How Urgently Do We Need Urgent Care?

July 21, 2014 3:16 PM

Posting on behalf of my partner, whose bad tooth has worsened: the crown's gone. They're experiencing a throbbing headache towards the back of their head, "behind the eyes." While the pain has been off-and-on for a while, the last two days have been tough to get through. As of today, they also have a combination of pain/stiffness in the back of their neck.

So, we want to know - how bad is this? Is this an imminent threat, or do we have time to schedule with a private practice? We have a practice that we'd like to use: I have an oral surgeon who's done all of my wisdom extractions, and does a terrific job from screening to post-procedural care. But we're concerned about the neck stiffness. My partner's neck is also kind of flushed, even though they're not warm. Does anyone have experience with this?

Partner (very) recently acquired insurance through the Affordable Care Act, if that helps.

Thank you in advance for your answers!

posted by Ashen to Health & Fitness (15 answers total)

Throbbing headache along with pain and stiffness in the neck, with flushed skin in the stiff/sore area, most likely spreading from an infection starting in the mouth?

Urgent care. Immediately. Like, go now.
posted by erst at 3:20 PM on July 21, 2014 [22 favorites]

Oh! I had a variation of this. My wisdom teeth stayed in (are still in, actually) and got infected. I had terrible pain. I googled "emergency dentist," made an appointment, paid $50 for the visit (it was just a regular dentist who fit me in last-minute), did a 10-day course of antibiotics. Mine had the same type of off-and-on pain and then became pretty terrible towards the end.

Honestly, it will only get worse so even if you can wait, you really don't want to. It's terrible pain, and infections in your head are nothing to mess around with. I'd call the advice line of your partner's new insurance ASAP and see if they need a dentist or another doctor, but go go go.
posted by c'mon sea legs at 3:25 PM on July 21, 2014 [1 favorite]

The mouth is seriously the nexus of so many things. Don't chance this. Urgent care, stat, then follow up with private practice.
posted by Hermione Granger at 3:25 PM on July 21, 2014 [1 favorite]

Who put in the crown? Call them NOW and communicate the urgency. Because that is an urgent situation. Don't wait please. It only gets worse from here.
posted by guster4lovers at 3:25 PM on July 21, 2014 [1 favorite]

This is an emergency and can get dangerous fast. Please go see a dentist ASAP.
posted by quince at 3:27 PM on July 21, 2014 [4 favorites]

People have died from tooth infections.
posted by showbiz_liz at 3:28 PM on July 21, 2014 [5 favorites]

Their insurance may have an advice nurse phone number to call.
posted by aniola at 3:36 PM on July 21, 2014 [1 favorite]

so, if this is truly urgent urgent urgent, and it is after hours for every dentist near us, should we go to the emergency room? I've heard horror stories about the ER mistreating Dental cases and charging massive amounts to mess up your mouth, frankly I'm very reluctant to go there. I was going to go to a dentist tomorrow morning, but if that is not okay to wait, is the hospital okay?
posted by Teddle at 3:43 PM on July 21, 2014

Yes. You need to be on antibiotics at a bare minimum, and fast, just in case.
posted by hollyholly at 3:47 PM on July 21, 2014 [1 favorite]

Best answer: If I were you I'd go to an urgent care place and get on antibiotics. Your fears aren't unreasonable, but they can't do dental surgery on you without your consent!
posted by showbiz_liz at 3:49 PM on July 21, 2014 [2 favorites]

Best answer: Yes, go to urgent care to get started on antibiotics and get the infection evaluated. Get to a dentist to fix the crown later.

Worst-case scenario, you're describing the beginnings of bacterial meningitis. Best-case scenario, you're describing a dental abscess with a spreading infection. Either way, antibiotics are likely needed ASAP.
posted by erst at 3:50 PM on July 21, 2014 [6 favorites]

Best answer: Went to urgent care a few weeks ago for a similar situation (dental pain so bad I couldn't even sleep). Skipped the dentist due to lack of dental insurance, urgent care set me back ~$75 + antibiotics. I just told them I had an infection and needed some antibiotics, no one batted an eye. Two days later went to an oral surgeon to get my tooth removed, he told me my infection was a Very Bad Kind but I didn't have to worry since I was already on antibiotics.

So yeah, do what you can to get some antibiotics.
posted by soma lkzx at 4:06 PM on July 21, 2014 [1 favorite]

To the ER immediately.

There are kinds of Strep living in the mouth that can get in the bloodstream and cause meningitis.
posted by jamjam at 4:08 PM on July 21, 2014

Response by poster: We're sitting in the ER. Thanks, everyone!
posted by Ashen at 4:26 PM on July 21, 2014 [7 favorites]

Best answer: Emergency departments are staffed by doctors, not dentists, so they generally don't do any sort of dental procedure other than a dental block (injection of anesthetic to numb up the tooth for 6ish hours). Then we put people with dental infections on antibiotics and advise them on pain control, and refer them to a dentist. If you go to a big academic center they may consult a dental resident or oral maxillofacial surgery resident to see you.

But a straightforward dental infection is not the only possibility for what could be causing you headache and neck stiffness, so, just waiting and going to the dentist may not be a good bet because of that.

I know you're already at the ER, just wanted to support your decision and to clarify the usual practice in contrast with the rumors you've heard. Source: ER doctor.
posted by treehorn+bunny at 4:58 PM on July 21, 2014 [20 favorites]