Discussions By Condition: I cannot get a diagnosis.

Swollen face related to tooth issues. . .

Posted In: I cannot get a diagnosis. 0 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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