Expert: Lawrence Spindel DDS, www.lspindeldds.com - 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
Dear Melanie,

It is really not possible to diagnose via the Internet. Seeing an Oral Surgeon is a good idea. If you presented at my office with your symptoms, I would send you over to my Oral Surgeon for his diagnosis. Since Oral Surgeons receive referrals from a large number of general dentists, they tend to see a greater number of patients with significant oral infections and have can have more experience in diagnosing and treating them.

I will offer some general information that you may find helpful. The swelling in your cheek may be from an infection in your parotid gland. Parotid infections can be painful and tender to the touch. Often a diagnosis can be confirmed by pressing on the cheek and seeing whether any purulence is expressed from Stenson's duct which is in the cheek adjacent to the upper molars.

If your submandibular gland is also involved, you may be suffering from a viral infection and not a bacterial infection, which might account for you infection not responding to the amoxicillin you are taking.



I hope this information is helpful and please feel free to contact me again with any future dental questions you may have.