Discussions By Condition: I cannot get a diagnosis.

Swollen face related to tooth issues. . .

Posted In: I cannot get a diagnosis. 8 Replies
  • Posted By: Fortuna
  • February 14, 2007
  • 10:52 AM

Hi all :). Just looking for any input on this.

My 15-year-old root canaled tooth became a problem last Friday. Suddenly it hurt like all ***l, and only gobs of Ibuprofen relieved the pain. Being the weekend, I muddled through, though it never let up, and by this past Sunday night (this now being late Tuesday), the swelling began for the first time.

Not my gums, though -- they looked perfectly fine through this whole thing. The swelling developed in the cheek tissue that extends up from the jawline, just in front of the molar in question.

On Monday, I went to a root canal specialist, payed the requisite bloody fortune to have it redrilled, cleaned and replugged, assuming that would put me on the road to recovery. Apparently they weren't able to actually drain anything at that point, though, since the inflamed area was so undefined. That part remains unclear to me -- where the supposed abscess actually IS. The work itself was quite pain-free (old root canals have already had the nerves deadened within them), and the pain I have now involves recovery from the drilling trauma, the nocacaine needle ****k sites, and the swollen cheek area. . . which spread to beneath my chin by this morning, even though I've been on antibiotics since last night.

After my frightened phone call to him, my dentist wanted me to go to the emergency room, since he worried the swelling might continue into my neck, or into my mouth, causing swallowing or breathing problems.

At the ER, they basically just looked at it, said it was not anything they could fix at this stage (???), and that it did NOT appear to be in danger of spreading out of control, but that it might indeed get bigger, for a time. I mentioned that I had read that antibiotics often prove ineffective for inflammations like this, since the areas of swelling can get cut off from the normal circulatory system -- the meds cannot reach the infection -- but the ER doc was not concerned about this. He says to just stay on the antibiotics and wait a couple days to see if things improve.

He called it Cellulitis (based on nothing more than a brief touchy-feely exam), and told me to just 'watch it'. . . . but there's nothing worse than knowing something needs fixing, and being told that all you can do is observe as it gets worse and worse. Or possibly better, ideally. But I was hoping for something proactive, to get me on a path to resolution, rather than waiting for it to worsen.

Here's a description of the swelling: The main site begins at my right lower jawline, just outside where the corresponding molar is located. The swelling spreads up from there, nearly to my cheekbone. The diameter of the 'welt' is about the size of an apricot, and swollen to about 1/2" above the normal skin elevation. It's very tender and achy to the touch, and has a firmess similar to a cystic-type pimple that is still brewing under the skin -- it's located deep within, in other words. The area under the chin is puffy and sensitive, but not of quite the same consistency as the cheek welt. . . at least not yet. There is no drainage point yet, either -- but not to say that won't develop. I think it was this nebulous consistency that kept the root canal doctor from attempting to do any drainage.

The meds at this point are Clindamycin (antibiotic), Ibuprofen as needed as an anti-inflammatory, and Vicodin for the extremes.

Any thoughts on what is potentially ahead for me? I would like to be braced. I've read about surgical solutions, like lancing and syringe extraction of puss (argh!) but cannot find details on what exactly that entails, or how horrid the procedure might be, much less what complications might arise. Is this basically a dental procedure done under novacaine, or something more, where I am under general anesthesia and hospitalized? Do they drain from inside my cheek? Does swelling like this ever 'resolve', as pimples sometimes do, where the swelling dissipates without ever "coming to a head", so to speak?

I would appreciate anything you have to offer. I am quite frightened, anticipating my head swelling up completely :p. . . even though it seems unlikely.

Thank you,
Mia :)

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8 Replies:

  • Although I haven't received any feedback, I did want to follow up, for the sake of anyone who might encounter a similar icky issue.In brief, the abscess under my molar apparently developed over a prolonged period, perhaps a few months, and only became an acute situation as of one week ago. Plum-sized swelling developed in the corresponding cheek and underneath my chin. Even 36 hours after the root canal therapy (flushing out the old canals, disinfecting them, then replugging) the swelling seemed to progress. I went to the ER at one point because it was starting to interfere with swallowing, a frightening sensation, and my dentist thought it best to have a doctor look at the situation. The doctor thought it still looked okay, considering, so I was sent home with only stronger anti-inflammatory meds -- called Methyprednisolone, which I am now taking in addition to Clindamycin (the antibiotic).In the last 24 hours, the build-up of weapons seems to have finally kick in. The swelling was WAY down this morning, which indicates that the fluid/puss/whatever is gradually being reabsorbed by my body, and may require no external draining. Such good news. Now all I'm left with is some bone loss in the jaw, due to the abscess eating away at it. There's a 75% chance that the bone will fill back in, but we'll see.So if you ever go through this, do try to be patient for 4-5 days after initial treatment, since the body needs that much time to really show you it's working on the problem. It can be a long, scary and uncomfortable few days, but disinfectants and antibiotics should be able to get in there and start killing the bacteria. Ice packs may also help calm the worst of the inflammation. Some suggest that hot presses can increase circulation, so I did a bit of that, too -- a washcloth dipped in very hot water and held to the area, continuing for 5-10 minutes, reheating the towel each time it cooled down.Hope that's a comfort to whoever might be as scared as I was :). My best friend throughout the painful portion was Ibuprofen. I never realized what a miracle that was.
    Fortuna 3 Replies
    • February 15, 2007
    • 09:34 PM
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  • Sounds like a horrendous ordeal! I am glad you are feeling better, but also wish to caution you on the clindamyacin: This antibiotic can cause a clostridium difficile infection, which in turn causes pseudomembraneous colitis. PLease, PLease, take a good quality probiotic to help rebuild your intestinal flora. This is your best defense against this infection, which causes horrible diarrhea and can start up to six weeks AFTER the antibiotic use. No one told me this, and I developed c. Diff and thought I was going to die with diarrhea 10-20 times/day! Of course, western treatment is MORE antibiotics, but I declined to take these and went to my acupuncturist who prescribed herbs to clear it up. And they did. Just wanted you to keep this in mind and please take the probiotic to prevent this ordeal! Best wishes,DOM
    acuann 3080 Replies
    • February 16, 2007
    • 06:28 AM
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  • Thank you for that warning, DOM. I will begin taking extra acidophilus starting immediately :).
    Fortuna 3 Replies
    • February 16, 2007
    • 09:54 AM
    • 0
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  • I had the same thing. Just got back from the oral surgeon, gave me 2 prescriptions - 1 for antibiotics and 1 for a painkiller. He also put a drain into my gum. My jaw swelled up over night, had no clue why. I had gone to my doctor, she sent me to the oral surgeon. I even had my jaw x-rayed and a ct scan!
    Anonymous 42789 Replies Flag this Response
  • My sympathies :(, especially if you got the sort of nerve pain I did. It completely froze me -- so intense.I know I've already posted this, but it's worth re-summarizing: Bear in mind that the swelling can worsen for a good 24-48 hours even AFTER beginning the antibiotics (and any anti-inflammatory meds they might give you). My dentist did not seem to be familiar with this reaction, so when the swelling continued under my chin even a day-and-a-half after re-doing my root canal and beginning the meds, he advised I go into the ER, since swelling in the neck can be dangerous and it was seemingly threatening to push into that zone. But the ER doc took one look at me and immediately deemed it typical inflammation, under the circumstances. Great, so I wasted a trip :rolleyes:, and the money -- and, like you, the nurse was initially saying the doc might want to do a ct scan -- when I could've simply been forewarned that swelling may not immediately begin to decrease. It did stop swelling the following day (after the ER), but the existing swelling took 7 full days to resolve. They also failed to make clear to me that it totally WOULD resolve, and not need to be surgically drained (I kept envisioning this horrid puss-busting procedure). Maybe in many cases it does require physical drainage/cutting/popping, but they were very vague about that with me, which only added to my alarm.Second. . . either right near the end of your antibiotics, or immediately after you're done with them, per the advice above, start taking 3x/day of acidophilous/probiotics, for at least a week, so as to get good flora back into your intestinal tract. My antibiotic Clindamycin had me all messed up during the time I was taking it. No painful diarrhea, as DOM noted, but I was definitely pooping constantly :p. The acidophilous began to ease that situation almost immediately.Good luck with your recovery :).
    Fortuna 3 Replies Flag this Response
  • Please do not listen to anything Shula or Acuann tell you. My sister just passed away because Shula and Acuann told her that her doctor was wrong and she did not have a serious condition. Acuann even told her to get acupuncture to get healed. These people are going to be investigated for practicing medicine without a license. Shula and Acuann are specifically wanted in connection with my sisters homocide. Thats right homocide. If she would have listened to her doctor instead of these internet quacks she would still be here today. Rest assured I will do everything in my power to put these two behind bars and shut this website down for good.
    Anonymous 42789 Replies Flag this Response
  • I have a tooth that hasn't been pulled due to medical insurance giving the run Around and being mother of 5 I can not afford the cost of extraction. But the nerve finally died and I forgot about it. Well three days ago, I woke up and my face was swollen. From my upper check near cheek bone. I went to the ER. The Dr. Looked gave me kflex.Today swelling spread up to my temple. I went back to the ER. I informed this Dr about the dead tooth my but no swelling or anything in my mouth. Dr said he believes this is unrelated due to where the swelling occurred. He said probably a bite or pimple or ingrown hair. He gave me a local aesthetics, and then took a 16 needle syringe and tried draining it.by running the syringe near the skin surface threw one entry point located in the middle of my face near my ear all the way past my eye. Several times but about a normal pimple amount came out, the doctor said that's almost nothing.He thinks by adding a new anti.with the old one will work. I'm worried.
    Anonymous 1 Replies Flag this Response
  • Hello! So I am currently swollen to the size of a baseball and am in need of a root canal. My dentist prescribed me clindamycin as well and Vicodin too. I stopped taking the Vicodin because it wasn't doing much and is very strong on my stomach. Ibuprofen doesn't seem to be helping... Last night I ran a fever of 102 and had the chills all night until I puked and felt a little better. I'm worried but my mother says it's just swelling from the infection. I get my root canal Tuesday and the pain has stopped I just can't eat or feel the right side of my mouth due to the swelling...any suggestions? (I look scary and I'm just a tad bit worried..)
    Anonymous 1 Replies Flag this Response
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