Mary Wei answers:

Your sinus are so swollen that they are literally pushing on the roots of your teeth.

For some reason, my bottom teeth hurt at the same time as my top, but this makes no logical sense to me.

Here is a link concerning it

http://www.atlantadentist.com/maxillary_sinus.html

Most times I just grin and bare it, pop pain relievers and periodically ask someone to shoot me.

Mary Wei answers:

Is sinusitis always associated with secretion/pus?

Mary Wei answers:

I very often get sinusitis, so I’d have to say, these are the symptoms I have.
Symptoms:
1. Ethmoid sinusitis (behind the eyes)
Nasal congestion with discharge or postnasal drip (mucus drips down the throat behind the nose)
Pain or pressure around the inner corner of the eye or down one side of the nose
Headache in the temple or surrounding the eye
Pain or pressure symptoms worse when coughing, straining, or lying on the back and better when the head is upright.
2. Maxillary sinusitis (behind the cheek bones)
Pain across the cheekbone, under or around the eye, or around the upper teeth
Pain or pressure on one side or both
Tender, red, or swollen cheekbone
Pain and pressure symptoms worse with the head upright and better by reclining
Nasal discharge or postnasal drip
Fever common
3. Frontal sinusitis (behind forehead, one or both sides)
Severe headaches in the forehead
Fever common
Pain worse when reclining and better with the head upright
Nasal discharge or postnasal drip
4. Sphenoid sinusitis (behind the eyes)
Deep headache with pain behind and on top of the head, across the forehead, and behind the eye
Fever common
Pain worse when lying on the back or bending forward
Double vision or vision disturbances if pressure extends into the brain
Nasal discharge or postnasal drip

Mary Wei answers:

Sounds like a sinus issue to me. I have had chronic, bilateral (both sides), maxillary sinusitis for 40 years. Try adding about a teaspoon of salt to 8-10 Oz’s. Of warm water and gargle with it before bed time. The phlegm you are coughing up sounds like sinus drainage which is causing your sore throat. It could also be allergies but if it were you would likely have eye symptoms like them being itchy and watering. No eye symptoms likely sinusitis or cold. Other home remedies include taking a wash cloth and soaking it in hot water, wring it out and place over your forehead, or wherever you feel pressure. The moist heat will help to break up the congestion in that sinus (frontal). If the stuffy nostril worsens or doesn’t improve there are 2 non medication ways to attack that issue. One is get some vapor bath from the local store/pharmacy. Pour 2-3 Oz’s. Into a pan of water, heat to a rolling boil. Remove from heat and then take a towel and drape it over your head and the pan (like a tent). Breathe in through your nose. Go to the local pharmacy and buy either saline spray or a neti pot. The small hairs in your nostrils act like filters. They need to be cleaned. If all else fails or condition worsens go see your primary care doctor. If your condition warrants it you might need a referral to an otolaryngologist (ear, nose, throat doctor). Last but not least, their is a medication choice. DO NOT USE NASAL SPRAYS LIKE AFRIN. They cause “rebound congestion” if used for more than 3 consecutive days. Try some pseudoephederine Hcl. The brand name is Sudafed. You must show an I.D. Card and sign for it as it is used as a base for some illegal drugs. They Sudafed PE which is a different chemical compound which does not work for me but it might help you I cannot predict. Hope this helps you and best of luck.

Mary Wei answers:

Sinuses are paired air cavities/spaces (pockets) found in the cranial (head) bones. Sinuses are also referred to as “paranasal sinuses”. They are connected to the nose on the facial part of the skull where air passes and mucus drains.

We have four paired sinus cavities. Each sinus cavity has an opening (ostium), which opens into the nasal passages for free exchange of air and mucus. The mucus linings have ciliated epithelium (cells with fines hairs) that moves dirty mucus from the sinus cavities which drains into the nasal passages.

Sinuses are often confused with sinusitis. Sinusitis is a condition that occurs when your sinuses become inflamed and infected.

There are four pairs of sinus cavities:

Ethmoid (between the eyes) sinuses. These sinuses are located behind the bridge of the nose and at the “root” of the nose between the eyes. We are all born with ethmoid sinuses and as we grow, they also grow. When these cavities become inflamed, you have a condition called ethmoiditis.
Frontal (forehead) sinuses. These sinus cavities are located above the eyes in the region of the forehead and only develop around seven years of age. When the frontal cavities become inflamed, you you have a condition called frontal sinusitis.
Maxillary (cheekbones) sinuses. These sinus cavities are found on either side of the nostrils in the cheek bones. They are present at birth and grow as we grow. Inflammation of maxillary cavities due to bacterial, viral and other irritants is a condition called antritis.
Sphenoid (behind the eyes) sinuses. These sinus cavities lie deeper in the skull behind the ethmoid sinuses and the eyes. We only develop sphenoid sinus cavities during adolescence. Inflammation of these cavities due to any irritant is a condition called sphenoiditis.

What causes sinusitis?

Fungi, Bacteria and viruses can be a cause of sinusitis.

Any affection of the nasal passages that cause it to swell can affect the opening of the sinuses. If the ostium (opening) is blocked, air and mucus secretions collect and cause pressure on the sinus cavity walls. This is the main reason why we have pain during sinusitis. Mucus is an excellent culture medium for bacteria and if the mucus is not cleared quickly, bacteria can infect the sinus and an abscess may develop.

If the nasal passages are swollen extending to the ostium of the sinuses, air cannot enter the cavity and a vacuum is created. This causes the mucus membranes to be “tugged” away from the bones they line and hence produces pain.

Mary Wei answers:

Sinus related pain evolves from the inflammation of the mucosa leading to pressure and congestion within the sinus cavities. Depending on which sinus cavity is affected, the pain may be felt in the upper teeth or between the eyes, in your ear, on your forehead, jaws or cheeks or other part of your face. With a severe bacterial infection there is a possibility that more than one sinus cavity can be affected.

Often, many people may experience pain in their ears when there is eustachian tube dysfunction arising from an ear infection and their teeth in the upper jaws when there is maxillary sinus infection. (Maxillary sinusitis can cause your upper jaw, teeth and cheeks to ache and may be mistaken for toothache.)

Such pain can last for a few days or run into several weeks.

You should first finish the medication and if the pain still persist, you can try visiting an Ear, Nose, Throat (ENT) specialist who should be able to diagnose your condition accurately if those pain are sinus related. And if they are caused by your inner ear.

Mary Wei answers:

Acute sinusitis:

1. Ethmoid sinusitis (behind the eyes)

a. Nasal congestion with discharge or postnasal drip (mucus drips down the throat behind the nose)
b. Pain or pressure around the inner corner of the eye or down one side of the nose
c. Headache in the temple or surrounding the eye
d. Pain or pressure symptoms are worse when coughing, straining, or lying on the back and better when the head is upright
e. Fever is common

2. Maxillary sinusitis (behind the cheek bones)

a. Pain across the cheekbone, under or around the eye, or around the upper teeth
b. Pain or pressure on one side or both
c. Tender, red, or swollen cheekbone
d. Pain and pressure symptoms are worse with the head upright and bending forward and better when reclining
e. Nasal discharge or postnasal drip
f. Fever is common

3. Frontal sinusitis (behind forehead, one or both sides)

a. Severe headaches in the forehead
b. Fever is common
c. Pain is worse when reclining and better with the head upright
d. Nasal discharge or postnasal drip

4. Sphenoid sinusitis (behind the eyes)

a. Deep headache with pain behind and on top of the head, across the forehead, and behind the eye
b. Fever is common
c. Pain is worse when lying on the back or bending forward
d. Double vision or vision disturbances if pressure extends into the brain
e. Nasal discharge or postnasal drip

http://www.emedicinehealth.com/sinus_infection/page3_em.htm#Sinus Infection Symptoms

Mary Wei answers:

Its definitely a sinus infection. Whether it is frontal, maxillary, ethmoid, or sphenoid will have to be the doctors call. Go back to the doctor and have him check it out, he’ll be able to prescribe something to ease the pain and get rid of it.

Mary Wei answers:

It sounds like a sinus infection. Is it tender to touch right under your cheekbones? The fact that your teeth are tender is also suggestive of a maxillary sinus infection.
Do you have a fever? A ct scan will show you some characteristics findings suggestive of a sinus infection, but it wont narrow the organism for you. That can only be done with a culture. That might also explain why antibiotics didnt work for you, as you may be infected with an organism that the antibiotic didnt cover. I dont know what the protocol is where you live, but in the United States, if amoxicillin doesnt work the first time, they will usually give Amoxicillin + clavulinic acid, or erythromycin or some other drug. If that doesnt work then they might consider doing an investigation. Ask your doc to change up the antibiotics.

A chest xray will show if you have a pneumonia, or any pathology with the lung, NOT any sinus infections!

Mary Wei answers:

Sounds like it is a chain of swelling/inflammation in your head being set off in different areas.trappingelling is then traping air as it swells and decongests – they do sound related.

Mary Wei answers:

Kenalog Triamcinolone acetonide is known as a corticosteroid hormone (glucocorticoid). It works by decreasing your body’s immune response to these diseases and reduces symptoms such as swelling. . I have suffered from chronic, bilateral, maxillary sinusitis for about 30 years. I have had 4 surgeries and so many X rays that I glow in the dark. I have provided a link below to WebMD. I used inhaled steroids but the major side effects are gum recession and many other issues. I have received Kenalog/Marcaine injections in the past for arthritis and muscle strains. Marcaine is from the lidocaine family (numbing drugs for dental and other uses). Problem is the Marcaine is slower than the Kenalog. The first link below is WebMD (after my qualifications) and you can check out all there is to know about the drug, its uses, and side effects. The second link is to the medical professional version of WebMD, Medscape. I checked the “drug interaction checker” at Medscape and there is no problem using the two drugs concurrently. You can check the Astelin at the WebMD link for side effects.
Question? Have you ever seen an allergist? Having been dealing with sinus problems for 30+ years and dealing with flying personnel (head congestion could cause major complications for fighter pilots) if you are having issues with chroonic sinusitis there is usually a cause. So if you have not done so yet go see an allergist. Sinus surgery is no fun at all. But if the sinus problems persist if it is not allergy related than perhaps your nasal antral window (opening between nostrils and sinuses) is not large enough and you could develop polyps which will cause even more problems. All the answers can be found on the links I have provided for you. If you still have problems feel free to contact me via email and I will gladly address your issues/concerns with you. I highly recommend keeping a diary of symptoms and/or side effects of the medications. It appears as the Astelin Nasl is a basic antihistamine. Your voice could change due to post nasal drip and other problems that are part of life for a sinusitis sufferer. Best of luck.

Mary Wei answers:

You may be suffering either from allergic rhinitis or sinusitis. Both are synonymous, however it still varies. Do you sneeze whenever you encounter dusts, pollens or any allergens such as strong scents or smoke? Well, that would be an onset of allergic rhinitis. In that case, you should take anti-histamines (diphenhydramine, ceterizine, loratidine, etc..) to block the histamine release in your system. It may lead to sinusitis (swelling of the sinuses) which may produce pain and inflammation of the sinus areas (maxillary- around your cheeks; frontal- on your forehead; ethmoidal; or sphenoidal). In a case like this, you should take anti-inflammatory drugs (e.g. Sinutab) and consult your ENT physician right away.

Mary Wei answers:

This seems very odd. Usually it is only the back teeth that are near a sinus. Your second premolar and all your molars are often in very close proximity to your Maxillary sinuses. Front teeth are no where near a sinus so perhaps there has been some miscommunication there. Secondly, it is always possible that a root canal did not go as expected. It needs to be checked. Perhaps by your regular dentist, perhaps by a different dentist. It is never a bad thing and sometimes very illuminating to have an independent second opinion.
And I can’t really figure out why your nose would get all puffy unless you had a colds or something. An x-ray of the root canalled tooth would probably tell you all you need to know.

Mary Wei answers:

It all depends on the total procedure. Was it a total balloon sinuplasty case or a hybrid? Some surgeons will use a balloon for the frontal but a rigid cutting instrument for the maxillary and or sphenoid sinuses. Also, there will be pain associated with an ethmoidectomy. If the surgeon did a total balloon only procedure, then most people are pain free within 24-48 hours. Have your surgeon explain the entire procedure process for you to better understand.

Mary Wei answers:

Many people have heard that there is some connection between toothache and sinusitis, so it is quite reasonable to wonder “can wisdom tooth cause sinus problems”? It is easy to confuse the pain caused by a sinus related toothache and a “normal” dental toothache pain. One indicator is that sinus toothache is often followed up by an infection or inflammation of the maxillary sinuses whereas tooth/gum disease is the usual indicator of ordinary dental pain. In either case your cheeks will be very sensitive to touch. Some of the other symptoms of sinus toothache include facial swelling, fatigue, runny nose, swollen gums and a throbbing headache.
How could a tooth cause sinus problems?

There is a direct connection between the oral cavity and the maxillary sinuses – this is called the alveolar process. An infection of the maxillary teeth can extend up into the maxillary sinuses through the alveolar process. And if there is there no treatment then this might develop into a sinus infection. Often oral hygiene can be the cause of bacteria growth along the gum line and this may itself cause an abscess to form below the gum line. If there is no treatment the abscess-causing bacteria can tunnel up into the cavity of the maxillary sinus and you will have a very severe sinus infection.

It should also be borne in mind that if there is a sinus infection which is untreated it can be difficult to keep a good standard of dental hygiene. This is why in many cases of bad breath (halitosis) the culprit is a sinus infection because sinus drainage is falling into the mouth.

Also, a variety of studies have indicated some correlation between sinus infections and impacted wisdom teeth, dental work which is not complete, tooth cavities and fracture of a tooth or Crown.

If the cause of the pain is dental in nature you should visit the dentist immediately. However, if it appears that a sinus infection is the cause of the pain then a variety of treatments is available, which do not involve the use of harsh drugs. More details are available on the website link below. When the answer to “can wisdom tooth cause sinus problems”? Is yes, in other words a wisdom tooth might be the cause of sinus problems, dental treatment may not be the complete solution. This is because the secondary infection created in the sinus area (sinusitis) will still need to be resolved.

Mary Wei answers:

Maybe you should ask the neurologist who ordered the CT scan. Are you having some kind of symptoms?