Possible ongoing infection?

[Serenadasa23]

Hello everyone, I will try to keep this as brief as possible. Early June started with a toothache in the afternoon. It progressively got worse overnight so first thing in the morning went to urgent care. At this point did not have swelling in my face yet, just intense pain. Was given Augmentin and a dentist to make an appointment with, since I did not have one. I took the antibiotics right away. A few hours later, I felt what could only be described as an "explosion" into my left cheek. From there the swelling started, however by the following morning it was starting to go down already, presumably due to the antibiotics I started. So I didn't worry too much. Three days later had dentist appt. took the traditional x rays which showed a large periapical abscess. It was decided to remove the tooth that same day, which was uncomplicated. The swelling in my cheek was almost non existent by now, but I did ask about it, I said I suspected some sort of cellulitis or spread into what I have learned is "buccal space" but I was told "the antibiotics will take care of everything else now that we removed the tooth". So I didn't question it further.
The tooth socket healed fine, I finished my antibiotics but I am convinced I still have a tiny bit of swelling in my cheek, and it's been over a month. Also, I feel a little bit of pressure that just isn't going away. I called the dentist back who then gave me another 5 day course of clindamycin, which did not help at all. Do these things really just take time? I am scared because in my internet research it seems anything in the buccal space has to be drained by making an incision. But I get that if not much swelling was present who would think that anything was there? When I presented to the dentist it had gone away for the most part. but I feel like if I had presented to the urgent care when I had the swelling for a few hours at most, they would have admitted me for IV antibiotics and cut my cheek open. since it started disappearing almost as soon as it came on, I didn't think much of it. Only in my research afterwards am I finding out that this is what they do when there is swelling. Anything in the cheek cannot drain through the tooth socket when they extracted it, right? Because I was told "the infection drained through the tooth when it was extracted, so there would be no need to make more incisions" If there is no more infected tooth, can the body just absorb all the rest? could there possibly be a need to have anything else drained? and if so, who do I see? what imaging test would show it? Since I don't think the traditional x rays would?

 

[Dr M]

You need to determine if the tooth that was removed, was the only cause of infection. Sometimes there is more than one tooth that leads to infection. I would suggest starting with another x-ray post extraction. If there is no other cause and the swelling is still present, incision and drainage would be needed. In my opinion the dentist would then need to refer you to an oral surgeon.