Cheek/Jaw Still Swollen After Drainage. Why?

Hi Jerome.  I'm really happy this website exists.  I recently had to go to the ER after the meds my dentist prescribed me (penicillin and hydrocondon) were not able to reduce the swelling in my jaw and cheek.  The Oral surgeon basically took a scalpel and drained my cheek.  I smelled the puss and there's plenty of blood, but when I looked at my cheek later, I noticed it's still swollen to about the exact same size (maybe a tad bit smaller but not much).  Is that normal?  This was done about 2.5 hours ago.  I thought the drainage would make the swelling go down instantaneously.  Anyway the prescribed me a stronger antibiotic and painkillers, but I just wanted to make sure because I've been in serious cheek pain for like 4 days.  What gives?

[Jerome Tsang, DDS]

Did the oral surgeon leave a drain in your cheek too?  It helps to relieve some of the pressure and infection/pus to allowing an opening for the pus to leak out.  If there's no drain, it'll build up in pressure again at some point in time.  The antibiotics you were using before may not be working so hopefully the new antibiotics will do the trick.  

It may take some time (2 days or so) for the swelling to go down significantly.

More importantly, where's the abscess coming from?  Your dentist needs to find out where the source is and get that taken care of as well.

[LoveJungle]

Hey Jerome.  Thanks for the quick reply.  I don't know what you mean by a drain.  The OS took a scalpel and made an incision on the in my mouth down in the space between my gums and cheek.  I guess toward the jaw.  I definitely saw/smelled pus leak out and lots of blood (I changed gauze every 20min for 3hrs before the bleeding totally stopped).  They gave me a different antibiotic and painkillers.  

The abscess was on the lower ridge in front of the two molars on the right side.  Tooth 29.  I had a filling done 3 months ago and I guess it got infected underneath.  2 days before the ER my dentist performed some of the beginning stages of a root canal on that tooth (you have to make multiple visits at a community clinic; no insurance).  Gas was released and other things that I don't know about happened and then they put a temporary filling on.  So I believe the source is being taken care of.  Does that answer your question?  

I see now from your answer that the swelling won't go down immediately even with a drainage.  I thought I would be back to my attractive self (half of my face looks like the Godfather).  I can feel with my tongue that the flesh down by my gums is not as puffy as  but the area further back inside my cheek and by the jaw bone is still rather puffy and kinda hard.  Visibly there's not a big difference.  

Had a hard time getting info out of the Doctors in the ER, which is understandable since I was at Bellvue NYC and there were people in much worse condition than I was and lots of them, but still it was stressful.

Thanks.

[Jerome Tsang, DDS]

A drain is usually sort of like a flimsy straw that put into the infected area to keep it open so it can drain out.  If there's no drain, the pus can accumulate again.  Perhaps your surgeon felt a drain wasn't necessary because you already had the beginning stages of a root canal and antibiotics.  

Sorry, some of the swelling will be due to the infection, some of it from the trauma of having an incision made.  

It will take awhile but you'll be back to normal soon.