Gum swelling resolved on it's own - expensive treatment?

Three things come to mind.
One, do a google search and learn as much as you can about it.
Second, if you are not in pain cancel or reschedule your surgery for a later date.
Third, get a second opinion...good luck !

Hello @bethj, From what you described it sounds more like you may have a periodontal abscess instead of an abscess forming at the root area.
With periodontal disease, a ‘pocket’ can form where the gum tissue is no longer tight against the tooth. That gap can collect food debris and something as minor as a popcorn hull can get trapped and eventually cause inflammation and swelling. If that pocket becomes infected with pus it’s pretty painful and nasty. You may have had that drain overnight on its own overnight…explains the nasty taste.
https://www.healthline.com/health/gum-abscess

Usually if it’s an abscess at the root of the tooth, which would be what you had before in that tooth to warrant a root canal, it wouldn’t show up as a painful swelling around the gum line of the tooth. That’s more of a symptom of a periodontal abscess. If it was a root abscess that infected, it should have shown up on the x-ray.

I’m not a dentist so I can’t diagnose a condition, but I’ve been in the dental field for 30+ years and have experience with what you’re describing. If it is an abscess it would definitely need to be treated in the method the emergency dentist suggested. However, if the bone/gum health around that tooth is lacking then a new root canal and a new crown wouldn’t really be the best option.

May I ask when was the last time you had your teeth professionally cleaned? Did you have any discussions with your dentist about having periodontal disease? If there are pockets around your teeth, this can happen repeatedly. There are deep cleaning and reparative methods to help restore the gum tissue to a healthy level though so it may be worth postponing this appt to get a second opinion first.
Do you have a regular dentist you see? Could you get in to have a second opinion?

Hi, I had them cleaned a few months ago. But this inflammation happened after I spent a week away staying at a hostel with limited access to my usual care equipment. I usually use a hydropulser to clean between my teeth because they are close together making flossing tricky, and I have two implants on the lower jaw as not all my adult teeth came through. Tbere I only had a regular toothbrush and very early flight. I might have nlt brushed that morning. Maybe that is how this happened. Seems like a good idea to get a second opinion. I don't want to do any expensive surgery which may be useless. Although the tooth no longer hurts as much it is sensitive when I bite on it and it does feel a little bruised above the teeth, I guess where the sinus is. It hurts to touch here or if I strain cheek muscles like in a big smile. I don't have any other symptoms so maybe just inflammation that irritated this area too? I'm going to see if it stays relatively pain free this eve then see if I can book in to get a second opinion..

It sounds like you’re getting very good dental care and also a proactive with your dental health. ☺️

Since this is an upper tooth, that may change the situation a bit. The sinus cavities on x-ray can mask the possibility of an abscess at the root of the tooth. So the emergency dentist might be right, but it could still warrant a second opinion.
Since you have a general dentist. whom you’ve seen in the past few month, see if you can’t get in to have that tooth looked at for a second opinion.
But you also don’t want to get caught on a weekend again with a flare up of symptoms if it is abscessing. Give your dentist a call…
Does your general dentist perform root canals and crowns? Would you feel more comfortable with your usual dentist?

Hi Lori,

I've just written to the dentist who helped me last time when I had an issue. If I can get a consultation with them in the next days I think that's the best strategy. I would feel a lot better with a second opinion from someone I've seen before. Thanks a lot for your guidance. Hopefully they have a spot for me in the next days.

Best,
Beth

If you’re going to cancel your appt for tomorrow though, do it soon because often there can be a charge if not canceled within 24 hours. That’s a large portion of time set aside for your treatment so the dental office would want to be able to fill that if possible. Good luck! Let me know what you find out with your consult, ok?

Hi Lori,

I didn't hear back from the other dentist so I went in today for the appointment. The dentist said it was up to me but that the residual pain was due to the infection and I was likely to have more problems, that it could come back. I decided to go ahead with the procedure. It was very unpleasant. Lots of hammering and some disconcerting not very reassuring comments like telling a person who came into the surgery during the treatment he was busy with a difficult case, not finding the right drill at some point, asking the assistant if she was asleep at some point and general comments about the root being difficult to get to. I didn't take this as a mark of incompetence, just style. The French don't always treat customers delicately and I guess that goes for the dentist and not just the waiter. Also I was far too tense to react anyway. I think he did a thorough job. Jaw pretty sore but hopefully made the right decision. There's just one thing i'm unsure about. He prescribed predisolone, if still pain, codeine-paracetamol, and amoxixillin to take only if it seems like the infection is reflaring up. What I don't understand is that if the point is to get rid of infection, and protect the newly done tooth, surely it's advisable to take the antibiotic? I know they aren't great for the guts and resistance is a real thing so if it's safe to not take them at all I'm happy with that but I want to have the best chance of keeping this tooth now. I think the otber dentist prescribed antibiotics for this treatment the last time. Is this new guidelines for dentists and antibiotics? Should i just take them or wait and see for the flare up?

Oh my goodness, you had an epic appointment…
Well, I’m relieved for you that it’s all behind and hopefully the infection is gone and won’t return.

While it isn’t usual to prescribe prednisone after dental procedures/surgery, it is used to keep swelling to a minimum. Is this just for a day or so?

It will be difficult over the next few days to determine if the discomfort is from all the work or the infection. Generally there is an antibiotic prescribed but if your dentist feels all signs of the cyst/infection has been eliminated maybe that’s why he’s having you wait? There can be issues with antibiotics but if used in conjunction with probiotics or yogurt, most gut issues are avoided. So if you need them, don’t hesitate. But if you start, make sure you take the prescribed amount for the full course of days.

For now, it might help to apply an icepack in a towel to that area on and off for 20 minutes at a time for an hour or so. Relax today and take an analgesic if you need it. Your jaw may be sore and stiff, so cold compresses on each side might feel good too. Also, today and tomorrow, exercise your jaw muscles by doing a few gentle openings while placing your tongue to the roof of your mouth. You can also wiggle your lower jaw side to side, again…gently. That will keep the muscles from tightening up.

How does your gum tissue look. Does it still look infected?

No it doesn't. It looked fine today before the procedure. I could close the jaw no problem. The only pain was above the root of the tooth around the cheek bone. I couldn't see anything there so couldn't tell if it was swollen from the infection inside somewhere or residual pain from the gum swelling or maybe irritated nerves around there. That's why I wasn't sure ifbkt was worth going ahead or not. Will never know now I guess! Moving the jaw around is a good idea.. The predisolone is for 3 days. I guess if it looks like it's swelling after that I should do the antibiotics. I've got actimel in already, just in case. 😊

Hi @bethj, how’s your tooth/mouth feeling after all the dental excitement last week? Did you experience any more signs of infection?