Locked up Jaw, abcess! Oral Cancer survivor

[foxie]

Hello
I had to go to ER with an extremely huge swollen and painful jaw area. I do have a history of TMJ, but this was different. The Dr. diagnosed probable abcessed tooth, which I agreed with and started me with a transfusion antibiotic, as well as a follow up prescription. Then the following Tuesday I went to the local dental clinic and they were totally unable to help me and suggested I go to an oral surgeon. Her reasons were 1) I was unable to open my mouth even big enough for xrays and 2) In 2000 I was treated for lingual cancer and had radiation over my mouth area which may lead to a secondary infection from the radiation treatment itself??? (literally destroyed my teeth as well as ruined my saliva gland)_. I am fine as I am alive, but I was a gal with perfect teeth prior. (no i do not smoke or chew) She mentioned some people can get a secondary infection due to the radiation treatment??? I thought okkkkkkk, but it still has to come out obviously.

I went to the oral surgeon, he was wonderful and stated the ER doc did good with the antibiotic but I needed more...so he prescribed another as well as codiene/advil..basically. let me add, I am disabled and I do have some strong meds already. He was able to get a para film done and was able to decide which teeth are prob the problems. However, again he could not get my mouth open and stated it was because the muscles were very contracted and having spasms due to the pain. Well its been a week since Ive seen him, although I am keeping in touch by phone. I have seen my chiropractor who has often had good results with getting my jaw to release, in the past. The swelling is significantly down, and the pain extremely better!! But I am only able to open my mouth about 1/2 an inch. She would put that lower jaw in place and the muscles would pull it right back out. You can feel where the muscles are totally hard and contracted now. I am going back to her tomorrow. How long should it take for a jaw to open up? Have any of the dentists here seen a case where the jaw was so locked up? I would like to get some answer here, as its been so long. It swelled up over 24 hours and started on May 29 with some pain, next day totally swollen. Im not the most patient person, I have to admit.

I have been eating almost total fluids for 12 days. Tonight I got down some overcooked pasta, lol. I am drinking yogurt every day to protect from other infections, from the antibiotics. Its on the borderline of getting really annoying but again thank goodness the pain is improved..and the swelling. I was fortunate in the people I put my trust in. On top of that, being a past oral cancer patient I do have several issues with people working on my mouth area, such as anxiety as well as a feeling of people hedging around me and I feel a lot of claustaphobia.

So again my questions are: first have you seen such a case where opening up the jaw has been so dramatic over time? what might I do to increase this potential to do so? (I did try relaxing all day today)

Another question: Is there a potential for an infection due to past radiation exposure, from several years ago, when extracting a tooth? Ive never heard fo this.
Thanks
foxie

 

[Gordon]

Hi Foxie. Yes, there is a potential for severe infection after extractions, if it's in an area which had radiotherapy, the risk is quite high and the resulting infection can be very serious.

I'm curious, did you have the opening problem before the abscess all started or afterwards?

It's not at all unusual to have very limited opening after radiotherapy due to scarring of the facial tissues. If this is the case, then it's unlikely that the opening will get much better no matter what you try, the best thing may well be a general anaesthetic to get as much opening as possible.