Could a Tooth Infection be the Source of Chronic Sinus Problems?

According to Dr. Michael J. Lewis, a specially trained root canal dental specialist known as an endodontist, chronic sinus infections are sometimes caused or intensified by an underlying tooth infection.
“In short, sometimes the roots of one’s teeth become infected and that infection can spread to a space located behind one’s cheek bones,” Dr. Lewis said. “The patient may experience signs of seasonal allergies or of a sinus infection and be prescribed antibiotics by their primary care providers. While these antibiotics may treat the infection in one’s nose, they don’t always cure their tooth infection.”
The medical process Dr. Lewis referred to is called Maxillary Sinusitis of Endodontic Origin (MSEO). MSEO is when the roots of someone’s upper back teeth extend quite close to an air-filled space located behind their cheekbones called the maxillary sinus. If one of their upper back teeth becomes infected, the infection can spread rather easily out of the end of the tooth’s root into the maxillary sinus. Patients with MSEO often exhibit sinus or nasal symptoms including post nasal drip or general sinus congestion which they may think is due to seasonal allergies. Some patients may even experience recurring sinus infections, which are often treated by their physician with antibiotics. While antibiotics will resolve the infection for a period of time, the antibiotics are incapable of reaching the source of the infection inside the tooth.
Once the antibiotics are ceased, the infection will slowly re-emerge from the tooth and spread back into the sinus. Ironically enough, patients with MSEO will usually not exhibit any tooth pain. This absence of dental symptoms can make it very difficult for both the patient and their medical doctor or general dentist to recognize that there is even a tooth infection present. As a result, patients often suffer from this condition for many years before it is recognized. Dr. Lewis says easy and relatively painless treatment options like a root canal may help rid the bacteria that causes the infections.
“Many people may cringe at the thought of having root canal treatment, but in the right hands of a highly skilled and specialized endodontist, the process is quite easy and relatively painless,” Dr. Lewis continued. “For those patients diagnosed with MSEO, root canal therapy or retreatment alone may completely resolve their sinus symptoms, with about half of all patients experiencing the procedure requiring no other medical care. Patients who do not experience relief may need additional care from an ENT to fully resolve their complaints, but a root canal treatment is a necessary first step.”
Dr. Lewis received his dental degree from the University of Pennsylvania in 2004 and completed advanced, specialty endodontic dental training at the New York University of Dental Medicine. He is a member of the American Association of Endodontists.
To learn more about MSEO, interested parties are encouraged to sign up for the AAE’s webinar being offered Feb. 21, 2019, or refer to articles featured in Dear Doctor or Decisions in Dentistry.
About the American Association of Endodontists
The American Association of Endodontists, headquartered in Chicago, represents more than 8,00 members worldwide. Endodontics is one of nine dental specialties formally recognized by the American Dental Association. The AAE, founded in 1943, is dedicated to excellence in the art and science of endodontics and to the highest standard of patient care. The Association inspires its members to pursue professional advancement and personal fulfillment through education, research, advocacy, leadership, communication and service.