I received an after hours emergency call yesterday afternoon from a long time patient. He complained of pain on his upper right side and said anti in flammatory meds have helped but he was still concerned. I told him to come into the office asap and I would take a look. Upon examination of the upper right side there was no swelling of the face or gums. The patient had a crown with a root canal done 5 years ago. There was no mobility or break in the tooth. The crown was stable and healthy. There was slight tenderness to percussion, or when tapped on but not when chewing food. The patient did admit to having aggressive sneezing lately with discharge and water in the ears. I re assured the patient that his tooth /teeth were stable. I was suspicious of sinus involvement because of the lack of dental findings. Also, the maxillary sinuses are located above the roots of the posterior upper teeth. If there is ever any fluid build up or irritation of the maxillary sinuses it can manifest as a toothache. I recommended that the patient seek evaluation and treatment of the sinus cavity to help rule out dental involvement. In my experience dental pain in the posterior segment with limited clinical findings associated with sneezing, nasal pressure, cold and flu symptoms is usually sinus related. If we proceeded with some kind of dental therapy without further investigation we might have compromised the long term health of the tooth.  After the sinus evaluation I recommended we still follow up to re evaluate. The patient was grateful for the after hours attention and recommendation. Dentistry is not a 9-5 job. We owe it to our patients to be available in their time of need whenever possible. I have always made myself available to the emergency needs of my patients.