Your description of the infection can be indicative of an infected tooth/teeth. Yes, please post the pre and post op radiographs if you can as they may be helpful in pinpointing which tooth or teeth may be involved. Another thing that could be picked on the x-rays is a questionable area of a long standing infection that was not treated.
The swelling above the tooth could have been a fistula ... as you would probably know this occurs when bacteria proliferates beyond it's original site and saturates the tissue. Or it could have been a pocket of infection brought on by bacteria from a source other than a tooth... a contaminated instrument or a piece of "foreign" material that was used during all the prep and finish of your dental work.
The chances of this infection being unrelated to a tooth is pretty slim. Especially given the extent of dental work that you've had done. The prognosis of this healing on it's own can only be determined once the source of the infection is diagnosed. If it is tooth related, the infection will be present as long as the tooth is present because there is no mechanical or medicinal method to "cure" a tooth of an infection.
If you can, post the x-rays...
Originally Posted by DigitalNY
I'm a 34 year old male patient, 6'5", 185lbs, in good overall general health. I take no regular supplements or medications with the exception of a daily multivitamin. I have a drug allergy to Sulfa drugs.
On March 21st of this year I flew from my home in the US to eastern europe to visit a dental clinic and have major dental reconstruction performed.
8 teeth had previously been extracted approximately 5 years ago (Teeth 1,2,15,16,17,18,31,32)
On day one my lower teeth were prepared for crowns. On day two my upper teeth were prepared for crowns. The remaining root (radix dentis) of one decayed tooth (tooth 13) was extracted. After each preparation I was provided with temporary crowns.
On day 3 I had a root canal of tooth 7 performed by an endodontist. Overall the root canal wasn't that bad of a procedure and only took approximately 20 minutes. The canal was packed with medicated temporary filling and I was scheduled to return a week later.
A week from the root canal I returned, had a new x-ray performed and was given the green light having the permanent crown with pin placed. To tide me over until the placement of the crowns the tooth was again packed with a medicated filling as a prophylactic. Final impressions were taken and I was rescheduled to come back a week later for placement of the permanent PFM crowns.
I returned a week later and had the permanent crowns placed. The fit and finish was absolutely amazing. After 5 days I returned once again for minor adjustments and couldn't have been happier.
I returned to the US on April 11th. Since returning I have had what feels like sinus pressure and minor swelling above the lip line of tooth 10. This progressed to a throbbing pain upon laying down and I began worrying that I might have an abscessed tooth.
Having a family of medical professionals and being a paramedic myself I have a tendency to self-medicate and I understand the dangers associated with that.
I began taking 600mg Ibuprofen Q6H along with the occasional 5/325 Hydrocodone / APAP.
Approximately 4 days after onset of symptoms I noticed a slight swelling of the gum tucked way under my front lip in front of that tooth. Fearing the worst I took a 450mg loading dose followed by 300mg QID of Clindamycin.
I don't believe the infection involves the nerve of a specific tooth. I have tested each tooth individually for both cold and hot sensitivity and find that none of them are abnormally sensitive. They are all equally sensitive to direct cold with minor discomfort and none of them are sensitive to heat (I can comfortably drink hot tea). I find no particular tooth has a deficit of sensitivity.
The infection progressed until the gum at that point was slightly discolored and white when the infection came to the surface. 24 hours ago I lanced and drained the abscess and have been proceeding with saline rinses of my mouth intermittently since. I slept last night with absorbent gauze packed in my gum and there were signs of continued drainage this morning upon waking.
I have been off the ibuprofen and hydrocodone / APAP since last night as there is no need for it now and I feel the infection is resolving itself. My minor fever that was previous prior to the gum being lanced is gone and it feels as though I'm on the road to recovery.
Now the question. With no obvious involvement of a specific tooth, and the fact that this happened after rather major restoration (18 crowns, 1 permanent bridge). What are the chances that this is unrelated to a tooth root? What is an honest prognosis if the antibiotics are continued and drainage opening allowed to heal on it's own?
Before / After pics & Panorex Available.