PM.