Toothache in the right side of the mouth with swelling in the jaw under the ears

[Du_deleted]

I had some fillings on the left side last year. I will get regular cleanings done.I have toothache in the right side for past 2 days.it started after I take fish and chicken after a long time.means I didn't eat those past 2 months. I did chew those a lot.it started off with dull toothache on the right side.it was there on top side first. then I felt some pain on the down side too.it was like needle pain and the whole right end side is not comfortable. I avoided eating on that side past 2 days. today I see some swelling on the end of the right down side.its close to my ears and end of the jaw. I have already taken wisdom tooth on the lower side and upper wisdom tooth is still there. I have bad breadth and smells very bad. the Swelling is at the end of the lower jaw. does it related to any tooth or sinus issue?I have sinus issue and never had any swelling like this before. I am in US. what could be the issue? upper wisdom tooth has small cavity. Lower ones doesn't have any cavity as per last x-ray. The swelling is little but feels very uncomfortable inside the mouth. But not very continuous pain in the tooth. I am able to eat and drink hot liquids. What could be the reason? The little swelling is on the upper and lower jaw side. Exactly under the ears. No pain when I touch any tooth or gums. Only the jaw hurts while I touch.what could be the reason? I am in the US and feel scared to go to dentist. That too in this current covid-19 situation, I am very nervous.
Whenever I open my mouth,it hurts on that side and hear some scratchy noise in there. The swelling is small only. Will it go away on its own.

Please share your inputs.

Edit to add: it gives a sharp pinch like pain in the right side sometimes lower and sometimes on the upper side. I see swelling only today. The pain was there for past 2 days. I feel like shiver and chill along with bad breath. Checked my temp and it's normal.

 

[honestdoc]

I'm in the Pacific NW. I almost went to Emory for college. I will recommend you go to thttps://agd.org/ and on lower right in blue will have "find-a-dentist" tab. There are a lot of dentist in Atlanta the Coca Cola capital. Find one that has over 15 yrs experience. Also depends on your insurance coverage as well. You may not need to go to Endo.

 

[Du_deleted]

I'm in the Pacific NW. I almost went to Emory for college. I will recommend you go to thttps://agd.org/ and on lower right in blue will have "find-a-dentist" tab. There are a lot of dentist in Atlanta the Coca Cola capital. Find one that has over 15 yrs experience. Also depends on your insurance coverage as well. You may not need to go to Endo.

Thanks doctor. I will check the link.
I will get the xray images on Monday and post it here. My dental office said they will give referral to an Endo for RCT. But I really don't know if I been that or not. I will get a second opinion from another experienced dentist then.

 

[Du_deleted]

Uploading images @honestdoc.

I am yet to get cbct scan. They said they can't send those in email. So I have to go in person and collect the CD.

 

[Du_deleted]

I didnt get any appointment with an Endo or Oral surgeon yet. Don't know how to start with.
I did call my dental office to talk to my regular dentist,but he is booked till JUly 6th and they told me to check somewhere else. So, I cant rely on my dental office for another opinion. My dentist have only 4 yrs of experience though. I have to look into another dentist.

I am planning to see an oral surgeon to check my upper wisdom tooth and jaw. Hope Oral surgeon can also look into TMJ issues. Is it not?
I am really not sure if i have tmj or not. the dentist said no. i have throbbing pain in the upper jaw since weekend. I am little scared to do dental treatments in ths=is pandemic. if its rct or wisdom tooth extraction.

I don't want to exaggerate the tmj pain by doing other treatments if tmj is the source of this pain and swelling. there is no reduction in the swelling. its still the same.

 

[honestdoc]

I don't think you need a root canal. The upper wisdom teeth are fine unless you are biting your opposing cheek or gums. If they need to come out, it shouldn't be as traumatic as lower wisdoms. I think you may have TMJ stress. Your condyles (neck of your lower jaw connecting the skull) particularly the left side (your right on the Pano) look flattening indicating wear. I'll PM Dr. MattKW to evaluate it as well.

 

[Du_deleted]

I don't think you need a root canal. The upper wisdom teeth are fine unless you are biting your opposing cheek or gums. If they need to come out, it shouldn't be as traumatic as lower wisdoms. I think you may have TMJ stress. Your condyles (neck of your lower jaw connecting the skull) particularly the left side (your right on the Pano) look flattening indicating wear. I'll PM Dr. MattKW to evaluate it as well.

Thank you doctor @honestdoc.
Is it my left side or right side of the mouth? Which one looks flattening?

I have pain and swelling on the right lower side of the jaw.

 

[Du_deleted]

@honestdoc..
Doctor, I would like to add one more thing. Whenever I close my mouth, the right side of the tooth touches first and I feel that so hard. All three molars on the upper side and 2 molars lower. It feel that bite so hard and stiff. Especially tooth#3 and#30. Is that normal?

 

[honestdoc]

The pano does not diagnose but provides a baseline road map of your anatomic features. It is like a mirror image. Your left side is viewed on the right side of the pano. The condylar head appears flatter the left side. It could just be without symptoms.

Have you been experiencing a lot of stress at work or at home or both? When you clench, it causes stress to your TMJ. It's best to have the TMJ specialist evaluate.

 

[honestdoc]

@honestdoc..
Doctor, I would like to add one more thing. Whenever I close my mouth, the right side of the tooth touches first and I feel that so hard. All three molars on the upper side and 2 molars lower. It feel that bite so hard and stiff. Especially tooth#3 and#30. Is that normal?

No. It is best to test #3 & 30 with cold using a cotton pellet and getting it very cold to have an accurate response to make sure the root canal nerve is healthy or not. Hopefully those teeth are not swollen due to nerve (pulpal) disease.

 

[Du_deleted]

No, I don't have any stress. I am not sure if I clench or grind. Do I have any jaw infection?
Is that hard bite normal while closing the mouth? I never had fillings on any of the tooth that side.

 

[Du_deleted]

No. It is best to test #3 & 30 with cold using a cotton pellet and getting it very cold to have an accurate response to make sure the root canal nerve is healthy or not. Hopefully those teeth are not swollen due to nerve (pulpal) disease.

No. It's not swollen. I don't see any gum swelling in those 2 tooth. Only outer side. On the cheeks and lower jaw.

 

[Du_deleted]

No. It is best to test #3 & 30 with cold using a cotton pellet and getting it very cold to have an accurate response to make sure the root canal nerve is healthy or not. Hopefully those teeth are not swollen due to nerve (pulpal) disease.

Do the Endodontist or dentist have to do that cotton pelleted test? How do I check at home if I have healthy nerve or damaged?

 

[honestdoc]

I looked at your xrays and know you don't have fillings on right side, just 3 on UL. I can't explain why #3 & 30 close first. The cold test is to rule out pulpal disease. If the nerve died, then it will be a source of infection and swelling which can lift the tooth up. An inexperienced dentist will use Q-tip which doesn't get cold enough and get a false negative. The inexperienced dentist will think the tooth is dead. I can't explain why you are having problems with possible grinding/clenching. Some factors which may cause problems such as previous braces (I don't see any usual teeth removed to create space for braces), stress like dead lines, bad boss/coworker, home & family issues, trauma to the jaws/TMJ, and similar. I think the TMJ and clenching is the most likely culprit but I can be wrong so it is best to eliminate other factors.

 

[Du_deleted]

Thank you so much doctor @honestdoc. Appreciate it.

Yeah, you may be right. All this jaw pain and swelling started 4 weeks back after I chew some chicken and fish more than usual. I chewed fish so hard that day than usual. It was so soft and I chewed so hard and slowly for a long time. The same evening, the jaw pain, ear pain with swelling under the ear started. So it might be trauma to the TMJ or jaw. Then the hardness started while closing the mouth. I feel stiffness in the#3,#2 and#30,31. But #3 and#30 hit first. Never had this before. I have a sharp pain under the ear sometimes which goes down the neck. The area under the ear and neck is very sore.

How to identify if it's trauma to the TMJ? The dentist said it's not TMJ and my pano looks normal and jaw bone is fine.

 

[honestdoc]

Thank you so much doctor @honestdoc. Appreciate it.

Yeah, you may be right. All this jaw pain and swelling started 4 weeks back after I chew some chicken and fish more than usual. I chewed fish so hard that day than usual. It was so soft and I chewed so hard and slowly for a long time. The same evening, the jaw pain, ear pain with swelling under the ear started. So it might be trauma to the TMJ or jaw. Then the hardness started while closing the mouth. I feel stiffness in the#3,#2 and#30,31. But #3 and#30 hit first. Never had this before. I have a sharp pain under the ear sometimes which goes down the neck. The area under the ear and neck is very sore.

How to identify if it's trauma to the TMJ? The dentist said it's not TMJ and my pano looks normal and jaw bone is fine.

2 things you can do. Go to the drugstore and get Over the Counter Nightguard. 2nd, you can "reboot" your jaws and TMJ. This is very awkward to do but if you do it correctly, 9/10 times you may feel improvement. You open comfortably wide. You roll your tongue and far back as possible. You may notice your jaw shifting back. Keep your tongue as far back as you slowly close your teeth until some of your teeth start to touch. As your teeth begin to touch, relax your tongue and you will notice your jaw slightly shift forward to normal position. A lot of people do this wrong. If you do it right, your jaw will shift back then forward.

 

[Du_deleted]

2 things you can do. Go to the drugstore and get Over the Counter Nightguard. 2nd, you can "reboot" your jaws and TMJ. This is very awkward to do but if you do it correctly, 9/10 times you may feel improvement. You open comfortably wide. You roll your tongue and far back as possible. You may notice your jaw shifting back. Keep your tongue as far back as you slowly close your teeth until some of your teeth start to touch. As your teeth begin to touch, relax your tongue and you will notice your jaw slightly shift forward to normal position. A lot of people do this wrong. If you do it right, your jaw will shift back then forward.

Thank you doctor @honestdoc.
I will try this out.

It hurts more when I lie down. It's under the ear and on the neck line. Exactly under the ear. Paining inside the ear, exactly under the ear, top of the neck. It's like sore, scratchy pain. Don't know what's wrong. I am so worried if it's something big damage to the jaw or neck.

If I lie down on my left, right ear on top, it hurts a lot. Then if I am back to straight position, it will be ok. But still pain under the ear on the jaw end.
Before it all started, as I said, I did chew a lot on that side and next day I heard a big knuckle from that side jaw. Never heard so big sound from the jaw.

 

[honestdoc]

Did you get an OTC night guard. When your jaws are at rest, your teeth are about 1/4 inch apart. The night guard will force your jaws to be at rest. Have your physician refer you to TMJ specialist. If not, let me know what part of Atlanta is convenient and I'll look up for you. When you call, ask if they accept medical insurance. The catch word for medical payments is "severe pain."

Next time communicate the trauma to your jaws including how you were laying down and the noise you heard from your jaw. That would help out tremendously and prevent other false diagnoses.

FYI, I had dislocated my right jaw taking an elbow on a friendly BB game and only my Left side have severe wear like a misaligned car tire. I was fortunate to be in Dental Conferences with a TMJ guy and seeked his counsel numerous times. I also worked with someone trained in TMJ in the USAF.

 

[Du_deleted]

I got referral from my dentist for Endodontist and Oral surgeon.

I am also looking for other oral surgeon office. Whether oral and facial surgeon will be able to check TMJ? I thought I can sort out if it's upper wisdom tooth infection or the TMJ or any other jaw issue in one visit. It's paining more under the ear in the jaw end than tooth#30. So, I will first have oral surgeon visit and then check with endo.

Whether oral surgeon will be able to check the jaws?

 

[Du_deleted]

Did you get an OTC night guard. When your jaws are at rest, your teeth are about 1/4 inch apart. The night guard will force your jaws to be at rest. Have your physician refer you to TMJ specialist. If not, let me know what part of Atlanta is convenient and I'll look up for you. When you call, ask if they accept medical insurance. The catch word for medical payments is "severe pain."

Next time communicate the trauma to your jaws including how you were laying down and the noise you heard from your jaw. That would help out tremendously and prevent other false diagnoses.

FYI, I had dislocated my right jaw taking an elbow on a friendly BB game and only my Left side have severe wear like a misaligned car tire. I was fortunate to be in Dental Conferences with a TMJ guy and seeked his counsel numerous times. I also worked with someone trained in TMJ in the USAF.

Thank you doctor.
I didn't get any referral for TMJ from my physician or the dentist.

It's like sharp pain sometimes and very sore pain throughout under the ear. I am not sure if it's really jaw issue or tooth. I got one night guard and it was very discomfort to have it in the mouth. But no difference after wearing it.

I am near midtown Atlanta. Whether oral surgeon will be able to diagnose?? I am going to collect the cbct scan images. I will post that too.

I have sharp pain in the jaw end(under the ear) and on top of the neck. Sometimes it radiate over the jaw line till the center of the mouth.

 

[honestdoc]

They can. I must warn you. Surgeons' job is to do surgery. It is like everything to a hammer is a nail. Hopefully the surgeon can give you an unbiased assessment. I still recommend going to TMJ specialist. Make sure you communicate all the traumas to the TMJ so the dentists won't go on a wild goose chase.