Jaw pain and swelling for more than 4 weeks

[Useruser]

Hi,

I have been dealing with upper and lower jaw pain with swelling under the ear. It's been more than 4 weeks. I did have some sinus infection and ear infection. I got some antibiotics from urgent care. After 2 weeks of antibiotics, thelower jaw pain, ear pain with swelling doesn't reduce. I went to an ENT last week to check my ear. He did Endo to check my sinus and also checked my ear. He said there is no infection in sinus and ear.

I was so confused and did go to the dentist. He checked for infection in the x-ray and it's not. He said since I was on antibiotics, if at all there was an infection present in the upper wisdom tooth or any other, it would have been cleared. He checked all my tooth in that side with a blue color stick and asked me to bite. I felt some discomfort and tenderness on one tooth bite. It's tooth #30. He said I might have a fracture in that tooth root and asked me to get CT scan. I took CT scan for that tooth(#30) and pan xray.

He didn't see any jaw bone issue in the pan xray. He said he couldn't find any crack in the CT scan. But he see something little and he is guessing that it might have a fracture. So he told me to go for extraction asap. He said RCT with crown might not work. If I feel pain after RCT, it's a waste of time and money. So he told me to go for extraction and implant immediately. I dont have any pain in that tooth until i go to the dentist.

I was totally confused and worried. He is not my regular dentist . My regular dentist is not available today and he is a new dentist and he has been practicing for an year.

I don't know if I can proceed with extraction with this guess. I do have some pain in the upper wisdom tooth and i have to extract that. I feel sore and stabbing/throbbing pain in the upper wisdom tooth area and the lower jaw (exactly under ear and under tooth #30). It's swollen on the whole lower jaw and on upper jaw too. I don't know how to proceed with.

I was assumed that this swelling and jaw pain was because of ear pain and that was cleared by ENT. Then I thought it's TMJ. But that is not as per the dentist. He said TMJ issue will not give this swelling. I feel continuous pain in the lower jaw area. If i bite down, I feel sharp pain on tooth 30 and relief while releasing.

I don't know if its because of tooth# 30 crack or upper wisdom tooth or TMJ inflammation. How to identify?
I do have throbbing pain in the upper jaw and the lower jaw throughout the day. I have some sharp pain in the upper wisdom tooth area and the lower tooth area(#30).


I don't want to proceed with tooth #30 for rct or extraction without knowing the concrete answer for this issue. I don't want to exaggerate tmj pain if that's the cause.

any inputs?? please hlp. I am so nervous to do any dental treatments. that too in this current pandemic, i am so nervous.

 

[Useruser]

Attaching more images.
I am yet to collect the CBCT scan images in a CD from the office. I will post the ct scan images later.

 

[Useruser]

I haven't done any dental treatment in USA. So kind of nervous and worried. They also say I have a crack in tooth#30 and that's the reason for the jaw pain and swelling. I don't know if that's the reason. I don't feel any pain in that tooth. It's paining more on the upper jaw and lower jaw under the ear. I have throbbing pain in the upper wisdom tooth area. I don't know if it's TMJ or tooth#1 or tooth #30??

Is it erupted?
How soon should I remove this?

 

[Useruser]

Any inputs anyone??

 

[Gordon]

I'm not sure I can second guess a dentist who has actually examined you, so if they say you've got a cracked tooth and that's the reason for your symptoms, I would think that is the most likely thing.
Your upper wisdom teeth have over erupted out of their sockets because you've lost your lower ones, I'd consider removing them as they might be causing some trauma to your lower gums in the near future.

 

[Useruser]

I'm not sure I can second guess a dentist who has actually examined you, so if they say you've got a cracked tooth and that's the reason for your symptoms, I would think that is the most likely thing.
Your upper wisdom teeth have over erupted out of their sockets because you've lost your lower ones, I'd consider removing them as they might be causing some trauma to your lower gums in the near future.

Thank you so much.
How to diagnose if we have a crack? How do we confirm it?

 

[Useruser]

am having an Endo appointment today. This Endo doesn't allow/see images from another dentist office.
I have cbct scan taken in my dentist office last Friday. I have that on DVD. But she said she will take new one in her office for her diagnosis.

She said she has to take another CBCT scan in their office. I had CBCT scan last Friday. Can I take another one today? Is it very harmful Radiation of having more than one CT scan in a week?
This might sound silly . But I am anxious about dental treatments. So would like to know if getting more than x-ray and CT scan not harmful?
Any thoughts anyone?

 

[Useruser]

am having an Endo appointment today. This Endo doesn't allow/see images from another dentist office. She said she has to take another CBCT scan in their office. I had CBCT scan last Friday. Can I take another one today? Is it very harmful Radiation of having more than one CT scan in a week?
This might sound silly . But I am anxious about dental treatments. So would like to know if getting more than x-ray and CT scan not harmful?
Any thoughts anyone?

 

[Gordon]

It's not particularly harmful to have 2 scans in a week, it's not ideal though, I wonder why she won't use the existing image?
Cracks are very hard to diagnose, unless they're blindingly obvious. Normally you go by symptoms. Pain on release of pressure, pain when biting on a specific part of the tooth etc.

 

[Useruser]

It's not particularly harmful to have 2 scans in a week, it's not ideal though, I wonder why she won't use the existing image?
Cracks are very hard to diagnose, unless they're blindingly obvious. Normally you go by symptoms. Pain on release of pressure, pain when biting on a specific part of the tooth etc.

Their office said she will not allow other office images. She rely on her diagnosis for treatment plan. That's the answer front office said.

 

[Useruser]

Should I avoid going to this office? I am having appointment in another hour.

 

[krlovesherkids777]

Useruser

How did your appt go? How do you feel about it? Thinking of you..

 

[Useruser]

Useruser

How did your appt go? How do you feel about it? Thinking of you..

Thanks for checking.

I am just back from the Endo appointment. They took an x-ray on my lower teeth. They said they want to cbct scan. I told them that I have to talk to Dr for the confirmation before taking the scan.

She looked into my tooth with the microscope kind of thing. She said she couldn't see any fracture. She did cold test. Something very cold. She pour it on my each tooth and asked if I could feel soreness and for how long. I never experienced this before. It was very very throbbing for 2 seconds and stopped. But for #30 , I felt soreness and tender for about 5 to 10 seconds. She said there might be small crack in that spot. You don't need a RCT for they. You can get a crown from the dentist.

And I asked why I am getting the throbbing pain while lying down and I have swelling which is not reducing at all for about a month.

She said she will check the tooth with cold test again. And test me one more time. She has put more cold spray this time by mistake and she apologized for that. I was throbbing for more this time since she put more ice thing spray. Then I felt sore for sometime for about 10seocnds.

I have throbbing pain in the night when I lie down for about 20 to 30 minutes on and off. So she said if it's throbbing more and paining for you, you can go for RCT and put on a crown. This is what happened today. She initially don't want to do rct and since I said I have throbbing pain, she said I can go for RCT.

I asked her why I have the swelling. She said she is not sure about it and the crack or the sensitivity doesn't cause swelling and might cause only the jaw pain. She also said your Swelling doesn't look big inside the mouth. Inside mouth is fine. Only the cheeks are swollen and she is not concerned about it at all. She told me to come back for RCT if I decided to.

But my main concern is the jaw pain and the swelling. I still feel throbbing pain sometimes in the upper and lower molars. Is putting more cold spray causes more throbbing?

What should be my next step to get some relief from this pain and Swelling? Any thoughts doctor? @Gordon, @drhirst, @Dr. Daniel

 

[Gordon]

Throbbing pain on lying down isn't necessarily from your teeth, it can come from sinuses.
Cold test is not totally conclusive, but a positive one is a good sign. Did she only do this, no electric test?

 

[Useruser]

Throbbing pain on lying down isn't necessarily from your teeth, it can come from sinuses.
Cold test is not totally conclusive, but a positive one is a good sign. Did she only do this, no electric test?

No. What is electric test?

 

[Useruser]

Throbbing pain on lying down isn't necessarily from your teeth, it can come from sinuses.
Cold test is not totally conclusive, but a positive one is a good sign. Did she only do this, no electric test?

Attaching the x-ray which have taken in the Endo office. Does it shows any crack in this xray?

 

[Useruser]

I have right lower jaw pain with swelling for past one month. It started after I did lots of chewing one day. Next day ear pain, jaw pain exactly under the ear started. Its very tender and pain to touch under the ear. No redness. I went to Dr and got antibiotics for sinus,ear infection. I thought the swelling is because of that. Sinus cleared up. Still there ear, jaw pain with swelling was there. Went to an ENT, he said no infection in sinus/ear. Went to dentist last week, took x-rays and said might be a crack/fracture in one tooth. Went to Endo, he confirmed no fracture, might be minor crack in 1st molar. More sensitivity in first low molar, so said RCT, crown. Endo said this crack or sensitivity will not give jaw swelling and he said not sure why. I have pain continuously under the ear in the jaw. Pain inside ear too. Is like scratchy sore pain in the low jaw where jaw ends on top of the neck under the ear. Tender to touch. I hear snapping sound from the jaw when I open mouth.
I feel some throbbing pain in the upper and lower jaw. It's exactly under the ear and in front of the ear. What could be the reason?
Is it something related to my 1st molar crack or sensitivity? My Endo said I might have a minor crack and more sensitivity in that tooth#30. But he said that will not give any swelling in the jaw.

What could be the issue. I am taking ibprufen for pain and swelling. I was taking indomethacin for a week earlier which was prescribed by urgent care.

But the pain and swelling didn't reduce at all. It's constant from day 1. Any thoughts anyone? Please help.

 

[Useruser]

 

[Gordon]

In that film immediately above, there looks like an obvious fracture down the MB root of the first molar, it could be a false image due to the angle of the film, but there's something odd there.

 

[Useruser]

In that film immediately above, there looks like an obvious fracture down the MB root of the first molar, it could be a false image due to the angle of the film, but there's something odd there.

This is my upper first molar?? Do you say that I have fracture in the upper molar? My dentist said I could have a crack in the lower first molar. Went to an Endodontist and they also checked my tooth#30. Lower first molar only. They didn't see anything on upper molar. They diagnose only the lower molar. I couldn't feel any discomfort while bite test on the upper molar. This is a new diagnosis. I have to confirm this. Thank you.

Btw, does the fracture cause lower jaw swelling and pain? I have pain exactly under the ear in the lower jaw. It's like sore scratchy pain.

Another question, did you see the crack in the other images attached on that molar?

Any dentists here in this forum who can confirm. Please.