tooth abscess and swollen cheek

i have a couple of questions about abscesses. last week i developed an abcsess in my tooth. my cheek became very swollen. the doctor said the infection from the abscess had passed from my tooth into my cheek. they put me on keeflex. within 24 hours about 60% of the swelling in my cheek had subsided. i am now on day 6 of a 10 days worth of the keeflex. my questions are how exactly does the infection from the abscess get into your cheek and even though i am now on day 6 of my medication there is still some swelling in my cheek that feels hard to the touch. all the pain from the infection as been gone for some days now and i did notice a little more improvement in the cheek today, but how long should it take for the swelling to completely go away?

[Jerome Tsang, DDS]

The abscess you speak of can spread through the facial spaces in your head.  My guess to your situation would be that a dental infection started in your tooth and has spread from the pulp of the tooth into the jaw bone.  From the jaw bone, it has broken through the jaw and is now spreading through the soft tissue (muscles, skin, etc) and spreads out to wherever there is space to grow.  

The antibiotics should be completely finished.  

Is your doctor bringing you back for further treatment?  Antibiotics only help to keep the infection from spreading and to reduce the swelling but it does not solve the underlying dental problem.

[edward84]

yes they do plan further treatment. i was told that i need to get all the infection cured up first though. so my concern was that it showed such a dramatic improvement in the first 24/48 hours. what i refer to as the "infection" pain has been gone for several days. what i'm left with now is still some minimal but noticable swelling to my cheek that feels hard and has a "bruised" feeling to it. it does still feel warm to the touch which i was always taught is a sign there is still an infection present. i do of course plan to finish all 10 days worth of my antibiotics but i'm just wondering how much longer it should take for the last bit of infection to clear completely out of my cheek and it go back to it's normal shape.

[edward84]

i think, what i want to know most also is. besides taking my antibiotic, ibuprofen, and cold packs to help inflamation (inflammation). is there also anything else i can be doing to aid in healing and reduce swelling?

[Jerome Tsang, DDS]

Sounds like you're doing fine.  The swelling may not resolve for awhile because you still have an active source of infection due to a bad tooth I assume.  Once the tooth it out, the swelling should probably be gone in a week or so.

[Cloudwindgate]

I have two abscess but not the money to pay for the surgery what can i do? I took antibotics and got ride of the infecttion to spread but its still there and im worried
1 it will cont to grow till my jaw bone is weakend and brakes
2 i dont have the thousands of dollars for the procude any way
3 no insurance will cover the procidure i  can try and get money back but they want the full pay up front and i just dont have that kind of money in my back pocket.

[Jerome Tsang, DDS]

The antibiotics do help keep the infection in check but once the antibiotics are stopped, the infection may continue to grow.  

1) Yes, it is very well possible that the abscess may grow within the jaw and weaken the jaw.  I haven't seen a broken jaw due that before but it can spread within the jaw bone and cause extensive damage.  Another more likely scenario is that the abscess will escape the jaw bone and spread to the soft tissue of the head which is extremely dangerous.  It can spread down the neck and cause breathing problems or spread to the spaces near the brain.

2) I'm not familiar with your financials but you may want to contact your local dental society and see if there are any resources available for your situation.  They may be able to refer you to a dentist who may do it for low/free or a clinic in which these services are provided for people with financial difficulty.  But generally, the most likely scenario is to extract these teeth.

Hope that helps.  I would strongly encourage you to seek treatment as soon as possible since those complications can occur at anytime.  

[Cloudwindgate]

Thank-you for the help and i will try

[Jerome Tsang, DDS]

Best of luck.  Hope everything turns out well.

[Stace_case]

Wow, this is a great online service.  I have an abscessed tooth and am taking amoxicillin.  Two questions:

1.  The dentist can't fit me in for a root canal for 30 more days.  Is it safe to wait so long?

2.  My cheek is very swollen, even though I'm taking antibiotics.  (Today's my second day.)  It didn't become swollen until I started the antibiotics.  It's putting slight pressure on my eye. Is there reason for concern?

I tried calling the dentist but the receptionist wouldn't let me talk to him and said not to worry;  however, she's not a medical professional!

I appreciate your providing this service.

[Jerome Tsang, DDS]

Hi!

The amoxicillin should work fine in reducing the spread of infection and reducing any swellings that may occur.  Its a little bit more odd that the swelling occured after the antibiotic treatment and not before.  It does take a few days for the antibiotics to work and as long as the swelling doesn't worsen on day 3 to 4 on the antibiotics, it should be fine.  If it doesn't work and the swelling gets worse, you should see a dentist and get treatment as well as change the antibiotics.  It may be that the bacteria you have in your mouth is resistant to the antibiotics.

As for waiting thirty days, it does seem a bit longer than usual.  Has any treatment been started on it?  Or did he/she just prescribe the antibiotics?

[pupaerika]

Hi,
Thank you for this website!

I am 1st year Dental Hygiene student. We were taking pano on each other and I noticed that I had a radiolucent area around the apex of tooth #19. This tooth had root canal done 3 years ago and I got a nice crown on it too. I visited my dentist regurlaly. I had no pain or discomfort prior to the pano that we took on Nov 18. Since then, I visited my dentist and he told me it is an abscess. I started the Amoxicillin on monday, I also noticed that I had a throbbing pain since last sunday.Well...I believed that it was in my head because I had no pain before I looked at the radiograph. Pain got worst yeasterday and I noticed that my cheek strated to swell. It is horrible all night long. I called endodontis in the morning and he retreated the tooth. I look like a chipmunk now but NO PAIN:).
Well my question are:
1.Why it started to hurt now??? Did I do something to agitate it? This abscess was visible on pano that was taken in Febr.
2.Is there any home remedies for swelling?

Thank YOU!

[Jerome Tsang, DDS]

Sometimes with a root canal and abscess, it can be treated and leave a radiolucency in the area.  As long as there are no symptoms, we generally keep an eye on it and make sure that it doesn't enlarge in size.  Sometimes these area will scar and leave a permanent radiolucency.

I would guess that the endodontic treatment did not sufficiently clean the canal.  The infection from the bacteria may have been quite extensive and it was difficult to remove all bacteria from the canals or a canal might have been possibly missed. Also, with the anatomy of the canals, its possible you have lateral canals, canals that split, etc which make cleaning it out difficult.  

As for the swelling, the antibiotics and time will take care of it.  If theres a fistula (lil gum boil), sometimes warm salt water will help pull the pus out of the abscess.  Otherwise, your dentist can perform an incision and drainage but I wouldn't recommend that route at all.  The root canal was done and everything should be fine now.

Good luck with hygiene school!   Maybe I'll see you at some ADA functions.  Best wishes.

[MaxAsh]

It is so nice to find a website that is so straight forwad and helpful, thank you.

I have a concern, 3 days ago I came out with a massive cold sore on my upper lip. I had eaten rather spicey food and thought that might be the cause. Then 1 day later swelling appeared on my gum above my upper right canine tooth. Then yesturday my cheek started to swell around the jaw line, bottom right. There is a little lump and it is throbbing and very sensitive.

My first thought is I could be coming down with a bad cold, as I have had glands swell before yet I feel fine. The swelling on the jaw seems quite far from the swelling of the gum, yet I am confused as to wether this three symptoms might be connect. Does it sound like they are?

Should I wait to see if the swellling goes down or should I see a family docotor or a dentist?

Thank you

[pupaerika]

Thank you!

I was told that the crown was not fussed to the metal promptly, which caused the bacterial build up and an infection.
I feel much better today and swelling is almost gone. I just wanted to share that heating pad helped the swelling to go away. I also used the Vit. A and D ointment that seemed to help too.

[Jerome Tsang, DDS]

They may be unrelated but its also possible that with a cold sore, it has spread from one area to another.  A cold sore can be quite infectious and can occur in more than one spot although the cheek is a little bit more of a rare location for it.  Cold sores usually appear on the lips and gums but not on the cheek unless its on the gum area and when you press down on the cheek from the outside, you're causing some pressure/pain onto that gum area

Its a little unusual to have more than one cold sore.  I would wait another day or two and see if it gradually gets better.  If not, it would be a good idea to go in on Monday to have it checked out by your doctor.

[aristacus]

hi,  i was in excruciating pail last sat, and put it down to t neuralgia, as i was told i had this about 3 months ago, but my increased medication would not get rid of the pain, and then my cheek from my jaw started to swell up, not to mention my neck and glands, swallowing food or drinking became excruciating, i decided to get things checked out. went to dentist who immediately put me on amoxillin 500mg 3 x a day but for only about 5 days, have to go and sort out the tooth, but am worried is this enough anti biotic and how long for the pain to go and swelling on cheek and glands, how much rest do we need please help

[Jerome Tsang, DDS]

Trigeminal neuralgia shouldn't directly cause any swelling.  It is usually associated with an electrical pain.  Was your pain an electrical pain or a sore/throbbing/burning pain?  

The antibiotics are useful for controlling the infection if you have one.  This should help get rid of the infection if you have a healthy immune system.  It would be best to go back to your dentist to seek definitive treatment that will solve the problem.

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[ssantana14]

I had a retreatment on a root canal because it had an abcess (abscess) they had to basically perform another root canal to drain the abcess (abscess) below the tooth. The doctor put me on antibiotics. How long does it take for the pain to go away.  

[Mmorris1977]

I have a tooth that is broken down to the gum line.slot of pain..so I went to tue emergency room and they looked at it.they said that I didn't have no infection.but the next day my gums and cheek/nose area stared swelling up.so I went back to the emergency room and then they said I have an infection.so they put me on pennicilian..I have been taking that for a day and tue swelling has gotten worse and I'm worried that there is something else going on.I have a dentist appt this Tuesday..but I'm just nervous on all this swelling and tue feeling that it's giving me..I have had bad toothaches before but never had swelling like this..please help and lmk all info you can on this topic...

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[Jo_07]

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[ZWilhite]

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[squizy]

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[VixenDeathDoll]

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[gidavis]

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[gidavis]

My tooth was broke and the infection spread to my jaw. It swell so much it looked like I had an Orange inside my mouth. It hurt so bad it then spread to my neck and I started having problems breathing. They started iv antibiotics thru iv right away it took four days to get something to work and now I.am at home with a picc line for two weeks to do antibiotic.   It was very scaring. If something might be wrong go to the dentist. This is just awful. If I had gone to the dentist I could have saved me a lot of hospital bills.  

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