[32F] With severe toothache and facial swelling

Patient Description

A 32-year-old female presents with a toothache on the lower back right side of her mouth for the past two days. The pain is described as throbbing and sometimes sharp, rated close to severe, and exacerbated by eating, drinking, or touching the face. Accompanying symptoms include facial swelling, ear pain for one day, and a mild fever of 99.9°F. The toothache developed gradually, with swelling appearing before the pain. The patient reports difficulty opening her mouth fully due to pain. She has not had recent dental work, injuries, or infections. There are no known drug allergies. The patient has been taking Excedrin every four hours for the last 24 hours without side effects. No other medications or supplements are reported. There is a history of lack of dental treatments.

Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

Dental Abscess: This is an infection at the root of a tooth or between the gum and a tooth. It can cause severe pain, swelling, and fever. The throbbing pain and swelling you describe are common symptoms.
- Treatment typically involves antibiotics to clear the infection and dental procedures to drain the abscess or treat the affected tooth.
Tooth Decay or Cavity: If untreated, cavities can lead to pain and infection. The pain can become severe and affect surrounding areas, like your ear.
- Treatment involves dental fillings or other procedures to repair the tooth.
Gum Infection (Gingivitis or Periodontitis): Infections in the gums can cause swelling, pain, and fever.
- Treatment includes professional cleaning and possibly antibiotics.

What you can do

See a Dentist: It's important to see a dentist as soon as possible for a proper diagnosis and treatment.
Pain Management: Continue using over-the-counter pain relief like Excedrin, but follow the recommended dosage.
Warm Salt Water Rinse: Rinse your mouth with warm salt water to help reduce swelling and discomfort.
Cold Compress: Apply a cold compress to the outside of your cheek to help reduce swelling.
Track Symptoms: Use MDandMe to journal your symptoms, track progress, and share notes with your healthcare provider.