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What Causes Facial Pain And Swelling Post Dental Cleaning?
Question: Good Evening:
My friend has just described an unusual situation. He has had maxiofacial surgery resulting in multiple plates and screws- he also has delt with ca of the thyroid w/ total thyroidectomy and radiation. After a dental claning, he experienced unilateral facial pain and swelling increasing dramatically w/ light touch and/or cold application to that side. His dentist/surgeon has told him he may have a stone in the parotid gland, yet he also reports unilateral dry-eye and an odd taste- not the typical sour of infection. Antibiotics were essentially ineffective. A CT is planned as a routine x-ray showed nothing. Suggestions? Well appreciate your in-put.
My friend has just described an unusual situation. He has had maxiofacial surgery resulting in multiple plates and screws- he also has delt with ca of the thyroid w/ total thyroidectomy and radiation. After a dental claning, he experienced unilateral facial pain and swelling increasing dramatically w/ light touch and/or cold application to that side. His dentist/surgeon has told him he may have a stone in the parotid gland, yet he also reports unilateral dry-eye and an odd taste- not the typical sour of infection. Antibiotics were essentially ineffective. A CT is planned as a routine x-ray showed nothing. Suggestions? Well appreciate your in-put.
Brief Answer:
gum or tooth infection, OPG
Detailed Answer:
Thanks for your query. I have gone through your query.
As far the pain is concerned the possible cause of pain can be tooth(gum) infection or infection from the fracture site, where the plates have been placed.
Consult a oral physician and get yourself examined to rule out the infections.
The cause for dryness, altered taste and reduced lacrimal secretion is because of thr adverse effects of radiation therapy.
If i am your treating doctor, i would have suggested you to get a radiograph done like OPG and Occlusal radiographs.
after getting the radiograph we can come to a diagnosis and treat accordingly.
I hope my answer will help you, take care.
If any queries are there reply me back.
gum or tooth infection, OPG
Detailed Answer:
Thanks for your query. I have gone through your query.
As far the pain is concerned the possible cause of pain can be tooth(gum) infection or infection from the fracture site, where the plates have been placed.
Consult a oral physician and get yourself examined to rule out the infections.
The cause for dryness, altered taste and reduced lacrimal secretion is because of thr adverse effects of radiation therapy.
If i am your treating doctor, i would have suggested you to get a radiograph done like OPG and Occlusal radiographs.
after getting the radiograph we can come to a diagnosis and treat accordingly.
I hope my answer will help you, take care.
If any queries are there reply me back.
Above answer was peer-reviewed by :
Dr. Prasad
The surgery with the plate insertion was about 4 years ago. Occlusal radiographs were done.
The maxial-facial surgeon suggested it was a parotid stone yet unseen by x-rays. If this be the case, what may he anticipate as far as the behavior of a stone, duration of pain expected, and if the multiple plates and screws are in danger of needing removal.
Would you recommend some blood work, CBC, perhaps to assist in determining an infective process? He has undergone a course of zythromycin without appreciable change.
The maxial-facial surgeon suggested it was a parotid stone yet unseen by x-rays. If this be the case, what may he anticipate as far as the behavior of a stone, duration of pain expected, and if the multiple plates and screws are in danger of needing removal.
Would you recommend some blood work, CBC, perhaps to assist in determining an infective process? He has undergone a course of zythromycin without appreciable change.
Brief Answer:
Sialography, CBC, Plate removal
Detailed Answer:
Thanks for your information.
It is difficult to arrive at diagnosis without clinical examination.
Since you are telling your maxillofacial surgeon is thinking in favor of stone in the duct I would suggest investigations like Sialography.
If the stone is in the initial stage it will not be seen in CT, so get a sialography done which clearly shows the presence of stone.
You can get a complete blood count done to rule out whether infection is acute or chronic.
If there is any pus discharge, we can do a culture and sensitivity so that we can give a particular drug for the infection.
Regarding the plates, if there is infection in that site, it has to be removed.
I hope my answers will help you..
If any queries are there, reply me back.
Take care.
Sialography, CBC, Plate removal
Detailed Answer:
Thanks for your information.
It is difficult to arrive at diagnosis without clinical examination.
Since you are telling your maxillofacial surgeon is thinking in favor of stone in the duct I would suggest investigations like Sialography.
If the stone is in the initial stage it will not be seen in CT, so get a sialography done which clearly shows the presence of stone.
You can get a complete blood count done to rule out whether infection is acute or chronic.
If there is any pus discharge, we can do a culture and sensitivity so that we can give a particular drug for the infection.
Regarding the plates, if there is infection in that site, it has to be removed.
I hope my answers will help you..
If any queries are there, reply me back.
Take care.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
Dr. Mahesh Kumar T S
Dentist, Oral and Maxillofacial Surgery
Practicing since :2007
Answered : 3377 Questions
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