Expert: Jeff Dalin DDS - 12/15/2009

Question
Hi,
I have seen a dentist and have an appointment with an oral surgeon Wednesday. But I am hoping you may have some ideas as to what is going on with me. I know it is difficult without seeing me but if you could throw some possibilities at me I would appreciate it.

A little over a week ago, I had pain in my lower jaw. It felt bruised, but it wasn't. The next day it felt worse. By the 3rd day I had an almond sized lump near my submandibuler (?) salivary gland that I could feel with my tongue and fingers. Went to dentist, he said my teeth look fine, put me on an amoxicillin "just in case."  Last night, I woke up in agony. My whole left cheek was killing me and interfered with sleep. The pain now extends up my cheek and around where my upper lip starts. Not alot of swelling, just major cheek pain. My mouth is not dry and it seems to stay the same through eating so I am not thinking a blocked salivary gland. When I open my mouth all the way, my cheek feels extremely sore.  When I look with a flashlight, it looks normal.  If my teeth are fine, what other things could it be?  And is an oral surgeon the appropriate doctor to see?

Answer
i wonder if this could be some sort of masseter muscle pain (people call the whole are the temporomandibular joint area or TMJ). sometimes it can spasm and cause a great deal of pain. you mention no tooth pain or swelling so that kind of puts the abscessed tooth on a back burner. start with an xray to rule out anything with your teeth...nerve, cavities, gum problems. then have the surgeon palpate the joint and the muscles on that side. and of course have your salivary glands examined. these are possibilities to think about. good luck...i am glad you will be seen soon so that you can get a definitive diagnosis and put your mind at ease.

jeff dalin, dds