What is this and how worried should I be?

[VeryScaredGirl]

For context:

This tooth broke off over 20 years ago. Around 15 years ago I saw a dentist because it was digging into my cheek. He said it was dead and wouldn’t cause me any issues as long as he filed it down. Which he did. And that I could get this taken care off once I’d sorted any other dental treatment I needed sorted and it wouldn’t ever cause me any issues.

For the last, 10 days, I have had ulcers appear on my gum line near this tooth but also on the roof of my mouth on both sides and on my throat. They are always linked to food and in particular foods I have sensitivity to and disappear when I avoid those foods. (So I think this may be related to potential Crohns just wanted to add for context in case related)
I have also recently been on 7 days of antibiotics for tonsillitis (again not related as both my son and husband had it too so not a spreading infection).

Since around the time of the tonsillitis I have had a general jaw ache, ear ache and cheek swelling on the left hand side of my face. Which we assumed was linked to swollen lymph nodes/glands. (I have had 3 weeks of antibiotics, a week of antibiotics for an infected piercing and then the antibiotics for tonsillitis so haven’t really been well for over a month and a half).
The last couple of days I have felt a slight sensitivity sort of around the broken tooth. But nothing similar to an abscess. Gums have always been a normal pink colour and I’ve been able to eat on that side. Today when taking a photo of my cheek I noticed the clear blob type thing shown in the picture. I don’t think I’ve seen it there before?!

I made the mistake of asking AI what might be happening and it has suggested a fistula/sinus tract and suggested I’m at risk of osteomyelitis and should to go hospital immediately.
Obviously that’s now put the fear in me. I visited a dentist recently for a separate issue and had a panic attack with her just putting the mirror in my mouth. She gave me antibiotics and referred me to an oral surgeon to have a wisdom tooth removed under GA because I wouldn’t be able to tolerate it normally.
So the thought of this being a serious dental issue is making me very very anxious.

• I appreciate it’s difficult with only an image but what do you think this is likely to be?

• Despite this being on the bottom tooth and the inflammation of my cheek being higher up are they likely related?

• What are the chances this has also caused the ulcers elsewhere in my mouth?

• If this is an abscess which has spread so badly, how has it done so despite me having 4 different types of antibiotics (albeit for different reasons)

• I am on a high dose steroid (20mg) - does this put me at more risk of this causing me serious harm/sepsis? I know you say this isn’t the case usually but with my medical history?

• What would the treatment/next steps be? I have Ehler Danlos so am immune to local anaesthetic and also have POTS so can’t get my heart rate too high which, with anxiety, is challenging.
I am on the wait list for a specialist NHS dentist but the wait list is upwards of two years. Will it kill me before then?!

I’m so so so scared.

Pain is mostly in my jaw/ear/cheek rather than the area of the tooth specifically. And I can touch with my tongue without any real pain.

 

[Gordon]

• I appreciate it’s difficult with only an image but what do you think this is likely to be?

Pulp polyp. Oddly enough the second one today Harmless.

• Despite this being on the bottom tooth and the inflammation of my cheek being higher up are they likely related?

Not likely. Maybe there's a sharp edge on the broken tooth that's rubbing against the cheek when you're eating/talking

• What are the chances this has also caused the ulcers elsewhere in my mouth?

Zero

• If this is an abscess which has spread so badly, how has it done so despite me having 4 different types of antibiotics (albeit for different reasons)

It isn't

• I am on a high dose steroid (20mg) - does this put me at more risk of this causing me serious harm/sepsis? I know you say this isn’t the case usually but with my medical history?

Nope

• What would the treatment/next steps be? I have Ehler Danlos so am immune to local anaesthetic and also have POTS so can’t get my heart rate too high which, with anxiety, is challenging.
I am on the wait list for a specialist NHS dentist but the wait list is upwards of two years. Will it kill me before then?!

Get the tooth out when you're getting the GA? It won't kill you at any time, ever.

 

[Gordon]

As a by the by, some of the alternative local anaesthetics like Articaine and Bupivacaine are effective in E-D syndrome, you might find they work on you where the "standard" Lidocaine doesn't work so well.