Pus and Swelling after Dental Visit
July 22, 2011 10:07 PM   Subscribe

Cheek swelling and pus after local anesthesia and a fairly minor procedure at the dentist. I went back today and he prescribed an antibiotic, but I am still worried. (Grossness inside...)

A few hours after a dentist visit yesterday to have two crowns placed, my cheek has swollen to look as if I am holding a golfball in my mouth, and there is a small hole in my cheek (maybe half the diameter of a normal headphone jack?) near my gumline where pus and blood will expel if I press on the nearby area. The swelling and pus is around the area where the local anesthetic was administered. The dentist had to stop twice to add more anesthetic so I know the area has to be pretty traumatized. The teeth don't hurt even a little bit. It's all in my cheek/jaw/face. I have had the most epic of headaches and light sensitivity since yesterday, but that could be a coincidence. No fever to speak of, but I've been taking ibuprofen since the procedure.

This dentist has been pretty dismissive of my concerns. Today when I went in to have it checked out he said he wasn't even sure if what I have is an infection but that he would prescribe the antibiotics anyway because I am traveling out of the country soon and he didn't want to risk fubaring my travel plans.

I am pretty sure that where there is pus, there is an infection, and so I am glad to have the antibiotics. However, is there normally anything more done for a giant pus sac in one's face? He prescribed me 500 mg of amoxicillin every six hours, 24 capsules.

Of course this happened right as he was leaving the office on a Friday, so it's down to the ER if I have to have anything done until Monday. I am already delaying part of my trip a few days so my face can recover from this but my plans are only so flexible. I am staying with my mom, about to leave the country for three years with minimal visiting opportunities, and this waiting time is basically at the expense of a planned visit to see my father before I go.

Has this ever happened to you? Are you a pus expert? I guess I just want to know if anyone has experienced something similar, and if this treatment sounds okay or if I need to consider dragging myself into the ER. I really don't want to call this dentist because I am pretty sure he'll just blow me off again, if I can even manage to get in touch with him. I am pretty sure their phone number just tells you to go to the ER if you think there is a medical emergency anyway. I did call a nurse hotline and they just told me to call my dentist.

I had an infected finger once and the doctor I saw told me how to drain the pus (no insurance) and made sure I knew to do it in order to get the healing started, so I wonder why it's cool to just let the pus in my cheek hang out there and not do anything about it, but obviously I'm no expert!
posted by ZeroDivides to Health & Fitness (5 answers total)
Best answer: NAD but you seem to be on amoxicillin at a reasonable dose for a reasonable amount of time. Unless you've got something remarkably antibiotic resistant, that should do the job. Give it a day or five.

If it doesn't work, you'll probably notice increasing swelling, discharge, pain or fever. In that scenario your next port of call should definitely be an emergency ward, not your dentist. Your concern if things get worse is an antibiotic resistant bug of some kind and the ER is going to be better tooled up to work out what it is and hit it on the head fast.

On the draining the pus front, my NAD impression is that you shouldn't be doing that until you know that antibiotics haven't worked. And then it's a matter of having a professional do it. That's because it's easy to create further damage, and risk further infection or scarring, by messing with an area that's already wounded.

Finally, if you're really worried, plan ahead by finding out where the ERs are in the place to which you're travelling.
posted by Ahab at 10:52 PM on July 22, 2011 [1 favorite]

Best answer: Happened to me before, after my root canal. I freaked out, called the dentist's office, and they prescribed me some $4 antibiotics. I took them as prescribed and it - literally- immediately went away. Never had a problem with it again.

It hurt like HELL before I got those antibiotics, though. I drove to the WalMart pharmacy spitting weird shit out the truck window the whole way, and I thought I was going to die.

Long story short, take what they gave you and it will be fine.
posted by deep thought sunstar at 10:56 PM on July 22, 2011 [1 favorite]

Best answer: I would give time and the antibiotics a shot for a day or two.

IANAD, but I can also tell you that if you go to the ER and things don't look too concerning, their first line of offense there is likely going to be to throw some antibiotics at you (you already have some) and some painkillers if you need them (are you doing okay with just the ibuprofen?) and then tell you to...you guessed it, call your dentist, they don't spend a lot of time dealing with mouth stuff beyond first-line stuff like that. However, if your possible infection gets worse than it is (increased/weird discharge, fever, more swelling, pain you can't handle with ibuprofen), they can give you a different antibiotic/dose/form or better painkillers and you *should* go there in that event. As things stand, though, it sounds like it would be a long wait and a hassle for essentially the same treatment you received this afternoon.
posted by charmedimsure at 11:11 PM on July 22, 2011

Response by poster: It's a lot better today, though still pretty gross and alarming. Thanks for the reassurance -- this came on so quickly and disgustingly that I was really concerned, and these anecdotes helped very much.
posted by ZeroDivides at 9:19 PM on July 23, 2011

Response by poster: As another follow up, for anyone who comes upon this in the future, it turned out that the tooth adjacent to the crazy swelling and all the whatnot was too damaged when the crown was placed, leading to infection and the crazy swelling -- even though the giant swelling was in my cheek and not my gums, and the tooth implicated didn't hurt all that much right at first.

The antibiotics got it under control but I was in a lot of pain from then until now. I finally saw an endodontist yesterday who figured out what was wrong and nuked the tooth. Before that, I'd heard everything from the various dentists I saw from biting on my cheek accidentally when still numb, wisdom tooth pushing on the affected tooth, and that it couldn't be the tooth and was probably some sort of tissue problem caused by the dentist who placed the crown.

It seems like the nonsense is drawing to a close finally, now, and I really appreciated the responses from metafilter because having golfball cheek is really alarming and it's sometimes nice to know just that other people have had such experiences and survived to tell the tale.

I still have a lump where the swelling was, but it gets smaller everyday.
posted by ZeroDivides at 8:57 AM on August 10, 2011

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