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Swelling in the face, enlarged glands near the jaw. Molars removed. Mild pain on opening the mouth. Reason? mother is a gynaecologist aged 50....about 7-8 years ago,her incisors and some other teeth loosened up
may be because of very poor dental hygeine and her habbit of eating solid ice which caused her gums to shrink....
now so many years passed but she didnt took dental care....about 1.5 years ago,she noticed an enlarged painless
lymph node(easily mobile) on left side of face along the outer border of lower jaw,which came to notice as could be easily seen
as a swelling on face over mandible....again left uncared but node did not increase in 4 months ago,
my mother attended to dental need and got extracted 2 lower molars on the same left side where the enlarged node was
had the upper moving incisors fixed.....everything was normal....the node remained same size and location......
suddenly there was an enormous swelling around the node through the night which bulged out of the face at the
left side but it was PAINLESS,when took infrared,it even increased in size.....she took oral antibiotics but no effect.
ultrasound done,found necrotic material in node but node same size 1.2*0.8cm and also there was NO BONE INVOLVEMENT
other nodes of the body were not enlarged.....doctors told may be infective because there was a molar root left as
found in OPG,.....but there was no pain....OPG report normal,no scar was found in tried to drain it but
there was NO PUS in the swollen area,only accumulated blood came out in the syringe when the swollen region along with
enlarged node was aspirated.....and FNSC report said chronic inflammatioN......then a dentist told to take
DEXONA,ZENTAMYCIN and TAXIM i.v for 3 days
and the swelling responded well and almost disappeared except the enlarged node......after 2 more days of stopping
of the antibiotics,the swelling again started to appear....when went to the dentist,he removed the molar root left
which he suspected to be a source of infection and said that there was a little pus found in its root but removal
of it enhanced the jaw swelling.....again he advised 5 days of DEXONA,TAXIM and zentamycin....and again in 2 days the
swelling disappeared but the enlarged node persists and she feels very mild pain only on opening of mouth and lower end of
node seems fixed to jaw bone.......
now WHAT CAN BE THE CAUSE of the swelling and whats the guarantee that it does not reappear once medicine is stopped,please help.
Asked On : Sun, 21 Apr 2013
Answers:  1 Views:  56
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Dentist 's  Response
First of all,the source of lump developed has to be ruled out.
The abscess if present has to be completely drained and curetted.
Since there was no pus within the lump,the growth can be cyst.
Usually enucleation or marsupialization of cyst has to be done with great care to remove them.
Also make sure that the enucleation has done perfectly,if any small amount of fluid within the cyst may be left out to remove,it can result in recurrence.
I advice you to visit an oral maxillofacial surgeon and get a detailed examination and treatment thereafter.
Take care.
Answered: Fri, 17 May 2013
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