Odontogenic Causes of Sinusitis and Cone Beam Diagnostics

On May 7th of this year, the University of Pittsburgh School of Medicine for Continuing Education in the Health Sciences & Department of Otolaryngology held their 5th Annual Update in Sino-Nasal Disorders and Allergy. One of the topics discussed was "Clinical Assessment of Dental Pathology for Otolaryngologists and Review of Emerging Dental Imaging".

With the recent addition of the 3D cone beam imaging, a new technology for the dental community, dentists and periodontists have been able to radiographically diagnose periodontal or endodontic problems that may be causing, or contributing to, unresolved or difficult to treat sinusitis in patients.

The trend for the future may be for dental / periodontal practitioners who have cone beam to work hand-in-hand with ENT's and doctors, helping them to be on the lookout for dental issues such as periodontitis and possible endodontic (root canal) issues that may be a possible cause of sinusitis. It is suggested that there may be value in physicians referring their patients for dental or periodontal evaluation, if there is evidence of dental problems. Indications could include:

1) Red, swollen or bleeding gums
2) Extensive dental work, crowns, root canals or large fillings in the upper molars
3) Sensitivity to chewing, temperature or percussion in upper molars

A simple examination to detect potential dental issues can be completed by a physician in 5 minutes, and the instruments needed to do so are few and inexpensive. Some questions that will guide the examiner are:

1) Is there any tooth discomfort? When did it start? What prompts it? Was any treatment rendered?
2) When was the patient's last dental exam? How often do they see their dentist?
3) Does the patient have any crowns, large fillings or root canals in the maxillary posterior teeth?
4) Is the patient missing upper teeth? When and why were they lost?
5) Was the patient ever diagnosed with periodontal disease? Do they smoke, have loose teeth or bleeding gums?