My Mouth Hates Me: Part 3

This continues the apparently never-ending saga of What the heck is going on with my mouth? and Help me prepare for my 1st tooth extraction.

First, I’ve already contacted my dentist but I just wanted more info because I’m a hypochondriac and scared, even though I know they’ll probably get back to me before anyone here does. I just need to vent.

A very brief version of this particular dental issue: I was having significant pain in my tooth – the 2nd molar (lower left) – and my dentist discovered a crack. She tried to fix it via a drilling & filling, but discovered that the crack went lower than expected; temporarily she put in a filling in hopes that would be enough to prevent an extraction.

That was toward the end of June. Two months later the pain has kept returning on and off, and I’ve been back to the dentist a couple of times for her to adjust the bite via shaping etc. (She noticed that I was biting unusually ‘hard’ on that side, so thought filing away at some of the cusps might ease the pain.)

Anyway, about a week ago we did one final attempt to fix things by reshaping stuff, but it was agreed the next step would be extraction if this didn’t help.

Fast forward to the end of this week, where this tooth’s been hurting me yet again. The pain lessened significantly; however Sunday morning (yesterday) I woke up with a lump beneath the gum-line on outside of tooth. I’m assuming this is an abscess. Of course Googling ‘tooth abscess’ resulted in my learning that I’m apparently destined for a brain infection and death. (Well, not exactly, but that’s the worst-case scenario, and that’s where my doom-laden mind takes me.)

I just texted my dentist’s emergency line & the dentist said he’s calling in a prescription for antibiotics I can get in the a.m. He told me not to lose sleep and I shouldn’t be scared–“a brain infection is possible, but so is lightning.”

My question: is he right? Also, what is the next step? He didn’t mention following up or anything, which seems odd (then again it was just texting). But I assume I should be making an appointment to get this tooth properly taken care of, because antibiotics won’t actually heal anything, will they? The meds’ll prevent it spreading (which is great) but the problem still exists. Should they be trying to fit me in ASAP to handle this? I’m just worried he’s not taking it seriously enough. Or am I being too paranoid?

I should mention the lump has a dull ache/pain if I move my cheek or touch it with my tongue, but it doesn’t hurt otherwise; the tooth itself feels uncomfortable but not painful at the moment.

Anyone have experience w/dental abscesses?

Well, I had an abscess in the vicinity of #10 (upper left-most incisor), on the palate side, that was there for about two years because I was too scared of dentists to deal with it. Then when it got really bad, I finally got it taken care of. They surgically removed the abscess, using local anaesthetic (dammit, I’m NOT going to look up again the correct spelling for anaesthetic!) and root-canaled the tooth, but they didn’t have to pull it.

So that was a lot closer to the brain that what OP seems to describe, and my brain didn’t get infected and they didn’t have to amputate my brain. (At least I don’t think they did. If they did, would I know it?)

Hey choie, sorry things are still a problem with that tooth.

Use the antibiotics and also place heat on the area and then don’t fret about a brain infection. It is very unlikely especially on a lower molar. An infection in your neck would be the more likely spread path and that is also extremely rare in these situations. Never seen either in 28 years of doing dentistry. Facial swelling yes, brain or throat infection no.

It (whithout haveing done an exam etc.) does appear the tooth is cracked. Since it is abcessing the best thing is usually extraction.

You are correct antibiotics help with the effects(infection) of the problem but don’t heal it. Call for an appointment as soon as possible. If he can’t see you tomorrow don’t worry a few day wait while taking antibiotics is no big deal.

Whether a dental abscess or an abscess somewhere else, dispensing of antibiotics prior to surgery/extraction is pretty standard. The only time I’ve heard of them skipping straight to the knife was under emergency circumstances (which, regrettably, I have personally experienced). I was once told the rationale behind antibiotics first, then incision/draining but I don’t remember it clearly, something to do with keeping the infection localized. Maybe one of the doctors, or our resident dentist rsat3acr will explain further.

Remember, an abscess is an infection. You’ll be on antibiotics regardless to fight it, so there’s no reason NOT to start them early.

I think your brain would perceive this as having the rest of its body amputated.

With a tooth though, either due to decay or fracture the tooth is acting as a wick taking bacteria into the tissues. Antibiotics help with the abscess but not the cause. If there is a delay in treatment then antibiotics are called for. In this situation if choie walked into my office I’d pull the tooth but not provide follow up antibiotics unless there was a fairly large cellulitis. Since there is a delay in treatment defineately needs to be on antibiotics.

Sort of like a splinter in your finger that festers up. Take out the splinter and the infection goes away. No antibiotics needed.

Years ago dentists were taught to give antibiotics to try to clear the infection prior to extraction because it was incorrectly believed that pulling the tooth force the infection into the tissues. Some guys still think this. I have no idea why.

Besides, the infection actually helps loosen the tooth making the extraction easier.

Thank you all so very much! I had a rough night because I’m a hypochondriac and of course had to search for every possible awful thing that could result. I understand a lot of the sites have to emphasize the importance of seeing a dentist and getting treatment asap, but honestly, the way I was reading them they were all “if you can’t see a dentist right away go to your emergency room or your head will fall off!!!” and that kinda exacerbated my concerns. Which is easy to do since I’m already a panic-attack-prone freak with depression, meaning I see doom and despair everywhere anyway. Of course all night I kept feeling my jaw and temple and was certain the pain was spreading. Sigh. It’s exhausting being this crazy.

But hearing (well, reading) your calming and experienced words helps a great deal and has made me get a grip. I’ve picked up my scrip for Amox-Clav (which amusingly is exactly what my cat gets for her UTIs) in these massive horse-sized pills, and have a call in to my dentist. They’ve been very accommodating considering how busy they are and hopefully I’ll get an appointment to get rid of this bleedin’ tooth once and for all this week.

Fortunately there’s actually very little pain, just minor discomfort (annoyance, really–just feeling a small lumpy thing against my cheek) and a twinge now and then. As I understand it’s possible that some of the pain I’ve been feeling might have been because the infection/pus (ick) might have been trapped inside the tooth, and now that it’s ‘leaking’ out to form an abscess, the pain is lessened a bit since the pressure is off? Of course I have no idea if this abscess started inside the tooth or outside it. My dentist will presumably figure that out. But rsat3acr–if I’m reading you correctly, the infection doesn’t have to clear up/abscess doesn’t have to go away before they pull the tooth, right? The meds are mainly to keep the infection from spreading?

Maybe it was a mistake to try and save this tooth rather than be aggressive and yank the mofo; I’ve appreciated my various dentists’ preference to try and use the least invasive treatments to see if they’d solve the problem rather than resorting to losing the tooth. But maybe we should’ve given up on this stupid thing earlier.

Why does a cracked tooth cause an infection like this, usually? I suppose the infection occurs because… what, the crack lets in bacteria? I have felt as if the tooth was almost moving when I pushed down on it… I could almost hear a vacuum-like sound as if there was an air pocket beneath the gum line. That doesn’t happen with any of my other teeth. If there’s room for air there’s room for bad stuff to get in, I guess?

I’d love to know what caused this stupid crack in the first place. I’ve since read that this particular tooth (2nd mandibular molar, I think it’s called?) is actually the most commonly cracked tooth. I wonder why? It’s so strong and big, I would’ve thought one of the smaller teeth would be more troublesome.

Anyway thank you guys very much again, this has been instructional and also calming, which heaven knows I need.

you are correct, the infection does NOT have to clear up before the extraction.

That movement you feel when you push on the tooth, that is what I meant by an infected tooth is easier to extract. the infection is already pushing in the direction we want the tooth to go.

When it comes to extractions, pus is our friend. Yes I am/dentists are gross.

It wasn’t a mistake to try to save the tooth but sometimes we can’t.

Thanks as always, rsat3acr.

I just wanted to let you know I’m having the tooth extracted tomorrow (Tuesday). I just finished the course of antibiotics–500mg of Amox-Clav 2x daily for 7 days–but the abscess is still there. It hasn’t changed in size, which I guess is to be expected? Even though I know it wouldn’t clear up the abscess, I was still hoping it’d magically get smaller.

But I guess the important thing is that it’s not bigger and I have no swelling in my throat or anything (my dentist asked me about that to make sure it seemed contained). However, the tooth feels more annoyingly loose and foreign than ever, which I’m hoping means it’ll be relatively easy for my dentist to remove.

Of course I’m now having more anxiety about this. I have to tell myself to stop googling because everyone has a horror story about someone removing an abscessed tooth and ending up poisoned or dead or whatever, or in some cases the infection preventing the anesthetic from working and thus the pulling caused them intense pain. Argh!

Any last words of encouragement or even warning you can give me, please? Is there anything I should remember to ask? Anything I should have prepared prior to an extraction? I already bought my own gauze and I have an ice pack. I suppose I should pick up some salt for rinsing when a day has gone by.

Help?

I am not a dentist, but I’ve known quite a few people who have had extractions.

They were all fine afterward and felt much better with the problem tooth gone.

That’s not to say everything was fine and dandy. There was pain afterward, yes, but they got through it. A couple had complications but they were MINOR problems in the larger scheme of things and, again, everyone got better and healed up.

It’s OK to be anxious or scared, in fact, it’s kind of normal under the circumstances. If you have someone to talk to in real life or, better yet, pamper you a little for a couple days please take advantage of them.

You can also come here to rant, whine, or just update us on what’s happening.

It’s going to be alright in the end.

I have the least-interesting tooth-removal story ever.

I had a root canal fail – I was grinding my teeth at night, and apparently I’m part pit bull and ground so hard the root cracked.

This is the same tooth that you’re having problems with, I think. It’s a big one, #19 in the US numbering system, IIRC.

Anyway, my dentist turned on the nitrous (I am a dental whimp), numbed the area, and got to work. He removed the tooth in sections, as it was large had deep roots.

It wasn’t any harder than a large filling.

I went home and took the pain meds he gave me.

I did manage to get dry socket the next day. It was uncomfortable but not terrible. I called my dentist, he saw me right away and fixed things up without any fuss.

It’ll be fine and you will feel much better once it’s done.

Fingers crossed for you.

Thank you Broomstick and GrumpyBunny. My goal is to have just as boring a tooth-removal story as most people. :smiley:

I do appreciate the encouragement and the stories/suggestions. I know it’ll likely be fine, it’s just I’m a general nutcase with major panic/hypochondria issues, and those aren’t a great combo for any new medical procedure!

Very coincidentally, the abscess seems to have leaked/burst/whatever last night, because today it’s suddenly gone, albeit with some roughness to the area. I hope my dentist believes me that it existed! I don’t want to look like an even bigger hypochondriac than I am. Or as if I have some dental version of Munchausen Disease.

Anyway, 1 hour to go. Thanks again guys.

choie, I don’t think that ***anyone ***has dental Munchausens!

Maybe the Bill Murray character in Little Shop of Horrors? :slight_smile:

Well, it’s over with, and it was hilariously nothing. Of course as I say this, I’m aware the anesthetic hasn’t worn off yet so it’s easy to shrug off. But the dentist gave me a topical to prepare for the needle, waited ten minutes; he injected me, then about 10 minutes later he started. And as he was pulling and pushing things around (felt nothing but pressure) I was still girding myself for the moment when he’d “snap” something or I’d hear bone crunching or whatever. But after maybe ten minutes, he stopped pushing and then said: “Okay, all done.”

I was like, “what? You’re kidding me.” But nope. Not only didn’t I feel pain, I didn’t even feel the tooth leaving the bone, which he removed a little bit of too apparently. How is that possible?!!

Anyway this will be of interest perhaps to rsat3acr, but my dentist said that “The tooth was awful. Very bad infection to the bone. Definitely good that we removed this.” He said he removed the infected parts and I didn’t need further antibiotics, which surprised me. But I’ll tell you I’m very very glad to hear there’s finally an explanation of the pain I’ve been in for two months. Kind of annoyed that it couldn’t have been caught earlier, but I guess infections don’t show up on x-rays.

All I have is gauze and instructions to use Ibuprofin / Tylenol combo for pain, plus an ice pack. And of course the necessary soft foods/don’t rinse for 24 hours/salt-water instructions. Oh, I have a couple of tea bags too, since I hear they’re good for clotting if the gauze doesn’t help after a few hours and I’m still having issues.

If anything my jaw is hurting from having clenched down on three different gauze pads for so long. But 90 minutes later I’m still not in any dental pain. I have a feeling when it hits, it’s gonna be a doozy!

So hopefully this will be the end of this relentless and unfathomably boring saga of The Evil Tooth. (Well, the tooth is gone so the only thing left is the socket causing problems; fingers crossed. I suppose something bad could still happen, so I don’t want to put a jinx on things.)

Thank you very much to everyone!

YAY! Tooth is out! Like I mentioned in the other thread, once the decayed tooth was out, my mouth went back to normal. I didn’t chew on that side for a week, but I had no real pain even after the anesthetics (and I had to go under general) wore off. I did still had some pain meds twice a day, for day and sleep, for a couple of days, and then stopped.

Also, like what was mentioned before, I was given antibiotics before the surgery. In my case, it was to be delayed by almost a month, so I saved the script until it became really painful (and swollen!) and then just used the sweet drugs. While I was on the antibiotics, the swelling and pain decreased. Luckily I only had to do that for one week before they finally extracted the tooth. Oh, and the reason I didn’t go earlier was because I was on a trip out of the country. :slight_smile:

I hope your mouth does like mine and goes “Woohoo, nasty tooth is out, celebrate!” and comes back as if nothing.

Take some Tylenol/Advil to get ahead of the pain for when the local wears off. Easier to head it off than to end it.

Glad it’s turning out to be easier than you thought!

The hypochondriacs I know who manage to overreact the least have a strict no-google policy when it comes to their medical issues. Is this something you could consider? Anxiety makes *nothing *better.

choie, sorry I didn’t see your yesterdays post until now. Glad it is over. Even though it is late now listen to GrumpyBunny, always take pain meds prior to the anesthetic wearing off.

Yeah, when I had surgery on my face I had local anesthesia and was awake the whole time. Felt no pain whatsoever during the surgery but I sure did the next day!

ALWAYS better to medicate before the pain gets cranking. Especially the first couple days post surgery/extraction do NOT try to “tough it out”. Be a wimp - you’ll feel better and sleep better, and you need your rest to heal.

Hey guys and thanks as always!!! Yes, I promise, y’all better believe I took the first of my Tylenol/Advil alternating cocktail as soon as I got home. The pain didn’t start until about two hours later (I was still using the gauze and putting pressure on the area, and that was definitely hurting the bejeezus out of me!).

Fortunately once the bleeding slowed/stopped and I was able to stop changing the gauze, it’s since calmed down considerably. Still hurts but a dull ache… sort of feels like a sore throat, in a way. I think I’m just used to having sore throats so pain that far back is registering in my brain as that “oh, must be a sore throat coming on” kinda feeling. I can take the next dose (back to Tylenol now) at last–I’m doing Tylenol or Advil every three hours. (The Tylenol is just the OTC version. I actually still have the prescription Tylenol w/Codeine they gave me from nearly two months ago, but I’ve read that the Tylenol/Advil combo is actually better for toothache pain, so I’m not bothering with the ‘harder’ stuff.)

I’m about to chance my first meal, which will just be cottage cheese and some mushed-up bananas. After that, pudding! Oy, I have officially become my grandmother. :smiley: