Tooth abscesses

May 26, 2005 1:24 AM

This is kind of a big one: Tooth abscesses, wisdom teeth, and finding doctors in Southeast Asia.

Yesterday I noticed a small bump on the gum above my back left molar. It's right by the scar left from where I got my wisdom tooth taken out about three weeks ago. It doesn't really hurt, only slightly when I tongue it (the bump, not the tooth), but it seems like it got a little bigger overnight.

Now, I wouldn't normally ask this here, because the best answer would probably be "we can't diagnose you over the internet, wait a few days to see what it does and then go to a doctor." The problem is I'm backpacking in Southeast Asia (I'm in Thailand right now, and starting tomorrow I'll be in Chiang Mai for four or five days), so it's slightly difficult to just up and go to the dentist.

So... If this is a tooth abscess, what should I be looking for? How soon before I keel over? Could the wisdom teeth operation have anything at all to do with this? Most importantly, how the hell do I find an English speaking doctor in this blasted country?

posted by borkingchikapa to health & fitness (13 answers total)

how the hell do I find an English speaking doctor in this blasted country?

Here
posted by the cuban at 1:28 AM on May 26, 2005

More
posted by the cuban at 1:29 AM on May 26, 2005

Dare I suggest you either consult your own or somebody else's Lonely Planet book. Their stuff is usually pretty good.
When I was in Vietnam last year I had a similar-ish sort of episode (no wisdom teeth extraction though). I went to a pharmacist and bought some amoxicillin 250mg x4 a day x 7 days, over the counter without need for prescription. I don't recommend you do that but if you're in the intrepid category like me then it's a thought to tide you over. A lump with pain would usually indicate some infective process. But of course you know that you have to see someone about it soon.
posted by peacay at 2:09 AM on May 26, 2005

errr.......LP is a suggestion for clinic addresses/trustworthy english speaking dentists .......not about treatment.
posted by peacay at 2:11 AM on May 26, 2005

Chiang Mai is quite a big town so you'll hopefully find some help. LP etc. should have a list of English-speaking pharmacies which might be a good starting point for questions. If it gets really bad and you think you need a dentist even if they only speak Thai, consider just taking an interpreter with you. When I was there there were quite a few people around who spoke really good English and probably wouldn't mind helping you if you throw in some baht. I guess the OTC-drug solution depends on your future plans and monetary resources. Bangkok or whichever big city you will be heading next will have everything you need, but for a price. Good luck.
posted by keijo at 3:28 AM on May 26, 2005

I've had a tooth abscess for a little over 4 years now. It's in a similar spot. You'll find if there is a bump over your molar, it will usually pop and drain, but, yes, you need to get it taken care of. In terms of keeling over, everyone's processes are somewhat different. I have no pain from my abscess, but about every six to eight months it gets so swollen that I have to take antibiotics. From a life threat perspective, the worry the dentists and doctors have is basically confined to erosion of the bone from the material up there and that the infection will spread, but that takes quite a while and in my case the infection is solely confined to the tooth. It's never good to leave the infection there for any length of time and it has impacted my general health, but a couple of weeks should be no problem. (IANAD).
posted by arimathea at 5:04 AM on May 26, 2005

If it turns in to real pain, sipping cold drinks so they wash over the area will make it feel better (the pain of an abscess comes from pressure inside. The cold reduces the pressure) But you'll want that cold constantly!

Peacay's advice for amoxicillin sounds reasonable, but I'd use erythromycin myself, double that dose (high dosage is more typical for tooth infection in my experience). I'm allergic to anything that even thinks its related to penicillin, including stuff the pharma corps claim to be safe.
posted by Goofyy at 5:17 AM on May 26, 2005

I remember after I got my wisdom teeth out the surgeon told me occasionally bits of tooth get left in there and they'll work their way out through the gum. Still go check out the doctors, but maybe it's not an abscess.
posted by schroedinger at 6:33 AM on May 26, 2005

From personal experience, I can tell you that your nearest US consulate or embassy will be able to provide high quality emergency medical care for US citizens.

Good luck.
posted by anastasiav at 7:13 AM on May 26, 2005

Chiang Mai is a large city and has more than a few options. You'll want to start looking for a good private hospital. Poll other farang, the front desk of your hotel, and anyone who appears to be affluent and not a tourist. You'll quickly narrow things down. Call the hospital and make an appointment (this was the hardest part for me, actually). They should have some dentists on staff.

Thai healthcare is generally of very high quality in their private hospitals. Some price control is also in place which makes it very affordable. My dental visit which included a cleaning, two fillings, and a followup checkup was about 40$. You shouldn't have a language problem with doctors.
posted by joelr at 7:58 AM on May 26, 2005

I live in CNX. I can reccomend Grace dental clinic - west end of town, big color ads in free mags, eg. Chiang Mai Citylife.

Also the dental clinic at Ram I (One) hospital, northwest corner of the moat.

CM University has a dental school. Many of the profs keep hospital or private clinic hours. Most speak English.

You'll be fine here!
posted by jaruwaan at 8:55 AM on May 26, 2005

Yeah, Chiang Mai is big enough, Bangkok is obviously big enough, and most places will have enough meds to cover you if you have to travel for real help. If you end up in Saigon/HCMC, I can direct you somewhere there.
posted by fionab at 9:48 AM on May 26, 2005

I second Chiang Mai's Grace Dental (out past Kad San Kaew "Central"). I'll be going there for a check-up in a couple of weeks myself. Much cheaper and better service than nearly any dentist I've been to in the states. So impressed with them, I actually sent them a thank you card. And, if I recall, there's usually no need to book far in advance for an appointment. Just call and they can generally fit you in the next day if not earlier.
posted by blueberry at 1:03 AM on May 29, 2005