Probable abscess - losing my wits!

[Sausage]

Hi all. Apologies in advance for the long post. I’m very severely dental/needle/anything medical phobic to the point that even having blood pressure taken makes me feel faint. It’s something that has got worse with age and now at 31 and 11 years since my last dentist or doctors visit has become truly debilitating.

I broke my second molar on my lower jaw sometime around March/April last year which didn’t really give me any trouble until mid August this year when biting something quite hard brought on a pretty sudden and severe toothache. A weekend of painkillers later I was resigned to finding a dentist that Monday morning but I woke up that Monday to a dramatic improvement so naturally left it be.

Fast forward a month to mid September the toothache came back and this time prodding around the area I found a hard lump under my chin around my submandibular gland. Not very big maybe slightly bigger than pea sized and can be rolled around a little between my fingers, not far, but as said quite hard and firm.

So finally I found an emergency dentist and plucked up the balls to go in and have it looked at. I was given an x-ray and she had a prod around the area and as I suspected infected, needing extraction. The lump under the chin didn’t even draw comment and so I was happy to delude myself that no news was good news and let it lie. I was given 7 days of amoxicillin and metronidazole and an appointment to have it extracted a week later. The antibiotics seemed to hit the infection quite effectively and it did go down.

Im surprised I actually managed to drive myself to that appointment and sit in the chair but needless to say as soon as I opened my mouth for the needle I fell to bits, full blown panic attack. The dentist agreed it would be difficult to work on me in the state I was in, tooth was relatively painless so she referred me to a sedation clinic within 2 weeks.

2 weeks passed, no sign of an appointment, infection coming back so I got back in, was given another 7 days of amoxicillin and metronidazole and a temporary filling to keep any nasties out of the gaping cavity. This time the antibiotics didn’t seem to do a lot, course finished, a day later I got the appointment at the sedation clinic - 12th November. 4 weeks away.

I got back in at the dentist because I really didn’t know what to do. 4 weeks seems such a long time and everything I read on Dr Google tells me there is no time to delay.

This time it was a different dentist. I got x-ray again, confirmed definite infection under the gum (visual inspection of the swollen bulge on my gum was enough to confirm really), all she could do other than extract there and then was remove the temporary filling so that pus and stuff could escape. She didn’t seem too concerned about waiting 4 weeks for the sedation clinic and told me the infection won’t spread. But cannot be prescribed anymore antibiotics, so it’s just me and a cup of saltwater feeling like we are defending Rorkes Drift.

So where I’m at now is, I have a permanently foul taste in my mouth, some minor but very bearable tenderness in the tooth (not severe pain by any stretch) but an obvious protruding swell on my gum from the infection, this hard lump under my chin and a mind numbing bout of health anxiety that I will either develop sepsis and die before my appointment at the sedation clinic comes about or that this hard lump in my submandibular area which has so far gone without comment is… best not go there.

Is another 26 days really so long? Am I worrying myself unnecessarily here? I really don’t know what to do. I am away from home now for the next 6 days and keep having random panics whilst I transfix on the very worst consequences.

I know I can’t go on like this and regret that I have let things develop to this stage.

 

[letsconnect]

Hi, we're getting this question about Dr. Google and sepsis every few days it seems! Your dentist is correct about it not being a problem to wait for a month - do a search for "sepsis" on this forum (there's a search icon at the top, in the blue bar). @Gordon must have answered this question about a hundred times by now - bless him ?

 

[Sausage]

Apologies, in fact I did! But via google website search rather than using the site search. The threads I looked at left it inconclusive for me!

Thank you for reaffirming that for me though. I know I should just trust the dentists word and not look on google, I wish I had.

Is the constant foul taste usual with a tooth infection? I have had one abscess before, 11 years ago on a tooth I broke in my mid teens by biting nuts open (why?!) which again I left for years before it became problematic. But that was unbearably painful, had little outward swelling and cannot remember any lingering bad taste. So the complete opposite to this current tooth, although I suspect abscesses are a lot like the people they inhabit and no two are the same?

 

[Sausage]

Thank you for pointing me to the search on this site. An hour or so flicking through the results for sepsis has made me feel much better about the prospect of waiting 4 weeks to be seen, will just have to try and ensure maximum cleanliness and try to keep up with regular mouthwashes throughout the day on top of morning and night.

Feel like a bit of a wet wipe for getting worked up to the point of hysteria I was beginning to reach to be honest!

 

[letsconnect]

Healthline Media has a lot to answer for (that and the fake OMS dude on Quora or Reddit or wherever he is now...)

Keeping my fingers crossed that it won't flare up before your appointment

The foul taste might be the pus draining? (@Gordon could probably tell you more)

 

[Sausage]

That is the logical conclusion although I would have thought that would be sporadic rather than constant. Food and drink still tastes normal and good just my resting saliva taste is yuck.

Covid test negative.

Could be something else I suppose.

 

[Gordon]

That is the logical conclusion although I would have thought that would be sporadic rather than constant. Food and drink still tastes normal and good just my resting saliva taste is yuck.

Nope, it'd be draining continuously so more likely to be constant. Unless the drainage "channel" gets blocked up, but then there would be a flare of pain before the bad taste i(f the drainage opened again).

 

[Sausage]

Well I made it. If anything the infection has probably improved with removal of the temporary filling and regular mouth washing with salt water and coconut oil.

Hospital appointment is tomorrow morning. I’d just put it to the back of my mind and tried to forget about it but probably should have been confronting it in my mind and building up some kind of battle focus… as absurd as that sounds. I’m genuinely bricking it now and have absolutely no idea what’s actually on the cards for tomorrow.

Does the sedation really make enough of a difference to keep you sitting still and let them crack on with the job? It just seems such an impossibility, as long you’re cognisant enough to know what’s happening surely the fight or flight just takes over?? I really don’t know how people manage to have dental procedures done, the concept of allowing someone to stab you in the face with a needle is just a complete non-starter to me.

 

[Gordon]

Read some of the articles on here about IV sedation. It's amazing stuff. No fight or flight, you're sort of aware of what's going on (although you won't remember that) but you just don't care a bit.

 

[letsconnect]

Here are the articles that Gordon is talking about:

IV Sedation

Find out all about IV dental sedation: what does it feel like, is it safe, and how do the sedation drugs midazolam and remimazolam differ?

www.dentalfearcentral.org

IV Sedation Experiences

Read about IV sedation experiences which people have shared on Dental Fear Central over the years!

www.dentalfearcentral.org

It can be helpful to keep in mind that you're taking action and doing this for yourself and your health, rather than "allowing someone to do something to you" ?.

Best of luck for tomorrow and let us know how you got on!

 

[Sausage]

Thanks, I have seen that. Whilst the effect sounds ideal the IV part gives me the shudders, so I’m kind of hoping the diazepam and/or gas & air might be enough to get me over the line. It’s the needle that is the big obstacle, once that’s done I think I will be ok. But at this point after 3 failed trips to the dentist I would take whatever help is necessary.

Is there likely to be a consultation appointment first to be followed by the procedure at a later date or will they be planning on pulling the tooth there and then on the day? I have tried ringing several times but from what I gather it’s just a pop up clinic rather than an actual dentistry department and so have never managed to actually speak to anyone who knows anything.

Unfortunately my young daughter may well have just thrown a spanner in the works by testing positive on a lateral flow after school, so awaiting PCR result but looks like I will have to reschedule as my appointment is in the morning, even if it returns negative first thing it would be a push to get there on time.

It took 2 months to get this appointment!

How long can I reasonably carry on with this infection? I’m not sure if the tooth is dead or not but it’s generally painless, sometimes some discomfort and mild pain which comes and goes. My submandibular lymph node behind the broken molar has ballooned into a what I personally would call a big hard round ball (although GP said it’s soft, smooth and not extraordinary to accompany a long term infection, but did seem surprised that other lymph nodes in my neck and head weren’t enlarged, not sure if that’s good or bad). I am just so tired in general most the time though these last few weeks, I can certainly tell it’s starting to take its toll. I’m sure catching covid myself won’t be much fun with this infection running alongside sapping my reserves away and already keeping my immune system busy.

Wish I could just go and sit in the dentist chair like normal people! I just want it all over and done with now.

 

[Gordon]

I would think it will be a treatment appointment. Have you been given a list of instructions including bringing an escort?
Usually a bit of premed can help get over getting the IV line in. They'll be used to needle phobics so don't be embarrassed to tell them how you feel.

The tooth is already dead, you don't get an abscess with a live tooth. There is absolutely no way to tell how long you can go on like this, sorry.

 

[Sausage]

I was not, just a letter for the appointment. I managed to make it anyway thank god, it was just a consultation. She didn’t go into different types of sedation she just said she can either numb it or put me to sleep. It sounds like going to sleep is going to be the likely way forward, and take out another cracked tooth on the other side at the same time (which I didn’t tell the regular dentist about).

So it’s back to the regular dentist to get another referral for the other tooth and then another consultation I think before finally getting the treatment at an as yet unknown lead time.

Today’s appointment was very fast and brusque, in and out then sent for a full mouth x-ray in preparation for the next appointment, so don’t really know where I stand any better than I did this morning! But at least things are moving I suppose, and I got a bit of exposure to being in a hospital and managed to sit there relaxed and calm by the end which will hopefully help quell some of the apprehension towards actually taking myself there in the future.

In terms of how long I can go on, I just don’t know what the potential dangers are - if any - and what I need to watch out for really. Trying to find an answer to that question on google tells you if the tooth doesn’t get extracted immediately you will get sepsis and die! Or if so long as there is no pain or the pain and discomfort is bearable what’s to stop me leaving it indefinitely?

 

[Gordon]

What can go wrong is if the abscess gets blocked up, it's currently draining into your mouth. If that happens then you'll get acute pain and possibly some swelling. The issue is that you can't tell in advance when this might happen so it's totally random and likely to be at the worst possible time. 3am Xmas morning for instance.
You won't get sepsis and there is no huge risk to your life.

 

[Sausage]

Fantastic, thanks Gordon. That helps put my mind at rest. Why can’t they just put these things simply on the pages that get the top results on google, instead of trying to scare everyone half to death!


I have been quite meticulous about keeping the tooth clean and regular mouthwashes after eating, restricting food and any sugary drinks to meal times, so fingers crossed I manage to go the distance.


It will inevitably be 3am Christmas morning though, and Santa will get delayed whilst he’s searching for his whiskey.

 

[Gordon]

I don't know enough about how Google works to comment. All I can do is keep repeating it on here and hope it finally sinks in. We've covered it a LOT of times.