Expert: Mark Bornfeld DDS - 3/29/2007

Question
I visited the dentist on Saturday for a simple filling (top right section of mouth-3rd molar from the back). He injected my mouth in 3 different areas. The first 2 - no problem, the 3rd injection in my cheek area I experienced a warm sensation and my cheek swoll up to the size of a golf ball. He only mentioned it in passing (I was not aware until after he completed the procedure how bad the damage was) and continued. After the procedure he told me to ice it. I went to my internist and now I am on amoxcillin and naproxen. The swelling has gone down a bit, but the swollen area is painful to touch. My dentist is aware but has been of no assistance in helping to figure out what went wrong so I can be treated. He used lidocaine 1:100,000 which he has used before and I did not have this terrible rxn. I am trying to figure out what went wrong so I can return to my normal self.

Answer
Dear Ms. Kelly,

If the swelling was the direct result of the anesthetic injection, you most probably sustained a hematoma-- internal bleeding as a result of injury to the maxillary artery from the needle (this is probably NOT a reaction to the anesthetic medication itself). In a few days, this may or may not further manifest itself as bruising or discoloration of the face or neck. There is no special action that should be taken; the antibiotic is a good measure to prevent infection.

It is also possible that you may have had some air forced into the tissues from the air drill-- a so-called cutaneous emphysema. This is likewise a benign condition that will resolve on its own.

This event was probably a fluke, and will not necessarily ever recur with dental treatment in the future.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY