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Medical Forum / General / Dentistry / July 2008Tender jaw?
Can an infected tooth cause tenderness in the lower jaw? Starting to have some discomfort chewing on a lower left first molar. But more concerning, the jawbone below it seems tender. Is it possible that it is related, or are they likely two separate issues? Thanks. >Can an infected tooth cause tenderness in the lower jaw? Sure. > Starting to have >some discomfort chewing on a lower left first molar. OK >But more concerning, the jawbone below it seems tender. Not surprising. >Is it possible that it is related, or are they likely two separate issues? Much more than "likely related". Submandibular lymph node reaction to chronically infected lower molar. Classic presentation. >Thanks. Welcomed. Get thee to a dentist ASAP. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& For the SMD practitioners: Presentation of a lower molar infection is classic and we all have seen it countless times. The fact is, that the abcess is *always* sub-periosteal. The inferior mandibular border facia is less often pierced to the lingual <medial> aspect than the buccal. The Masseter and Medial Pterygoid meet in a dense connective 'symphysis' at the inferior border of the mandible, anterior to the angle of the mandible. Readily palpated as a minor concave curvature between the angle and the mental nerve prominence. Run your thumb along the inferior border of the mandible from the angle anteriorly and you will feel it. The lower molar abcess is always between these structures and most often presented inferiorly, then buccally. The lingual presentation has the aforementioned findings in addition to the sublingual periosteal dissection. SubMandibular lymph node tenderness and prominence can almost always be discerned to an extent related to the virulence or chronic nature of the infection. Chronic leisions exhibit recurrence and the classic 'phoenix' presentation. Class dismissed. I know it when I see it, but you describe it very well. :-) D > Get thee to a dentist ASAP. > [quoted text clipped - 31 lines] > > Class dismissed. > Get thee to a dentist ASAP. Thanks for the comprehensive answer. My bad: I was informed I was feeling my salivary glands, not my lymph nodes! (Guess I better break out my old high school anatomy book again.) In any case, my regular doc said my lymph nodes and salivary glands all seemed normal to him. But that still leaves the mysterious tendeness in the lower jaw and salivary glands. Incidentally, one of the molars has about a 1/2 onlay and the other has a full crown. Both placed within the last year. I've been to the dentist several times already. I can tell him I want him to do something, but what? Root canal? Extraction? Replace crowns? He said if I want him to do a root canal, he'll do a root canal (!). If you had those symptoms, what would you ask your dentist to do for you? Have you ever asked your dentist to be more aggressive than he was inclined to be? Thanks again. >> Get thee to a dentist ASAP. > [quoted text clipped - 16 lines] > >Thanks again. Next step is to see an endodontist. Find one here: www.aae.org > Next step is to see an endodontist. Thanks. Done all that too. No one can find a clear basis for doing a root canal. I'm thinking I should just tell him to go ahead and do it anyway. >> Next step is to see an endodontist. > >Thanks. Done all that too. No one can find a clear basis for doing a root >canal. I'm thinking I should just tell him to go ahead and do it anyway. How is this for a clear reason: "The tooth hurts !" It's what I'd do. > How is this for a clear reason: "The tooth hurts !" > > It's what I'd do. I suggested that to the endo, but he said we should make sure we are doing the right tooth. He said he's seen people come in with unlocalizeable symptoms go for root canal after root canal and not have relief. Hey, thats something to look forward to, huh? :) >> How is this for a clear reason: "The tooth hurts !" >> [quoted text clipped - 4 lines] > symptoms go for root canal after root canal and not have relief. Hey, thats > something to look forward to, huh? :) Try a bite guard at night for a while. Are you also finding it hard to get the floss in between the teeth? That could be jaw clenching squeezing out the blood circulation in the teeth sockets, like tight socks do to your legs. Try a bite guard anyway. Brian Sandle |
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