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Chronic swelling in submental region, normal test results, no relief with antibiotics. What could be the cause?

Hi there. I am a 36 year old female. For the past approximately 5 years or so, I have been experiencing chronic swelling in the submental region. I have gone to see Doctors and also a ENT Specialist . I have gotten blood work, an ultrasound and a CT scan done for this purpose. All have come back normal . This swelling occurs every few months for about 3-4 days. I took anti biotics the first few times to treat this but the past few years I have been trying to fight it without antibiotics and the swelling would last about 3-4 days as well. The only thing I have not ruled out is dental problems. But if I had an infection in my teeth, gums or anywhere in my mouth, why would the swelling go away after 3-4 days without antibiotics? I m getting frustrated with this issue and very concerned that it could be something more. :(
Asked On : Sun, 16 Sep 2012
Answers:  4 Views:  313
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Dentist 's  Response
hello and welcome to hcm forum,
i am glad you wrote in, according to the dental history provided by you it seems that the swelling is associated with the either the teeth or the gums.
in order to rule out the diagnosis you will have to see a dentist.
you have not mentioned anything about pain or sensitivity with respect to the teeth.
usually swelling if due to dental problem,is associated with pain or sensitivity.'
sometimes, salivary glands stones can also cause a submental swelling. you need not worry, your dentist will take care of it.
i advise you not to overdose yourself if antibiotics until prescribed by your doctor,
i hope i answered your query,
i wish you good health.
Answered: Sun, 16 Sep 2012
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Dentist Dr. Bindiya Bhaskar's  Response
hello and welcome,

this is a case of gingival abscess as per the description given by you.

this is an acute ,localised and painful lesion of sudden onset.
it is caused by sudden forceful penetration of any foreign objects such as a bristle of a toothbrush or an apple core,which carry bacteria deep into the gingival tissue.

it is usually limited to marginal gingiva.

initially it appears as reddish swelling with a smooth and shiny surface.
within hours,it becomes fluctuant and exhibits pointing and through which pus discharges.

the connective tissue show vascular engorgemant,edema and formation of abscess cavity surrounded by a diffused collection of polymorphonuclear leukocytes..spontaneous rupture is common.
the invading foreign material,if any,will be usually expelled along with the pus.

visit your dentist and get a thorough check-up.get your teeth cleaned professionally.

maintain good oral hygiene.use soft-bristled tooth-brush and dental floss to clean your teeth.

take care.
Answered: Sun, 16 Sep 2012
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  User's Response
Well, as your CT scans/ ultrasound reports all have come as normal, you need not think in terms of anything seroius, that i can assure you. As the swelling comes and goes since last 5 years in sub mental region, it is most likely to be either inflammaed submental group of lymph nodes or it may be an infected salivary gland. As if it would have been anything serious then swelling doesn't to away and keeps on enlarging only.

The submental group of lymph nodes may be enlarged in case of any dental infections arising from lower front teeth or from infection of Lips. these dental infections may be related to even attrition of teeth/ decay or chronic periapical infections. these needs to be ascertained by Dentist only.

Also, salivary gland have a possibility of inflammation sometimes due to bacterial infection or from partial duct blockages.
Answered: Sun, 16 Sep 2012
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Dentist, Orthodontics Dr. Rachna Dubey's  Response
I have read your problem. In my view ,this is 100% because of dental origin.Just think, you migth have any trauma in either on your lower four incisor tooth or on chin area in last 3-4 years. In this type of swelling peri apical region of lower four incisor are having chronic infection sometimes it will drain out ,so you will get relief or sometimes this area will becomes full of pus then you will feel severe pain.This disease is known as PERIAPICAL ABSCESS of lower incisor tooth.Treatment of this disease is to do ROOTCANAL TREATMENT of involved tooth then APICECTOMY surgical procedure of that involved tooth under antibiotic,anagesic trypsin,chymotrypsin and b complex coverage. Go to the DENTISTS clinic for solution. To take drugs are not sufficient for proper treatment.Have you checked your tooth color,if they are becoming dark because of trauma they become nonvital.
All the best.
Answered: Sun, 16 Sep 2012
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