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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do Swelling Under The Tongue And Difficulty In Swallowing Indicate?

Swollen underneath tongue, chin, severe pain, hurts to open mouth, chew, difficulty swallowing, pain so severe I can feel it in back of my head (headache). This follows dental surgery 25 days ago to remove teeth (front bottom), two implants, and two bone grafts. Also follows 5-6 weeks of flu-like symptoms (respiratory, high fever, chills, nausea, vomiting, diarrhea, etc.), but doctor tested me twice (two weeks apart) for flu type a and b and tests were negative. Doctor concluded some type of respiratory infection that mimicked the flu that had to run its course. I was on 3 different rounds of antibiotic before and after the dental surgery, which I finished clindamycin last Thursday, but this 'sore throat feeling in the glands' began Tuesday (two days before finishing third round of antibiotic. I am diabetic due to severe pancreatitis so diabetes behaves like Type 1. I am totally insulin dependent. I take huge doses of levamere (60 units a.m. and 50 units p.m.) and use Humalog sliding scale (high scale used at local hospital). I take Lyrica 100 mg 4 times daily for severe neuropathy for years now, and synthroid. Today I saw my doctor's nurse practioner who diagnosed my swollen, painful mouth as post dental surgery trauma. Tomorrow I will see dental surgeon who is unhappy with the speed at which I am healing (he's not the only one!). I have tried ice, heat, Tylenol, ibuprofen. Thankfully the nurse practioner gave me a few hydrocodone (7.5) to take today until I see dental surgeon tomorrow. I am a 56 years old woman and I live in assisted living so my diet and my medication are handled professionally. I am very afraid that my dental surgeon is not going to be able to diagnose this tomorrow and since last Tuesday the condition only worsens no matter what I try. Even the hydrocodone is not completely relieving my pain and what little help it does provide only seems to last for about 2 hours. (After the pancreatitis and complications, I have a high tolerance for pain meds). My doctor and I rarely choose the narcotic pain relief route unless we absolutely have to (i.e. following the dental surgery, I took 3 days of Percocet 10s. Since then I have only used Tylenol and Ibuprofen (neither of which are any help right now--they were helping until this swelling began last Tuesday. I am in tears as I sit here describing all of this. I realize my case is complicated: I had to move into assisted living 5 years ago when I started having TIAs and could no longer live alone. The professional care I receive here has made the TIAs almost non-existent. When I lived alone, prior to coming here, I did not take care of my diabetes. Now I do. What do you think?
posted on Fri, 2 Mar 2018
Twitter Thu, 8 Mar 2018 Answered on
Twitter Mon, 12 Mar 2018 Last reviewed on
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Dentist 's  Response
Hello,

It looks like there is some infection associated with the implant leading to Cellulitis or infection in the salivary gland leading to pain and swelling.

So, my suggestion is to consult your dentist or an Oral Surgeon and get evaluated. You can be advised an x-ray or MRI Scan to further confirm the cause.

For now, you can be advised antibiotics intravenously and a steroid shot to reduce swelling. Also you can be advised Implant removal if the infection or implant rejection is suspected. So, getting checked by an oral surgeon is a must.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Honey Arora
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What Do Swelling Under The Tongue And Difficulty In Swallowing Indicate?

Hello, It looks like there is some infection associated with the implant leading to Cellulitis or infection in the salivary gland leading to pain and swelling. So, my suggestion is to consult your dentist or an Oral Surgeon and get evaluated. You can be advised an x-ray or MRI Scan to further confirm the cause. For now, you can be advised antibiotics intravenously and a steroid shot to reduce swelling. Also you can be advised Implant removal if the infection or implant rejection is suspected. So, getting checked by an oral surgeon is a must. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Honey Arora