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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Tooth Fractured From The Injury. Now Lower Jaw Enclosed With Pus. Applied Antiseptic Rinse. Suggestions

Hello,

On February 23, 2013 I was assaulted during a party. A guy punch me in the face around the lower jaw area and blood instantly came from under the lower left canine tooth. I didn't think much of it because the area was not swollen nor painful until three days after the incident. I went to a dentist and they took x rays of the area. They said that the root of my 22nd tooth was fractured from the injury and referred me to a oral surgeon. When I went to the oral surgeon they took a panoramic x ray of my mouth/ jaw and they said from the looks of the x ray that the tooth wasn't fractured but the bone surrounding the tooth was fractured (alveolar bone). They consider the injury to be a green-stick fracture, minor and curable by a soft diet and pain medication. For two weeks straight I experienced unbearable pain. I had a clear, sometimes yellow, discharge coming from under the gums of the 22nd tooth. Furthermore, the lower left side of my jaw was swollen badly! During those two weeks I took my medication and had follow up visits to the oral surgeon because I was afraid that the yellowish/ clear discharge was a sign of an oncoming abscess. They told me that since I had a cut around the inner and outer gums of the canine tooth, that food and debris could be getting trapped with the cut and causing the discharge. From their the oral surgeon put me on an oral rinse called Peridex and took me to complete the course of my medication. Three weeks after the initial fracture date, the swelling begin to decrease and a soft lump begin to form around the lower part of my jaw/ chin area Also, a bump begin to form behind the 22nd tooth. Both formation are painless unless I irritate it. It hurts to chew on both the 22nd and 21st tooth. When you tap both of those teeth, it is sensitive. I have tried to burst the pimple like bump behind the tooth but nothing came out but blood. I applied antiseptic rinse to the area after I popped the bump. Also, I applied hot and cold compresses to the lump on my lower jaw/ chin but nothing seems to relieve the swelling. I research possible answer to my symptoms and some of the results I were given were question. Being that my jaw is fractured, the lump on my lower jaw/ chin area could be a soft callus which is a part of the bone healing process. My biggest fear is that the lower is enclosed pus that is leading to an abscess. I REALLY need someones opinion on this because all of the doctors I have went to have given me different diagnosis. If it is an abscess, Which I HOPE IT IS NOT, I need to get it taken care of as soon as possible so my adjacent teeth and jaw bone won't become infected. Please Help
Fri, 10 May 2013
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Dentist 's  Response
Hi ,
Thanks for writing in.
The tooth fractured may be periapically infected resulting in abscess formation.
I would advice you to get intentional root canal treatment done.
The abscess if spread into adjacent tooth,same procedure has to be repeated for the adjacent tooth also.
Pus has to be drained and curetted well.
Maintain good oral hygiene.
Take complete course of antibiotics.
Frequent warm saline and betadine rinse has to be done.
Take care.
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Dentist Dr. Sushma Rajesh's  Response
Hello,

Thanks for posting your query.

I understand that you had a trauma to your lower jaw few months back. But there are different diagnosis by different dentists. Going by your symptoms, if you have a boil which is formed in your gums now there is a possibility of an abscess formation due to the injury to the pulp of the injured tooth.

In this case, due to trauma, the pulp is injured and leads to non vital teeth. You may get pain or sensitivity on tapping . This in turn leads to abscess formation which is seen as a [black round] radiolucency in the xray. But if the root is fractured then the dentist needs to decide if the tooth needs to extracted or it can be saved by doing a root canal treatment.Also xrays need to be taken to check the jaw is fractured or not. An OPG should reveal if there is any fracture in the injured area.

Hope that answers your query.

Get well soon

Dr.Sushma Rajesh

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1 Doctor agrees with this answer

Dentist Dr. Shubhajit Chakraborty's  Response
do not wait dear u r simple petting some infection in ur lower jaw.according to my opinion when ever there is history of trauma to the tooth or surrounding structure .vitality test of the tooth must be performed not immediately that will give false result but afte 10-14 days.depending on the result of vitality test the rct to preserve the tooth not seeing the green stick fracture.newy wht i feel ur 22 may even 21 are not vital and having peri apical pathology ,now if u want to keep ur tooth,if there is adequate bone support thn go for rct.to get permanent solution.in case if rct is not possible ,thn u hav to for extraction.revisit ur dentist explain the problm u have they will guide in proper way.get well soon.
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Dentist Dr. Farah Hussain's  Response
Hello there ,

Thanks for writing your query,


According to your history i can suspect trauma to the jaw had injured your teeth and gums intraorally.

Trauma to the teeth may have lead to pulpal injury and you have developed a periodontal abscess due to spread of infection to the underlying tissues.

This type of periodontal abscess drains in the oral cavity and may lead to nausea and vomiting.

This type of periodontal abscess needs to be drained and compressed in position and then followed by a course of antibiotic and analgesic will subside the symptoms of pain and swelling.

once the abscess is drained the infected tooth needs to be explored again for root canal procedure.

you need to get an x ray done the affected area to confirm the presence of infection, approach a dentist for the treatment.

i hope this helps ,

take care.
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Dentist Dr. Shefali Gupta's  Response
Hi ,
Thanks for asking query,
According to your explanation it seems that you have develop abscess in relation to tooth injured during the trauma. It can be the possibility that it has spread to adjacent teeth also.
I suggest you to visit dentist get the fresh iopa and opg done .Get the root canal treatment done of the affected tooth followed by crown to the particular tooth, abscess should be properly drained and currated.
Take proper broad spectrum antibiotic and non steroidal analgesic as prescribed by dentist , gargle with warm saline water 3 to 4 times a day , use antiseptic mouth wash.
Hope this will help you.
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Tooth Fractured From The Injury. Now Lower Jaw Enclosed With Pus. Applied Antiseptic Rinse. Suggestions

Hi , Thanks for writing in. The tooth fractured may be periapically infected resulting in abscess formation. I would advice you to get intentional root canal treatment done. The abscess if spread into adjacent tooth,same procedure has to be repeated for the adjacent tooth also. Pus has to be drained and curetted well. Maintain good oral hygiene. Take complete course of antibiotics. Frequent warm saline and betadine rinse has to be done. Take care.