Sinusitis is well recognised as a common cause of headache and the patient with headache should be questioned about recent upper respiratory tract infections or a previous history of sinus disease. Tenderness over the affected sinus is an important sign. The headache tends to begin after rising in the morning and reaches a peak later in the morning. Pain from an infected tooth can be referred over the side of the face and cause some diagnostic confusion but it is usually worse when chewing or biting. Pain from a middle ear infection can cause similar problems. The temporomandibular joint is a recognised source of referred pain over the side of the face, and malfunctioning of the joint can result from incorrect jaw alignment or poorly fitting dentures.
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