Hi Magi,

It is difficult for conventionally trained dentists to think outside of their basic training. Unfortunately, they are not taught about the whole body connection, they are taught to be tooth carpenters. Unless they have sought additional education about how the teeth/oral health affects the rest of the body, they rarely look past the "tooth" of the matter.

Perhaps you misunderstood him or he misspoke because it is absolutely not true that ALL teeth penetrate the sinus cavity. If that were the case, then every person who has ever had a tooth extracted would have a sinus exposure....... completely false. In some people, the upper posterior molars are in or near the sinuses. In others, there is little to no correlation between the teeth and their sinuses.

The teeth and sinuses can be in close proximity for a variety of reasons.

1) Rarely but sometimes large sinuses and/or long rooted posterior teeth in healthy people.

2) Missing teeth in the upper molar region of the mouth will cause the sinuses to eventually hang lower as they fill up the space that was once a tooth.

3) Normal size sinuses that have become inflammed or infected will swell. As they become larger, they press down on the roots of the correlating upper molars. The inflammation/infection can be severe enough where the membrane perforates and infects the tooth/teeth.

4) The infection from a tooth can proliferate into the sinus through a perforation in the membrane which will cause the sinus to swell.

There is a strong correlation between chronic sinus infections and tooth infection. As there is just as strong a correlation between a tooth infection and a sinus infection. ENT's are more likely to discuss this issue than a conventionally taught dentist. The reason being is because the ENT has performed sinus surgery on people who have had sinus infections that were clearly tooth related.

Yes, there is always a possibility that when #1 or 2 was removed that there was a sinus perforation and due to infection or necrotic tissue left behind, the membrane never closed completely. The fact that you had the other two molars removed indicate that there was some type of infection going on up there 12 years ago. The fact that you still have chronic issues in that area of your mouth along with chronic sinus infections in spite of removing those teeth may mean that you have an unresolved long term infection going on in that area of your mouth.

Our bodies are marvelous at fighting infection. But when a bad strain of bacteria overwhelms a particular site of the body, the immune system cannot ward it off any longer so the bacteria travel in the bloodstream to another area of the body to set up shop there until that area becomes saturated and the process continues. The healthy mouth has over 400 different strains of bacteria, both good and bad. So most oral infections are of a variety of different strains of bacteria and as they grow, new bacteria join in. This is the body's way of continually trying to kill off the invaders but it can only do that successfully for a short period of time.

I would seek the opinion of an ENT who would take a CT scan of the sinus. This may be very helpful in determining the cause of the problem. Make sure you explain your tooth concerns to him because the CT scan ordered for dental/sinus problems is different than a normal CT scan.

I think your intuition is telling you something is not right and to ignore this tooth or treat it with a root canal may not be in your best interest.

Please keep us posted on how you are doing! I know this is very difficult, please try to stay positive and forge ahead with your intuition!!

Bryanna