Editing Sinusitis (section)

===Acute===
Health care providers distinguish bacterial and viral sinusitis by [[watchful waiting]].<ref name="pmid25833927"/> If a person has had sinusitis for fewer than 10 days without the symptoms becoming worse, then the infection is presumed to be viral.<ref name="pmid25833927"/> When symptoms last more than 10 days or get worse in that time, then the infection is considered bacterial sinusitis.<ref name="pmid17761281"/> Pain in the teeth and bad breath are also more indicative of bacterial disease.<ref>{{cite journal | vauthors = Ebell MH, McKay B, Dale A, Guilbault R, Ermias Y | title = Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusitis and Acute Bacterial Rhinosinusitis | journal = Annals of Family Medicine | volume = 17 | issue = 2 | pages = 164–172 | date = March 2019 | pmid = 30858261 | pmc = 6411403 | doi = 10.1370/afm.2354 }}</ref>

Imaging by either X-ray, CT or MRI is generally not recommended unless complications develop.<ref name="pmid17761281">{{cite journal | vauthors = Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, Gelzer A, Hamilos D, Haydon RC, Hudgins PA, Jones S, Krouse HJ, Lee LH, Mahoney MC, Marple BF, Mitchell CJ, Nathan R, Shiffman RN, Smith TL, Witsell DL | title = Clinical practice guideline: adult sinusitis | journal = Otolaryngology–Head and Neck Surgery | volume = 137 | issue = 3 Suppl | pages = S1-31 | date = September 2007 | pmid = 17761281 | doi = 10.1016/j.otohns.2007.06.726 | s2cid = 16593182 | doi-access = free }}</ref> Pain caused by sinusitis is sometimes confused for pain caused by [[pulpitis]] (toothache) of the maxillary teeth, and vice versa. Classically, the increased pain when tilting the head forwards separates sinusitis from [[pulpitis]].<ref>{{Cite web |title=Sinus infection and toothache: Any connection? |url=https://www.mayoclinic.org/diseases-conditions/acute-sinusitis/expert-answers/toothache/faq-20058299 |access-date=2025-03-18 |website=Mayo Clinic |language=en}}</ref>

For cases of maxillary sinusitis, limited field [[Cone beam computed tomography|CBCT]] imaging, as compared to [[periapical]] [[radiograph]]s, improves the ability to detect the teeth as the sources for sinusitis. A coronal CT picture may also be useful.<ref name="American Association of Endodontists-2018"/>