Dental abscess, in agony

[unrealhousewife]

I have been given metronidazole but the emergency dentist said there is bone loss and gum disease.
He said to swill it with very hot salt water and the nurse said NOT to put heat on my cheek.
It's a lower back tooth.
I have no more painkillers to take and I know a heat pad will soothe it but should I? Will it draw the pus out to the wrong place?

Heeeelp!

[BeingAMummyIsFabulous]

I would recommend continuing to swill with salt water, as it is a good way to keep the area clean and I would do anything (within reason) to ease your pain until you are able to buy some more pain relief. I wouldn't use the heat pad for prolonged amount of time, maybe use it it short bursts. Could you not access a chemist or open late store to get some pain relief?

[paddyclampo]

Hopefully the antibiotics will kick in soon! Def keep up the salt water! Can you not get somebody to bring you some painkillers? Have you a friend who has any heavy duty ones they could pass on?

Had an infected tooth myself once, shudder at the memory of the pain - worse than childbirth!

[unrealhousewife]

The reason I couldn't have any more painkillers is that I had taken my maximum allowed doses of neurofen and paracetamol.
I was almost getting to the stage of Tom Hanks in Castaway.

And as if by Mumsnet magic, shortly after my OP the pain has subsided. I did a lot more hot water swilling and that seems to have helped. Tiny bits of blood but no pus and my face still looks hamsterish, I hope that goes soon.

[unrealhousewife]

The reason I couldn't have any more painkillers is that I had taken my maximum allowed doses of neurofen and paracetamol.
I was almost getting to the stage of Tom Hanks in Castaway.

And as if by Mumsnet magic, shortly after my OP the pain has subsided. I did a lot more hot water swilling and that seems to have helped. Tiny bits of blood but no pus and my face still looks hamsterish, I hope that goes soon.

[unrealhousewife]

The reason I couldn't have any more painkillers is that I had taken my maximum allowed doses of neurofen and paracetamol.
I was almost getting to the stage of Tom Hanks in Castaway.

And as if by Mumsnet magic, shortly after my OP the pain has subsided. I did a lot more hot water swilling and that seems to have helped. Tiny bits of blood but no pus and my face still looks hamsterish, I hope that goes soon.

[Mrsmorton]

Antibiotics aren't the correct treatment. The tooth needs to be drilled. I'm running my wonderfulOOH clinic tomorrow and Monday so if you're in the south east, pop along and I will do this for you

Heat inside the mouth is fine but outside it can draw the infection out through your facial skin like this. Not a good idea!

[Boomboomboomboom]

Take something like diclophenic or panadol instead and double up with whatever pharmacist recommends. Can you send someone out to get you something as I expect you'll need it in the night - try and sleep upright.

Don't use heat pad, use ice pack.

Hope the dentist can fix it soon.

I ended up having root canal work and went back for my dentist to cut open my gum to release the pus.

Still took 1 week for the hamsterness to go and 3 weeks for it to disappear completely

:-(

[Mrsmorton]

This is a long term chronic presentation big pimple

[TheFairyCaravan]

You poor thing. When I had an abscess a packet of frozen peas against my face helped the pain.

I would try getting some co-codamol from the chemist tomorrow to take instead of the paracetamol and I found soluble aspirin (I took 3) much more effective than Nurofen tbh. If you don't want to try that, you can buy Voltoral over the counter which, I think, is stronger than Nurofen, but you mustn't take them both together.

[TheFairyCaravan]

X-post with Mrsmorton listen to her, she knows what she is talking about.

[Boomboomboomboom]

:-O to MrsMorton's pick!

[Mrsmorton]

fairy

[NearTheWindymill]

So MrsM if the OPs in the South East can she PM you and get sorted?

[Mrsmorton]

Yes, she would still need to call 111 as that's where our funding comes from but I can tell her prescisely what to say to come to my clinic obvs the south east is quite big so may not be feasible but don't want to completely out myself

[unrealhousewife]

Mrs Morton, how is antibiotics not a good idea ? This was a young NHS dentist who seemed to know what he was doing.

[unrealhousewife]

I am in zone 3 London mrs m, would that be good?

[unrealhousewife]

It has stopped hurting but there are lots of lumpy swellings

[Mrsmorton]

Antibiotics not recommended because they don't treat the problem. Unless you have frank swelling (in which case antibiotics and drilling but never just antibiotics). Toothache is usually cause by the nerve inside the tooth dying, that's not an infection, it's an inflammatory process. The nerve and stuff inside the tooth can't swell because it's inside the tooth and you get hideous toothache. The nerve needs to be removed. Antibiotics can't even get to the nerve because the blood supply is so poor so even if it was infection, it wouldn't treat the problem.

He may have known what he was doing but he was still being lazy.

East or west london?

[unrealhousewife]

He said there were signs of gum disease and bone loss, could it be that that's infected?

[Mrsmorton]

Local measures means cutting, drilling or extracting. Not prescribing. This is from the scottish national guidelines ( the English ones cost money)

[unrealhousewife]

He did say I should see the dentist in two weeks to get treatment, I presume that was so I could get the work done after the infection had cleared.

[Mrsmorton]

Not really, still local measures apply, the tooth should have been cleaned under local anaesthetic if it's a gum problem., then maybe antibiotics on top but never just antibiotics.

If you describe your symptoms it might help?

[Mrsmorton]

It should be done in order to clear the infection. I promise that at least 75% of the patients I see tomorrow will have been inappropriately prescribed antibiotics. Drives me potty.

[unrealhousewife]

Ok it started Thursday, a bit of tenderness. Friday morning 3am I was crying like a baby. Paracetamol and I survived until Friday afternoon when the Castaway phase set in. Got the last emergency dental appointment from 111 and took my first metronizadol on Friday eve. He gave me a wonderful injection which gave me 2 hours relief. On maximum dose painkillers until this afternoon when it subsided.

The pain was severe throbbing, changing as I moved about so stayed in bed.

I'm concerned the pus isn't going to come out without leaving me with a facial disfigurement. The pain is now a dull ache.

[Mrsmorton]

What about hot and cold? Does it affect your sleep? Is the tooth sore to bite on? Is it worse or better when you lay flat?