Expert: Tony Appleton BDS DPDS - 8/15/2007

Question
Dear Dr. Appleton, I have had pain which seems to originate in my next to last molar (not counting wisdom teeth, which are gone). This pain goes from my tooth, into my sinus on the right side, and into my eye socket at times. Cold doesn't seem to trigger the pain, but heat definitely does. I have suffered from migraines for over thirty years and I have sinus problems b/c of many allergies as well. My dentist has xrayed this tooth and says there is nothing visible on the xray (such as infection or inflammation), but wants to do a root canal anyway. I would like to be sure that the tooth is actually the problem, and that this isn't just sinus or migraine pain. I've had pain all the way into my jaw from migraine many times, but this really seems to originate from the tooth. Can tooth sensitivity (from a tooth that needs a root canal) actually trigger migraines? Please help. I don't want to have a root canal if the problem is not from the tooth. Thanks. Mary

Answer
Hi Mary

This can be a difficult one! Generally if heat triggers the pain it indicates that the pain is coming from a dead/dying tooth pulp, and often this will not show on an x-ray for some time.

However, your history of sinus trouble/migraine really complicates the issue.

If you aren't comfortable embarking on root canal just yet, then you could wait a while and see if any changes become evident on an x-ray that would confirm the diagnosis.

Regards

Tony Appleton