Swelling months after extraction (teeth, gums, pain, dentist)

[Birches]

Six years ago I had a root canal on a lower right tooth, followed eventually by a crown. Last summer, after I noticed my cheek swelling up around the same tooth, my dentist found an abscess and crack, gave me an antibiotic, and told me to schedule an extraction, which I had six weeks later. X-rays revealed nothing else wrong.

The swelling persisted, though less pronounced, after a second antibiotic prior to the extraction, and then also persisted unchanged after the extraction, which was five months ago by now. I initially used ice packs and Tylenol to try to reduce it, but eventually stopped. The swelling remains mild but clearly visible, leaving the lower cheek area to the right side of my mouth looking chronically slightly puffy. Though the area has a slight awkward feel, and once in a while a subtle dull ache that I’m mostly aware of at night, it isn’t painful. The awkwardness appears to be mainly in the cheek area, and not in the socket, surrounding teeth, or gums.

When I returned to the oral surgeon after a month to inquire about the swelling, he told me that the swelling could sometimes take three months or so to go down, since there had been an abscess, and that everything else looked fine. I waited three months and then returned again, at which point I received a strong antibiotic on the chance there was still some abscess. The other option, he indicated, would be to reopen the socket, but since it appears to have healed fine and I don’t have pain in it, doing so likely wouldn’t resolve the issue. No x-rays or other examinations were done.

I have since moved out of state, but the swelling remains unchanged. I am wondering if anyone has any suggestions for what might be causing it, or what can be done about it. Could it be simply a matter of very slow healing or might it persist as a result of damage or irritation to a muscle, nerves, or something else? If this is something I would like to follow up on in my new location, should I seek out another oral surgeon or a different kind of specialist?

I would be very grateful for any and all insights and suggestions.

[Roselvr]

Originally Posted by Birches

Six years ago I had a root canal on a lower right tooth, followed eventually by a crown. Last summer, after I noticed my cheek swelling up around the same tooth, my dentist found an abscess and crack, gave me an antibiotic, and told me to schedule an extraction, which I had six weeks later. X-rays revealed nothing else wrong.

The swelling persisted, though less pronounced, after a second antibiotic prior to the extraction, and then also persisted unchanged after the extraction, which was five months ago by now. I initially used ice packs and Tylenol to try to reduce it, but eventually stopped. The swelling remains mild but clearly visible, leaving the lower cheek area to the right side of my mouth looking chronically slightly puffy. Though the area has a slight awkward feel, and once in a while a subtle dull ache that I’m mostly aware of at night, it isn’t painful. The awkwardness appears to be mainly in the cheek area, and not in the socket, surrounding teeth, or gums.

When I returned to the oral surgeon after a month to inquire about the swelling, he told me that the swelling could sometimes take three months or so to go down, since there had been an abscess, and that everything else looked fine. I waited three months and then returned again, at which point I received a strong antibiotic on the chance there was still some abscess. The other option, he indicated, would be to reopen the socket, but since it appears to have healed fine and I don’t have pain in it, doing so likely wouldn’t resolve the issue. No x-rays or other examinations were done.

I have since moved out of state, but the swelling remains unchanged. I am wondering if anyone has any suggestions for what might be causing it, or what can be done about it. Could it be simply a matter of very slow healing or might it persist as a result of damage or irritation to a muscle, nerves, or something else? If this is something I would like to follow up on in my new location, should I seek out another oral surgeon or a different kind of specialist?

I would be very grateful for any and all insights and suggestions.

I suggest you see an ear, nose and throat doctor who may be better at figuring out what is wrong, such as if it is a salivary gland that is swollen or even cancerous.

See the photo at this link to see if it matches one of the glands.

[Nov3]

I cannot tell you what is causing it .

Will tell you that simplicity in gum care is usually the antidote.

There is zero harm and high benefit in doing the following:

Rinse mouth three times daily with warm salted water.

near the affected area - Use a product found in the spice aisle called alum. ( potassium aluminum sulfate).
Just wet a small amount on your finger and rub near the affected area.

Usually three to five days of this daily routine will show sufficient improvement. If there is ZERO improvement than its more a BONE /blood concern. Chipped bone that was healed over can aggravate and cause intermittent swelling... Dont quote me on this as an exray would need done to determine the cause and eventual treatment.

[Birches]

I very much appreciate the information and suggestions that both of you provided and will follow up both with the practical care recommended on my own and consulting with a specialist to dig deeper into the problem. I hadn't thought of the possibility of a connection to a salivary gland, but do see that there appears to be one below the area, nor the possibility that there could be a bone fragment that might cause aggravation, despite the area having healed nicely. Thank you so much for your responses!