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persistent cheek infection following #19 extraction
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persistent cheek infection following #19 extraction

Months ago I started having occasional pain in #19 while biting, which I ignored. At the end of April it really flared up. I had a slight temperature at some point. The pain completely disappeared on May 8 but came back with a vengeance the next day (May 9).

I finally saw a dentist on May 10. In addition to a tooth abscess, there was a pocket, I presume containing pus, in my lower buccal space. I was given 6 days of Penicillin and 5 days of Metronidazole and sent to and endodontic person to evaluate. The endodontist said a root canal was not possible, so I returned to dentist to have tooth pulled on May 15. The original antibiotics ran out around that time.

The lump in the cheek was never addressed. Two weeks later (May 30) the infected pocket was still present, and I saw an oral surgeon. He prescribed Amoxicillin, to be taken if it "flares up."

On June 5 it really flared up, growing forward toward the lips and downward. The growing areas had the texture of a raised poison ivy rash (in the forward direction) and a chewed lip (downward). I filled the prescription and started taking Amoxicillin.

The Amoxicillin helped some, but on June 13, about a month after tooth extraction, I returned to the oral surgeon. He could not detect the mass even though I could easily feel it with my tongue. I also tasted some sort of drainage and was coughing up white sputum every couple of days.

I saw my GP two days later (June 15), and he could not detect an active infection in the mouth, despite the above symptoms. Neither the GP or oral surgeon referred me to an ENT at that time.

On June 20, the day before the Amoxicillin ran out, I saw an ENT whom I found on the Internet. He suspected an infected lymph node and prescribed 3 weeks of Augmentin.

I've taken it for almost 2 weeks without any reduction of the cheek mass. The only concrete benefit of the Augmentin is that I haven't coughed up any sputum. The ENT wants me back in 4 weeks from June 20 (i.e., a week after the Augmentin runs out.)

What do you think is going on in my cheek? Is it possible that the decrease in pain on May 8 was due to the original tooth abscess "self-draining," perhaps through a fistula to my cheek? I've read that such a release in pressure can temporarily reduce the pain.

Given the above history, what do you recommend as the best course of action now? It scares me to think about what will happen during that week between ending the Augmentin and returning to the ENT.

Thank you for your consideration for such a long and detailed post.
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scottma
taipei, Taiwan