Odontogenic Sinusitis: Tooth-Related Sinus Infection
When we say sinusitis, we usually think of upper respiratory tract infections that develop after a cold, flu or allergy; caused by inflammation that accumulates in the sinus cavities due to blockage of the sinus openings, and manifests itself with nasal congestion, postnasal drip and headache. However, not every sinusitis originates from the nasal cavity. In sinus cavities, especially those associated with the upper jaw teeth, the source of the infection can sometimes be a tooth. This condition is called odontogenic sinusitis .
What is Odontogenic Sinusitis?
Odontogenic sinusitis is the inflammation of the maxillary sinuses (sinus cavities within the upper jaw bone) as a result of dental or upper jaw diseases. Oral bacteria can reach the sinus cavity and cause infection there. Since this condition can be resistant to classic sinusitis treatments, correct diagnosis and approach are of great importance.
Causes of Odontogenic Sinusitis
Tooth Root Infections (Apical Periodontitis)
The roots of the molars in the upper jaw are very close to the floor of the maxillary sinus. Root tip infections that occur as a result of inflammation of the nerve and vascular tissue (pulp) of the tooth can pass through the bone in this area and reach the sinus cavity. Thus, inflammation begins in the sinus membrane.
In summary: An infection at the root of the tooth can spread to the sinus cavity, causing sinusitis.
Complications After Tooth Extraction
During the extraction of upper back teeth, the thin bone between the sinus floor and the tooth root can be damaged. This can cause an open passage between the oral cavity and the sinus, called an “oroantral fistula.” Through this passage, oral bacteria can easily reach the sinus cavity and start an infection.
In summary: The opening created after tooth extraction can lead to infection of the sinus cavity.
Inadequate or Faulty Root Canal Treatments
Unsuccessful root canal treatments can result in the infection not being completely cleared. Over time, bacteria can spread to the sinus area. Additionally, if excess filling material spills into the sinus cavity, it can irritate the sinus membrane and lead to infection.
In summary: Faulty root canal treatment can cause sinus tissues to become infected.
Dental Implant Applications
Placing implants in the upper jaw area too close to the sinus floor or performing sinus lift procedures incorrectly may cause damage to the sinus membrane. This increases the risk of infection.
In summary: Implants placed close to the sinus area may cause the development of odontogenic sinusitis.
Cysts, Tumors or Impacted Teeth
Cysts or benign tumors that form in the jawbone can put pressure on the sinus cavity and cause irritation of the membrane. In addition, inflammation that develops around impacted teeth that are in contact with the sinus can spread to the sinus.
In summary: Impacted teeth or abnormal structures can affect the sinus cavity.
What are the symptoms?
Although odontogenic sinusitis presents symptoms similar to those of classic sinusitis, it usually follows a unilateral and chronic course. The most common symptoms are:
- Facial pain (especially in the upper jaw and cheek area)
- Unilateral nasal congestion and discharge
- Bad breath
- Toothache or tenderness when chewing
- History of dental problems along with sinusitis symptoms
How is it diagnosed?
In order to make a correct diagnosis, it is important for a dentist and an ear, nose and throat (ENT) specialist to evaluate together. The imaging methods that can be used are:
- Panoramic X-ray
- Dental tomography (CBCT)
- Paranasal sinus tomography
Treatment Methods
The primary goal in treating odontogenic sinusitis is to eliminate the source of the infection:
- Dental Treatment: Root canal treatment may be applied to the infected tooth or the tooth may need to be extracted.
- Antibiotic Use: Infection can be controlled with appropriate antibiotics.
- Sinus Surgery (FESS) and/or Caldwell-Luc: If the infection has spread or become chronic, the sinus cavity can be cleaned with endoscopic sinus surgery (FESS). In some cases, the classical surgical method, the Caldwell-Luc procedure, may be preferred.
Why is Early Intervention Important?
If odontogenic sinusitis is left untreated, the infection can spread to deeper tissues, causing damage to the sinus bones and significantly reducing quality of life. In cases of persistent facial pain that begins with a toothache, a detailed evaluation by a dentist and an ENT specialist is vital.
Conclusion
Not every sinusitis is caused by the nose. Especially if you have one-sided and persistent sinus problems , you should not forget that the cause may be dental. Therefore, it is possible to reach the right treatment by evaluating both your dental and sinus health together.
