draining abscess??

[edward84]

i posted before. i had an abscessed tooth and the abscess spread into my cheek. my dentist put me on keflex but after 10 days there was still noticable swelling in my cheek. so now the dentist has put me on a stronger antibiotic. when i woke up this morning i felt a very large "bubble" on my inside cheek. a few minutes ago as i was laying down i felt my mouth fill with some saliva and then suddenly i tasted something that can only be described as tasting like what road kill smells like. i spit it out and my saliva had some whitish/yellowish stuff in it that looked kind of like mucus. does this mean that my abscess is beginning to drain?

[Jerome Tsang, DDS]

It sounds like its draining out.  I'm a little concerned about the pus and saliva mixing though.  I'm not sure if its escaping from your gums and mixing with the saliva already present or if its coming from the parotid gland in your cheek.  The reason why is because of your swelling on your cheek and not on the gums.  You may want to go back to your dentist and he may want to "milk" the parotid to see if its infected.  

[edward84]

when i had gone back to the dentist and they put me on stronger antibiotics i do remember they said something about a lingular abscess and madublar extension or perhaps i have those phrases reversed. he said that the infection in my tooth had spread to soft tissue in my cheek. that's why i was put on stornger anitbiotics. he wanted it to clear up before he proceeded.
what would be the concerns with infection of a parotid gland?

[Jerome Tsang, DDS]

No major concerns, I would just want to be sure that there isn't any permanent damage to your salivary gland from an infection.  I'm sure the antibiotics will do the trick.  My only question is why the delay on treatment.  Are you extracting the tooth or are you planning to do a root canal or some other treatment?

[edward84]

i am scheduled to have the tooth extracted (cut out) tomorrow afternoon. the doctor said he had wanted to get the majority of the infection cleared away beforehand.

[Jerome Tsang, DDS]

Ok.  That sounds about right.  The extraction will solve any residual infection issues since it is the source of your infection.  The antibiotics were used to reduce the extent of infection but once the tooth is out, the antibiotics and your immune system should be able clear the infection.

[JODY71]

I Had to have two teeth pullled due to an abscess on my gum. I thought that you could not pull teeth while you had and infection in your mouth. Is this true or not. Also if you have teeth pulled does this clear up the infection. Even though you have to take medication for a week to ten days.

[Jerome Tsang, DDS]

Yes, it is possible to remove a tooth while you have an abscess.  It depends on the extent of the abscess and how serious it is.  Some doctors may opt to put you on antibiotics first to reduce the swelling then remove the tooth.  Other doctors may decide to remove the tooth first to get rid of the source of infection and then help promote healing by being placed on antibiotics.  

I was taught to do the antibiotics first then to remove the teeth afterwards in school but when I did my residency, I was taught the opposite.  I think either way is fine and the results are about the same.  There is some more risk involved with both options.

If you leave the tooth in, the antibiotics may not work and the condition may worsen or the antibiotic works well so the patient doesn't return and the abscess worsens later.

If you take the tooth out immediately, usually its a slightly more difficult extraction for the doctor and patient but it does remove the infection immediately.