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Just Dental Truths!
Just Dental Truths!, Dentist
Category: Dental
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Experience:  29 year clinical Practioner
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Just came from dentist. Been having horrible pain in jaw.

Customer Question

Just came from dentist. Been having horrible pain in jaw. xray showed infection of wisdom tooth and outside in jaw area. Gave me zpack. Will start taking it in one hour once its filled. but dentist scared me saying infection outside body and it can kill me!!!! I already have anxiety issues so this didnt help..tomorrow see surgeoon...can infection spread as dentist told me when she suggested to go to ER since face swollen? needed a follow up with justanswer dentist but didnt give option so restating it ... I havent started taking antibiotics yet but will in the next hour ..not filled yet..but I am concerned that some said the face swelling is a bad sign... I dont think I have a fever...just pain and swelling so I dont know if I should wait and take the antibitoic ORRRR is this is a life and death where I should go to the ER!!!! Very scared and nervous......
Submitted: 7 months ago.
Category: Dental
Expert:  Just Dental Truths! replied 7 months ago.

Ma'am, I typed an answer qbout 45 minutes ago. Perhaps you didn't get it. So I'll re type it:

I would get the antibiotic, as it will, in time, bring down the swelling almost always.

I'd hoped you received a pain medication prescription as well, as you sounded like you may well need it, understandably.

I'd NOT go to the emergency room. Let me repeat, no ER! Why? They seldom have any Dental staff on board to do anything, and Physicians won't touch it.

So what would I recommend?

1) Somebody said something to get you 'too worried', and worked up! Such as YOU WILL DIE or something. This is NOT TRUE! The tooth & surrounding tissue is uncomfortable and very, very annoying, but this TOO will pass - I promise!!!

2) I'd suggest either going to a Dentist you prefer that could/would extract it, or an Oral Surgeon. One of the two can extract the wisdom tooth and things then, will only improve and more rapidly...

3) Remember, the x-ray shows that there is infection around the wisdom tooth, coupled with infection that involves 'understandably' the surrounding tissue of bone and soft tissue, but that is typical and normal. So, do not let what this Dentist said earlier today get you amped up - you will not die or anything weird. I PROMISE YOU!

THE BOT***** *****NE:

A) Take the antibiotics

B) Take pain medication, as needed, if you have it

C) Have the wisdom tooth extracted by an Oral Surgeon or Dentist who wants to take it out (whom you feel comfortable with). But not with someone who says the tooth is "going to kill you", because it ISN'T!

I hope this helps you...

Dr. Rampton

*I've taken out thousands of infected wisdom teeth. Please remember, people don't die from this, any more than from a bad cold or flu!

Expert:  Just Dental Truths! replied 7 months ago.

I hope you are feeling OK. And, NOT worried too much if any!

Expert:  Just Dental Truths! replied 7 months ago.

Ma'am, just wanted to make sure you got my messages...?

Customer: replied 7 months ago.
this has been a horrible weekend for me. Been dealing with lots of pain in my right jaw since weds and as each day has gone by the swelling on the right cheek keeps getting bigger and bigger extending into the chin area and under jaw this morning! On Thursday I went to dentist who did xray and said my wisdom tooth was infected and gave zpack. Then since swelling kept growing with pain I went to ER Friday and ER doctor changed my antibitic to Clandimycin. They told me to be patient until antibiotic kicks in. Then yesterday I ended up at the ER two times!!! In the morning because of the swelling and afternoon because my hear went into tachy and pvcs after taking antibitic. At ER face more swollen and pain and I couldnt physically open my mouth enough for doctor to see inside so he ordered a cat scan. He told me everything looked good as far as catscan showed and same with blood work and again sent me home telling me to be patient. The second I walked into my home that same ER doctor called me and told me the radiologist contacted him telling him that he had overlooked something. That he saw in my catscan what seems to be a rock in the salivary gland blocking it and in fact didnt think I have a tooth infection but a salivary gland stone causing infection and told me to follow up with ENT and eat sour candy to produce saliva to try to dislodge it. So my questions are these:1. How can a dentist tell me I have a tooth infection and ER doctor tell me no that I have this other thing? Who is more rightly correct?2. I dont understand with all antibiotics I am taking WHY the swelling gets bigger or at least not just stay the same? I am so depressed. I look disfigured and really start to believe the swelling will never go down and I will never look like myself again. Will the swelling go down and away forever? If so when? And was does it keep getting bigger? How does it get reduced?3. Im scared to take antibitics because of tachycardia and pvcs I got yesterday after taking it and this morning again I took it and again I got tachycardia but went away after 1 minute and no pvcs. Is it a reaction to the med Im starting to have or anxiety? Keeo in mind I have been on clandimycin since Friday and havent had any side effects until yesterday and this morning.4. How our salivary gland stones treated if they dislodge on their own? I saw a photo where it shows an operation of the whle cheek, all skin peeled off? Is it that drastic?
And ER doctor said catscan showed no abcess
Thank you!
Expert:  Just Dental Truths! replied 7 months ago.

Well, I'm so happy that you do at least have a proper diagnosis. Because NOW it can be addressed.

In answering your questions above:

1. I can't speak for your Dentist or ER Doctor. I mean I know how you must feel. But from the beginning, the Dentist with the Dental x-ray, thought it was a wisdom tooth infection, right? Now the ER Doctor didn't see anything (initially anyway). And last, the radiologist looking more carefully finally determines they've all missed seeing the Parotid duct (saliva duct) clogged up until just most recently. I am glad that they've found the true problem however. It is NOT a frequent problem, is hard to see, detect, and diagnose, so with all that said, it's difficult, but at least it has now been identified. I'd focus on that & getting this swelling to decrease now...

2. At this present moment, I feel very confident to tell you that some of this swelling is from infection, and some is from a clogged saliva duct and gland. So, I would stay on the present antibiotic. You will get better. And you will get back to looking normal. Yes the swelling will go away totally & soon. The sooner you see someone who can get the stone out, the sooner you will begin to get relief and return to normal. I can't tell you specifics, but you'll feel almost instant relief once the stone is removed, and the swelling will subside, but understandably will take I'd imagine a week or so to begin to look more like yourself.

3. I understand your tachycardia concern/antibiotics. I'm assuming you addressed this with the ER Doctor. If he gave you a recommendation, I'd go by that. If he didn't you'll then have to use your best judgement. If it were me, I'd probably error with taking them (just don't be excessive, of course). Again use your judgement.

4. Here is the BIGGY - assuming the Radiologist and ER Doctor are correct, you need to get the stone out!!! Do as they told you, eating sour candy also things that are sour like grapefruit juice, etc., but these things are only possible helpers over a weekend. They have a 10% chance of working, so try them. But what you likely will need come Monday morning is to see an Oral Surgeon (dentist/specialist). So try on your own with sour things, possibly the antibiotics, etc., but you'll LIKELY need the services of an Oral Surgeon. They always go through the mouth. NOT the cheek. Often, they can manipulate it out, by palpation (working it out with mild hand pressure) alone. If no, they can open up the small (in the mouth)parotid duct a bit more, and pop it out! If it's going to hurt - he'll numb you, so don't worry about that.

BOT***** *****NE: DO WHAT YOU CAN TONIGHT WITH SOUR DRINK/CANDY. BUT COUNT ON SEEING THE ORAL SURGEON TOMORROW! Explain how this is an emergency situation/ER visits/clogged parotid duct/facial swelling. He or she will work you in one way or another, even if they have to stay late after normal hours. Again, as soon as they get the stone out - you will almost immediately begin to feel relief. The swelling will begin to subside, and you will be back to normal in days/ a week(ish) time frame. Quickly, by all standards. But, you've got to get the stone out - OK? So, if they didn't already tell you that, at the ER, do so immediately as possible on Monday! I'm sending this to you now. Please let me know how things go for you, alright?

I hope you get feeling better ASAP! ( -:

Dr. Rampton

*PS: If it weren't Sunday, I'd get to an Oral Surgeon today. But, I think they are all closed. You could check around for after hour phone numbers on their websites though? But, if no luck, get in to see one on Monday- OK?