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Sinus, TMJ, headaches, pain while eating, infected root in sinuses, on imetrix, history of migraines. Treatment ?

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Internal Medicine Specialist
Practicing since : 1998
Answered : 1579 Questions
My question had to do with sinus and TMJ problems. I recently have had severe headaches and I went to my oral surgeon because I felt it was because of TMJ because it would get really bad after I would eat something hard like nuts.. I would hurt for days. He found that I had an infected root up in my sinuses and he did a sinus floor patch. I am still having pain after weeks after this when I eat. He said my TMJ is mild. I woke up one morning to black stuff all over my tongue and teeth. What could this be? I am so sick of the headaches and noone can seem to help me. I do take Imetrix for migraines and this is not a migraine. It hurts above my ear, into my eye, the back of my head, and it is severe.

Posted Thu, 3 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Jasvinder Singh 45 minutes later

Thanks for posting your query.

You have mentioned that you found black stuff all over your teeth and tongue and recently you had a sinus floor patch. This raises the possibility of an underlying infection and the presence of a hematoma discharging blood or pus of the floor patch after the surgery.

Infection, inflammation and hematoma formation are common side effects of this procedure and this could be responsible for the pain that you are having.

You need to get a CT scan and a culture sensitivity of the discharge (black discharge) from the area to confirm the diagnosis.

Second possibility is of TMJ (Temporomandibular Joint) disorder but this possibility can be thought of only after the possibility of infection/ hematoma have been ruled out. You can apply warm compresses to the joint and take anti inflammatory pain killer drugs after consulting your doctor.

A physical therapist can also be approached as craniosacral therapy to relax the muscles and fascia of the jaw is very helpful in relieving the pain. You can use the day and night splints for TMJ. In addition, biofeedback instrument such as a biofeedback headband also helps at night.

Reconstructive dentistry, Arthrocentesis (joint irrigation), Surgical repositoning of jaws and oral surgery (as last resort) can also be tried.

Hope this answers your query.

If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your follow up queries.


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