Expert: Frederick R. Liewehr DDS, MS, FICD - 12/10/2009

Question
For some time I've had some discomfort in the vicinity of my left cheek and upper teeth, accompanied by a stuffy, pressurized feeling in that area. I've been relieving the symptoms with nasal irrigation and over-the-counter decongestants. Still, the problem persists. At a recent check-my dentist took X-rays and did some tests, including percussion, sensitivity to cold and electric stimulation. None produced pain. I'm wondering if this is a lingering sinus problem or something with a dental origin. At my dentist's suggestion, I've arrange a consultation with an endodontist but, due to her schedule, it's several weeks away. In the meantime, I'd be interested in your thoughts and, specifically, any advice on what I might do to minimize or, preferably, eliminate my discomfort.

Answer
Sounds like sinusitis to me. Have you seen an EENT? Your dentist was looking for a non-vital (dead) tooth. The tests are not supposed to produce "pain" per se, they are simply testing for nerve function. The percussion test is most significant for sinusitis; if you have several teeth that are tender to percussion, that usually indicates sinus issues, particularly if they are pneumatized on the radiograph, which is to say that you can see the sinus dipping down to encompass the roots of the tooth. It is a bit complicated to explain, but sounds like your dentist was on the right track. An endodontist should be able to perform this diagnosis also.