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salivary gland or tooth problem?
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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salivary gland or tooth problem?

About three months ago I developed an ache in my lower jaw.  Went to my dentist who took x-rays and said everything looked okay.  Both back molars have crowns on them.  Saw endodontist who also said everything okay.  None of the teeth hurt - just the jawbone under them.  

I saw an ENT who thought it might be a salivary gland stone as I have some swelling in the area when I eat.  Antibiotics did not help.  X-rays and CT scans showed no stone, but he incised the duct and dilated it anyway. Said x-rays did not show stones 20% of the time.  It got infected - another round of antibiotics and two weeks later I am back to where I started from.  Now he says my options are to live with it or have the gland surgically removed.  The gland hurts when I eat but the swelling goes down in between.  I do still have a constant low-grade ache in the area, however, which is making me crazy.  Would a salivary gland problem ache like this all the time?  I thought it was just specific to mealtimes but I know the nerves in this area can do strange things.  I am worried the antibiotics are masking a chronic dental infection - although x-rays were negative.  Is there anything else I can do to get a definitive diagnosis short of removing the gland and seeing if it fixes the problem?  If I could see a stone I would have the surgery in a minute, but I don't want to have an unnecessary surgery and end up with the same problem or additional ones.  I realize no one can make the decision to have surgery but me, but is there anything else you would recommend investigating before making this decision?
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My suggestion would be to see an oral pathologist . These professionals are usually associated with a large teaching hospital.
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