Jaw pain
 

I don't know what's going on with my mouth but my jaw is hurting terribly. I can't eat anything, my jaw is all swollen and I didn't sleep a wink because of the pain. I brush and floss every day so I never expected this. I had a check up 6 months ago and everything was fine.

I called my dentist but only got the answering service. Any ideas what I should do???? I've tried Ambesol and salt water but nothing has helped. :(

Hi BJ,
Anytime there is swelling in the jaw, it is imperative to see a dentist asap. It could be an abcessed tooth or an infected gland. Massive or rapid swelling in the lower jaw near the molars can be what is called Ludwig's angina. This is a bacterial infection of the floor of the mouth that occurs from an infected tooth or a mouth injury. It is very serious and can actually block the airway. It is not something that will go away on it's own and needs medical/dental attention asap.

Even people with perfect teeth get oral infections. Teeth that have fillings in them are more prone to infection due to microscopic cracks in the fillings of which bacteria get into and multiply.

I'm 30 years in dentistry and see alot of swollen faces ........ do not wait to seek medical/dental attention. Call your dentist and leave an urgent message on his machine or go the the ER at your local hospital and see their dentist on staff.

I hope your problem is not too serious and easily remedied. Please let us know how you are doing.

Bryanna

Thanks Bryanna I'm going to leave another message. All I know is I've never had pain like this before in my mouth. I do have fillings but I'm such a bed bug about my mouth and it's sort of an obsession to brush, and brush more.

I understand you do what you can to be deligent about your oral hygiene and that's realy great! But oral infections are extremely common and they occur even in the cleanest mouths.

The mouth also has several glands of which can become clogged or blocked either from an infection and/or a stone. Again, this is more common than people realize. These can be quite painful and cause swelling.

Please keep us posted on how you are doing!

Bryanna

My dentist is squeezing me in at 11:30. They're only open to 12 and there was a cancellation. Gosh, even my ears are hurting. :( I'm not looking forward to this at all but I'm so miserable.

It's my wisdom teeth. I have two that are impacted and they're going to take out all four at one time. I have antibiotics and Vicodin for pain. But it won't be until Monday. And I'll be in LaLa land so, according to the surgeon, I won't feel a thing. :thud:

Well I am glad that you got in to see the dentist today! The antibiotics will help alleviate some of the inflammation from the infection. However, antibiotics take 24-48 hours to get into the blood stream with consistancy. So don't miss a dose!

We always suggest that a patient taking antibiotics also take a probiotic to help maintain good intestinal bacteria since the antibiotics kill off the good and the bad. Supplementing with probiotics can alleviate the common side effect of intestinal upheavel that many people experience from taking antibiotics. The probiotic should be taken one hour before the antibiotic or two hours after so they do not counteract each other. Irrelevant of how often each day you take the antibiotics, you should take the probiotic twice a day. It is a good idea to continue with the probiotics for at least a month after the antibiotics are done to help build up the good intestinal bacteria. We usually recommend a product called Culturelle or Primal Defense.

Don't worry about the surgery. It sounds like you will be in no discomfort for the procedure and hopefully back to your old self in a day or two!

Please keep us informed of how you are doing!

Bryanna

Thanks Bryanna but what's a probiotic? :confused:

I was just researching what he's going to do and stopped looking. :eek:

All I know is I'm terrified of being put "out". I've had local many times but never general. I guess the good thing is I'll be "asleep" for a while since I haven't done much of that lately. :( I just wish it was all over. :D

I'm off to church. I hope I don't scare any of the congregation away with my swollen jaw. :eek:

Probiotics are various live mircroorganisms that are beneficial to your health. They are non-pathogenic bacteria which are considered friendly germs. Supplementing with them actually benefits the colon and the immune system. The word probiotic is a compound of a Latin and a Greek word, meaning favorable to life. People who strive for optimal health, either have a diet rich in probiotic foods and/or supplement daily with a reliable brand of probiotics.

Antibiotics are actually immuno-suppressants which work by killing off ALL of the (probiotic) lactobacteria in the intestines. Lactobacteria is healthy bacteria that lives in our intestines and is essential for quality of life. Without it, the intestines are severely impaired altering proper digestion and the assimilation of nutrients. When we are fighting an infection, it is imperative to keep the body as healthy as possible.

People end up with stomach or intestinal problems during and after antibiotic therapy because they are either low in lactobacteria to begin with (which is very common) and/or the antibiotic has killed it off completely. Supplementing with a product like Culturelle will replenish the lactobacteria that the antibiotic is killing off.

You can purchase Culturelle at many drug stores or health food stores. Their website is www.culturelle.com

I understand your fear and apprehension about having your wisdom teeth out and being put under anesthesia. If you weren't a bit nervous, I'd wonder why! They refer to the anesthesia as general because it is administered through an IV line and it does place the patient in a semi conscious state. We refer to it as twilight state because the drugs used do not put them into an unconscious state. For all practical purposes, you will be "asleep" and have no sensation of pain or memory of what is happening and time will have passed very quickly for you.

Post operatively, be prepared to eat a very soft diet for about 7-10 days. The main reason for this is because your facial muscles along the TMJ joint will be stretched to obtain easier access to the teeth and you will need to give these muscles a rest. You will also have some inflammation and swelling and may have limited opening for a few days. Drink at least 8-10 glasses of quality water every day as this will help flush out bacteria and help with the healing. Plan on taking it easy for at least the first 2 days, no strenuous work or exercise.

Please let us know how things are going!
Bryanna

Bryanna has been right...
 

on target about everything she's posted... I'm sorry I'm late here.

Those wisdom teeth are pesky things aren't they? I had all four of mine out at once and am glad they are GONE. Make if you can eat it [no gluten issues] a mashed potatoe soup, essentially mashed potatoes, milk, and souped up with chicken broth...a dash of garlic or onion powder can 'spice' it up. It's tame, filling [when my mouth was sore I NEEDED filling?] and even has a bit of nutrition in the broth and milk. Your gums will probably be very tender for a week to 10 days, then work your way up the 'solids' food-chain so to speak.

Priobiotics are good in any form...Bryanna, how about Danactive? It's a good thing it's [the teeth] aren't too abcessed! Abcesses anywhere in any form aren't FUN at ALL!

Do promise us you will NOT skip ONE anti-biotic pill? Please, Bad things loove to grow in mouths...don't let it happen! :hug: - j

They sure are......one day fine next day :eek:

I'm ready to go I think. I found the Culturelle at our GNC store and made some rice pudding and bought some Jello and went to my parent's graves and put flowers on. Don't know how hungry I'll be anyway. That potato soup sounds delicious. Hmmmm if I can't sleep maybe I'll make some. :)

Thanks for all your advice. Now there's only one thing to do........not chicken out and show up. :D I have to be there at 9 and they're taking them out about 10 then it's all over. :thud:

Bryanna - I so wish somebody had been there for me! My story: August 2003 failed root canal - sent to oral surgeon. My mouth and lower jaw were so swollen I couldn't get my mouth open properly, and it was hard to numb. So the oral surgeon put in a "jaw jack" and pulled it anyway (left lower molar) - that day I IMMEDIATELY felt something like lightning from the top of my head down to the jaw. That pain never left. I was on IV ABx X 6 weeks, Oral Abx 6 months, then surgery to debride the mandible (by another oral surgeon) - also 45 Hyperbaric TX to help heal the mandible. THEN, another round of IV ABX through PICC Line (Invanz) - then for the next year I was on ABX off and on - probably six more months. I took the live culture acidophyllis, ate yogourt TID and avoided crowds. Mandible stabilized for now. BUT facial pain still present. New DX: not atypical facial pain or atypical trimingenal neuralgia anymore. I now DX'd with trigeminal neuropathic pain. I've had accupuncture, chiropractic adjustments, massage therapy - and more meds than I can remember. Last Sept 2006 I travelled to Cleveland Clinic. Dr. Lee performed a "V3 neurectomy via mandibular osteotomy". Being in desperate pain I made a desperate decision. I was pain free for 16 days (except for healing pain where my jaw had been drilled and facial pain where my face was cut along jaw bone). Then day 17 I felt something like a spider web along that nerve and BAM - pain was back with a vengeance. So now: I'm on Lortab 10 mg. QID, Neurontin 1200 mg. daily, Ativan 1 mg. BID, Elavil 100 mg. HS and Ambien 10 mg. HS. I worked for a family practice MD for 34 years (Medical ***'t all the way up to office mgr) so I'm pretty familiar with medical conditions, pharmacology, outcomes, etc. I'm now unable to work and applying for disability because I'm either dysfunctional d/t pain (7 plus average) and really dysfunction on meds which provide on minimal relief (4-5 on the pain scale.) .................So: really big question: can you think of anything else I can try? I'm willing to seek any type of medical care because I think there has to be hope for me.
Thanks for listening.........Janet
PS - I'll be gone most of this wk - just in case you reply I wouldn't want you to think I'm ignoring you.

Hi dahlek,
The health benefits of taking a probiotic only come from supplementing with a product that contains live healthy microorganisms. These organisms are time and temperature sensitive. So the product has to be manufactured, packaged and stored in a way that allows them to hold their potency.

Products like danactive are not manufactured this way and they have also changed temperature a few times before they reach the store shelf. Their main source is from milk which would be intolerable for someone who has lactose intolerance. Danactive also has ingredients that are not only unhealthy, but they actually kill off the good bacteria in the product itself.

Ingredients in Danactive:
Cultured Reduced Fat Milk, Water, Sugar, Strawberry Puree, Contains Less Than 1% Of Dextrose, Modified Corn Starch, Natural Flavor, Carrot Juice Concentrate (For Color), Malic Acid, Sodium Citrate. Contains the active cultures L. bulgaricus, S. Thermophillus and L. casei Immunitas™.

It states that it contains the "active" cultures of some microorganisms. However, two things to keep in mind when you read the ingredient label. One, the first 3 ingredients are what the majority of the product is made from. So in this case that would be milk, water and sugar. Two, these microorganisms were only active (alive) at the time of manufacture and by the time the product was mass produced, they were no longer active or alive. Also, once you put sugar with any live healthy bacteria, you kill the good bacteria.

We recommend only quality controlled, patented or patent pending probiotics to our patients. I have personal experience with culturelle, having used it on a daily basis for over 5 years, and know that it's a great product.

There is always so much to learn!! I'm so glad to hear your stories and be able to share this information with all of you!

Bryanna

Me BP........... when you feel up to it, please let us know how you are doing!We are all anxiously thinking about you today ;-))

Bryanna

Janet,
You are not alone....... there are more people out there going through this than you could imagine. Most of them, are on heavy meds that make them unaware of life. Before I make any suggestions, please allow me to show your post to the dentist that I work with (on thursday) and see what he has to say about it. I'm not sure if there is anything at this point that would bring relief, but let's try to remain as optimistic as possible.

My heart goes out to you........ hang in there......... I'll get back to you asap.

Bryanna

It's over and I feel horrible. I didn't feel a thing until I got home and then the pain started. I finally fell asleep around 4am. My boss was being a real "****" and insisted I come to work to finish the pre-audit work for a client. He just came in and took one look at me and said go home, which I'm doing. I'm hurting terribly and I'm all black and blue and look like a racoon. I'm going home, taking some pain meds and closing the blinds. :(

Oh boy :-(((

You just had surgery and need to be resting! Your boss needs a kick in the *** @$@&#$%&&

Take the pain meds as prescribed, but make sure you eat with them to avoid an upset stomach. Drink alot of water to avoid getting dehydrated. Rest, rest, rest............

The black and blue is normal and may get a little worse before it gets better. In a few days that will be dissipating. Swelling is common the first 2-3 days and then you may find that it's swollen in the morning when you wake up but subsides during the day. Nap and sleep with your head propped up if possible.

I promise, you will be ok. Try to stay calm and think healing thoughts.. ~'.'~ We are all thinking about you!

Bryanna

Right now I feel like I've been run over by a truck. The percosets are tearing apart my stomach. I'm soooo tired but my stomach is flipping and flopping. :thud:

I know it's difficult, but you need to eat something when you take the meds. Even a milk shade or a smoothie would work!

You have been through alot. The pain and anxiety last week and then the surgery was a bit complicated since two of the teeth were impacted....... a few days of rest and you will feel much better.

Hang in there........ you realy will be fine!

Bryanna

I just left a message at the office Bryanna. I don't know if they can give me something for the nausea or else change the pain one. I tried to eat yogurt and brought it right up. Now my mouth is bleeding. :eek: My face is so swollen my eyes are almost closed and black and blue. I'm miserable, tired and if I had more time would never had this done. :(

Ok. Yes, they can prescribe something for the nausea. If they seem hesitant to do that, be insistant. You can always call your physician for anti nausea meds also.

All too often, people have stomach issues with the meds. Pain meds should never be started on an empty stomach. It just sets you up for a bad situation. Unfortunately, most dental offices don't stress that point enough. Small, frequent meals of bland foods to ease the lining of the stomach are best. Drink some plain black tea as the tannin in it helps calm the stomach down.

Some food ideas:
Bananas, canned fruit, sherbet, diluted fruit juice, fruit ices, well cooked vegetables, mashed potatoes, rice, toast, crackers, cream of wheat, Farina, noodles, puddings, custards, boiled chicken, baked fish, boiled eggs, soups.

As for the beeding..... it is not uncommon for the sites to bleed a little for a few days. If at any time they start oozing, then you need to be seen by the oral surgeon. The swelling can sometimes be extreme and move up towards the eye area. Definitely mention it to the oral surgeon on the phone today and follow his recommendations for taking care of it.

If your wisdom teeth were infected, you realy had no choice but to get them out. The antibiotic would simply have temporarily subsided the symptoms, but not taken care of the infection. In retrospect...... you will be so glad that you got it done and over with.

I know you are miserable......... I wish I could help you. This does not happen to everyone and there is realy no way to warn you ahead of time because why put something like this into someones head if the end result is less severe?

Please try to stay calm and positive......... I realy do understand how miserable you are right now. Let us know what the oral surgeon has to say.

Bryanna

Thanks for the food ideas and I know I have to eat but I'm afraid of bleeding more. The office just called a few minutes ago and said to come in at 11. And yes, he will give me something for the nausea. :) Miserable is putting it lightly. :(

I just wanted to leave you a gentle hug BP....:hug:

Bryanna, I'm a big fan of danactive....please tell me where does one buy culturelle? thanks.

Hi Alffe,
I can understand how people would make the assumption that a product like danactive would be "beneficial". However, once you become knowledgable about the ingredients in products like this, you understand that the healthful "benefits" are not what they claim to be.

Culturelle can be purchased in some drug stores; on line at sites like vitacost.com; or even directly from culturelle.com. I find the best price is from vitacost.

Bryanna

BP,
Eating is imperative! Once you get some nutrition in your system you will start to feel better. You just have to be careful not to chew way back there. Take small bites and chew slowly. Drink LOTS of water.

A little bleeding is OK! The areas are sutured and the clots have already begun to solidify in the sockets.

Please ask the oral surgeons office to give you clear instructions on how to take care of the surgical sites.

I promise........ you will be ok :-)))

Keep in touch.
Bryanna

I didn't pop a stitch so that's good news. He gave me some compazine (sp?) for the nausea and said to use ice packs for the swelling. He told me that but I forgot. :confused: I'm weak from not eating so hopefully once this compazine works I'll be able to eat something. Right now though, no way!! I'm exhausted and need sleep first anyway.

I didn't tell you to use ice packs because some surgeons suggest it and others don't. So I didn't want to suggest you do something that wasn't recommended by your particular surgeon. I'm not so sure the ice will help at this point, but if he says to use it, then give it a try!

The compazine will help with the nausea, but you've got to eat and drink something as soon as you feel that you can.

Your situation is typical of someone who had an acute problem, very apprehensive and basically as an emergency. It's easy to not follow the post op directions of the surgeon because you are just relieved to have it done and more than likely, the instructions were not presented to you as a YOU MUST DO THIS OR ELSE type of thing. I had to be careful making any suggestions to you via the internet for obvious reasons. But for all surgical patients in my office, I would be very explicit with what you would need to do and I would call you the night of and the day after the surgery to make sure you were doing ok and following instructions.

Once the nausea subsides, sip some weak tea or ice chips to attempt to rehydrate yourself. Avoid caffeine and sugar as these just cause dehydration. Once you get some nutrition in you, you will start to feel better.

Have a good nap and when you can, let us know how you're doing!

Bryanna

Thank you so much Bryanna for all your help. It's my stupidity though. The office did call the next day and left a message. I thought at the time I was "okay" so didn't return the call. But as the day progressed it got worse and worse. I've been just laying in bed staring at the ceiling and just realized I haven't taken my Lithium either. I'm going to try to eat something and try to sleep again. I'm really tired and the pain meds are kicking in. :)

Hey BJ!
How are you doing today?? I hope much better.
Drop us a note when you get a chance.
Bryanna

Thanks for thinking of me Bryanna. :hug: I'm doing somewhat better. I still don't feel like eating much yet but I'm trying to at least drink. I've just had a headache and can't seem to get rid of it.

Hey There!
Glad to hear that you are feeling a little bit better!
The headache could be from several things but it most likely is nutrition
related.

Your immune system realizes that there has been some trauma to the body and the response would be to send all good cells to the rescue! However, your immune system also recognizes that your body is nutritionally deprived. I know you basically feel like crap and food seems like the last thing on your mind, but your immune system cannot send those healing cells when it's trying to deal with the lack of nutritional support.

Have you tried to take in some nutrition through liquid in the form of protein shakes or fruit smoothies?

I know I am being a nag here....... I'm sorry. I just know how much better you would feel and better you would heal if your body had some nutritional support ~'.'~

Hang in there....... and please do keep in touch!
Bryanna

Bryanna you are not being a nag in anyway. I know I should eat and realize that now. I'm always late with everything and a little thick-headed. But I went out and bought some of Boost shakes to drink and hopefullly this is what I need to make this headache go away. Pain meds are kicking in and I'm really tired. And crying doesn't make it feel any better. :(

Please don't beat yourself up over this. Sooooo many people share this same type of experience and I just want you to know that it will get better! I think the Boost shake may be just what you need to pick yourself up! Hopefully by tomorrow you will wake up feeling more energetic and things will start to improve more rapidly!

Take it easy, rest when you feel tired and know that others are thinking about you!

Bryanna

Hi Janet,
Sorry for the delay in my reply to you. I briefly discussed your dental concerns with the dentist that I work with and he asked if you have ever had a Mandibular Nerve Block. This is an injection of a local anesthetic into the area of the mouth that would numb a particular portion of the mouth. In your case, it would be an injection to numb the lower left side of your jaw. This injection can sometimes help determine the origin of pain depending on the immediate relief you may or may not feel. It can help determine if it is coming from the central or peripheral nervous system.

During any of your oral surgeries, were there any biopsies taken? Are you familiar with osteonecrosis or osteomyelitis? A good website to learn about various types of facial, neuropathic pain is www.drshankland.com. He's written two books on the subject as well.

Let me know what you think.
Bryanna

Hey Bryanna - sorry I didn't include that important piece of info: Yes, I was diagnosed and treated for ostemyelitis. The biopsies didn't "show anything" according to the oral surgeon who did the debridement. Thank you so much for helping me. I've read your posts and am so amazed that after working all day you can still come home and be so attentive to our needs. I will check out the website now. **Sorry it took me so long to reply, but I didn't find this "thread" till tonight. Again, thanks. Janet

Thanks to Bryanna from Janet
 

Thanks Bryanna - through the website you sent me I found a dentist within 100 miles who is a member of the Academy of Craniofacial Pain. This path may lead me to my glorious healing!
Janet

Hi Janet,
Generally, the biopsies of root canaled teeth come back with an assortment of histology. Unfortunately, some oral surgeons do not order a complete biopsy and the report is inconclusive. I have never seen a biopsy of a root canaled tooth come back clean. There is always necrotic pulpal remnants in the canals. Frequently, there is evidence of Ischemic bone and various types of necrosis not only in the tooth, but in the surrounding bone as well. Osteomyelitis is more commonly found in the jaw bone than the conventional dental profession realizes because biopsies of root canaled teeth are not a common practice in traditional dentistry. Those of us who routinely biopsy these teeth, see osteo dx more times than not.

I am able to spend some time answering these posts because I have cut my work week down to two to three days a week. I commute 90+ miles one way to my job so I stay at a hotel near the office on the days that I work. I don't have a laptop, so I post on the days that I am home and in between housework!

I am glad that the website was helpful to you! Please let us know how you are doing ~'.'~

Bryanna

Thanks to Bryanna
 

Hey Bryanna - thanks for your explanation of the "biopsy" - I'm going back to the oral surgeon for a f/u and will ask him for specifics.

By the way, if you'll take your right hand, reach over your shoulder and feel between your shoulder blades, I think you'll feel wings! God sends angels, even ones we can't see.

Have a great day. Janet

Hi Janet,
Well thanks for the kind words ;-) I'm just the messenger..... but I do believe that God sends Angels and I have had several come to me in my lifetime ;-)

Our office sends all of the biopsies to Jerry Bouquot, DDS, MSD, Director of Head and Neck Diagnostics Of America in Texas. He gives a very detailed gross description of the tissue received; microscopic description and diagnosis. He also checks for malignancy. It's at least a full page or two long, depending on the specimen. I would suggest that you ask your oral surgeon to give you a copy of the biopsy report and explain the findings to you.

Keep in touch...... have a nice holiday weekend!

Bryanna

Bryanna - again, I cannot thank you enough. I've been sick now for almost 4 years. Coming to this web site helps me see I'm not alone. Janet