To think the doctor can't keep telling me it's a dental problem and the dentist that it's an issue for the doctor?!

[Howaboutthisone]

Surely they can't keep passing me to the other with no one actually investigating the problem?!
About a month ago I had an issue with my throat. It was a recurrence where I get a pea sized lump at the back of my throat (same site) and I phone for a dr appointment, am given an appointment with minor ailments nurse who tells me it will ease on its own and then I go back in a couple of days in agony with a raging infection. This time is was so bad they had to consult with the ENT dept in the hospital and I had to go there. Seen by three ent drs who think it's a retention cyst and gave me strong antibiotics and a promise for a follow up appointment in 3-4 weeks. Appointment came through for 6 weeks (in Covid times I thought I'd just go with that) So the appointment is now the week after next.
Last weekend I noticed on the Friday that the inside of my mouth was swollen. No pain. No redness. But all of the inside of my cheeks were swollen. Phoned out of hours, saw dr who gave me more of the strong antibiotics despite not being able to tell where the infection was. Told to go back to gp if it hadn't cleared or improved in a few days. Went back to the gp as no improvement (incidentally I take my last dose of co amoxiclav today and it still hasn't even improved one bit). They tried to palm me off on minor ailments again but I insisted on gp. GP told me that it looks normal. I pointed out that I'm 40 and that my mouth has never once looked like this and that every time I speak or eat I feel like I'm chewing on my face. So whilst it looks 'normal' it isn't for me. On my way out he suggested that I should see my dentist. So the lovely lady in the dentist fitted me in that morning. Dentist looked and told me that my teeth etc are all fine and that it isn't anything to do with the teeth and therefor I should go back to my doctor (as I expected to be honest as whilst it's in my mouth it's more the inside of my face iyswim)
I was a bit upset and phoned the gp to ask if I could have a blood work up. The receptionist there told me that that as it's something to do with my mouth it's nothing to do with them and that I need to go to my dentist 🤦🏼‍♀️
I finally got them to agree to the blood test after ending up breaking down crying in anger and frustration on the phone that they both are paying me off on each other and no one can be bothered to look into it. So now I'm waiting for my blood test. And my ENT follow up in the hope that they will take me seriously and at least look into why this is like it is. In the meantime, by then I'll have had a really swollen mouth for almost 3 weeks, being told it's normal when it's not for me!
Surely I'm not being unreasonable to think that the dentist/doctors pass the parcel isn't right. Has anyone else had this?
Thanks for making it to the end-didn't mean for it to be so long but didn't want to dripfeed!

I don’t think they are playing pass the parcel though, you’ve seen the doctor, and the denist, the dentist said nothing he can do, but the doctor hasn’t said to go back to the dentist.
It’s sounds really painful and uncomfortable, but I don’t think they given you bad treatment.

That sounds so shit. Can you get back to any of the ENT doctors you saw? Maybe tell the GP the dentist recommended an ENT referral? Good luck. Being passed from pillar to post while being told there is nothing wrong when there very much is is a horrible problem with medical care in this country. Sorry you're having to deal with it.

I think my GP would have said wait for the ENT appointment. It sounds horrible and a bit frightening but sometimes you do just have to wait to see the right person.

I’m not an expert but both the doctor and the dentist have the means to refer you to an oral/maxillofacial department (I don’t think all hospitals will have that speciality so you might be in for a journey) if they’re not coming up with anything between them.

I would be frustrated with the dentist if I were you tbh, their remit goes beyond the health of your actual teeth and they should have at least made a comment about the health of the skin inside your mouth.

I would say your dentist is right and the Dr wrong.

It seems a typical gp response. I had it with dd, problem with her mouth which according to Google was likely to be a complication related to one of her auto immune illnesses. Certainly wasn't tooth related. As soon as receptionist heard the word mouth she was adament I had to take dd to a dentist. I had to politely but firmly argue with the receptionist and in the end she reluctantly made an appt "because I was a nurse and seemed to know what I was talking about". There needs to be a bit more indivualised, holistic care.

I certainly don't think receptionists should be making those decisions. There's a lot of mouth issues which are medical not dental. Toothache fair enough.

Hope ent sort you out. My mum would have told you to gargle with salt water or diluted tcp while waiting. 🤷‍♀️. Was her answer to all throat problems.

Hmm it's tricky because it does sound like the ENT follow up appointment is what's needed the most. I don't think they're palming you off, dentists are obviously very good at diagnosing dental problems and they are good at diagnosing other oral conditions which would need referral to specialists (eg oral cancer, ENT issues), but you've already had the referral from the GP so there's not much more the dentist can do. No active infection detected so they can't prescribe you even more antibiotics.

It's good you fought to get a blood test done from the GP as this will at least help rule things out I suppose? But if antibiotics haven't helped this swelling, not sure what else the GP can do either.

Have you tried rinsing around your mouth with warm salty water? It sounds pointless but it does tend to help a lot with pain and swelling eg from dental extractions, although I note you have no pain so again it doesn't seem like an infection. But worth a try?

I was referred to a maxillo-facial surgeon by an NHS dentist for a
lump far back on the roof of my mouth so she's talking shit. Maxillo-facial surgeon operated on me to remove it.

Could the swelling be a local allergic or irritated reaction to all the antibiotics you’ve taken for the other issue? If there’s nothing obviously ‘wrong’, you’ve got no pain, bleeding, fever etc then the GP must be satisfied that it’s nothing that can’t wait till the ENT specialist sees you.

I had something very similar recently, Turned out to be TMJ combined with a frscture to the jaw (related to another condition). This was diagnosed and treated by the Oral Maxiollfacial dept (first referral was to ent after me insisting it wasn't dental)

Have you had any xrays or CAT scans to rule out other possibilities?

Oh that's interesting... I didn't realise dentists could refer to max fac.

The receptionist there told me that that as it's something to do with my mouth it's nothing to do with them and that I need to go to my dentist

Fucking GP receptionists who think they’re medically qualified, I’m sick to the back teeth (no pun intended) of them. I’ve had a very similar experience, I hope your ENT appointment brings you some answers.

I don't blame the receptionists who I assume are following policy laid down by the GPS and or practice manager. Maybe for someone else her advice about dd could have been OK but when the symptoms are an indicator of an autoimmune flare up it isn't. And receptionists can't be expected to know the difference nor should they be put in that position.

Can you ring ENT and see if there is any chance of bringing your appointment forward.

@MartyHart

I was referred to a maxillo-facial surgeon by an NHS dentist for a lump far back on the roof of my mouth so she's talking shit. Maxillo-facial surgeon operated on me to remove it.

Yes exactly what I said, dentists can and do refer but as the OP already had a referral to ENT they couldn't do much more. If ENT deem it a maxillofacial issue then they will refer to them accordingly. There's quite a fine line sometimes between what is max facs and what is ENT, often it may require the input of both.

My DH had a similar issue recently. He had a dental infection, which the dentist was dealing with but was in severe pain unable to sleep or eat. He has a heart condition which is exacerbated by not sleeping, so we tried to get a GP appointment to manage the pain and the heart risk, which the dentist couldn't do. Receptionist gave a similar line that the GP will not see anyone about face pain. Fortunately, we have a small work based health insurance policy that gives GP access and we dealt with it that way. I was really worried though.

I hope everything is sorted for you soon.

Sounds like it could be Quincy?

*quinsy

You’ve already seen a hospital specialist and you’ve got another appointment with them in the next couple of weeks. And at the moment all you’ve got is painless swelling in your mouth. Why not just wait for your hospital appointment?

To be fair to your GP, any mouth swelling should be assessed by a dentist as they have had I think 6 years training for oral issues. This is not part of the medical school or GP curriculum (they will see throat, neck and facial issues).
If the dentist couldn't identify a tooth related issue but you nonetheless had a symptom affecting inside your mouth then they should have referred you to the MaxFax oral surgery department as an outpatient and not batted you back to the GP.

What is actually wrong OP? Can you post a picture

All the insides of your mouth are swollen but not red or sore? I don't really see that that needs urgent investigation tbh or a maxfacs referral just yet.

I think they are both talking shit tbh. The dentist should be able to comment on more than just your teeth. They should be looking at your soft tissues and managing minor soft tissue ailments. What the dentist can't do is take bloods, however if they think bloods are necessary they can easily write to the GP with their assessment and requests. Its not hard

Equally if you've seen a dentist and your teeth are okay, GPS can also manage oral conditions. The fact of the matter is they are both passing the buck

Dentists can easily refer to maxfacs and tbh most GPS should refer to a dentist before maxfacs as the majority of oral conditions should be manageable by the dentist

I appreciate it’s frustrating but I don’t think they are passing you back and forth.

You’ve seen the GP, they’ve prescribed, you’re waiting for an ENT follow-up. So the GP has been dealing with it.

You’ve also seen the dentist, who didn’t think there was an issue to refer onwards (if they were concerned they would refer you to hospital for checks.)

The GP receptionist gave you a standard catch-all line about seeing the dentist, but now you’re getting the blood test you wanted.

I’m sorry you’re in pain and worried, that is scary and upsetting. But as you’ve had quite a few examinations by professionals and none think it’s an urgent issue it’s probably not serious, so try not to worry yourself too much.

@emlingccfc

To be fair to your GP, any mouth swelling should be assessed by a dentist as they have had I think 6 years training for oral issues. This is not part of the medical school or GP curriculum (they will see throat, neck and facial issues). If the dentist couldn't identify a tooth related issue but you nonetheless had a symptom affecting inside your mouth then they should have referred you to the MaxFax oral surgery department as an outpatient and not batted you back to the GP.

This is correct.

GPs do not treat mouths - the people with 6 years training do and YES they can and should refer to Max Fax.

And Dentists also have a habit of sending pts back to a GP for antibiotics and pain relief so the prescription costs are not assigned to them. Bloody cheeky so please do not be shocked if the GP sends you back to the dentist who is treating you.

I'm not sure what else could be done. The Gp has done the right thing and you have a follow up in 2 weeks with ENT. It's out of the Gp's hand until you see ENT and what the next steps will be.

The thing with most people now is they don't get the answers or treatment right away and expect to walk into a the Gp been seen, diagnosed, treated and cleared by the time they walk out the surgery. Most things don't work like that.

There's not a lot that can be done now except wait for your follow up. The Gp has hasn't told you to go back to the dentist so your not being passed around.

I really appreciate all of these replies and different perspectives. Thanks you!
I have clear photos of the throat issue which I'll attach but am about to watch DS play rugby so will try to take clearer ones of the swelling when I get in.
I was wondering about maxillo facial to be honest. I do feel like it was pass the parcel slightly as when I recontacted gp I was told that mouth = dentist. And to be fair this receptionist was going with the line she had be told to and really was very understanding and helpful in the end.
It's difficult to explain but I can see that it definitely isn't right. And I get that it doesn't look abnormal generally but I know that it isn't my normal. And hasn't ever been before in 40 years.
I am grateful that my last throat episode meant that I would get the follow up appointment as I'm pinning everything on getting somewhere from that now. Perhaps I am over worrying-I do take that on board. But I think sometimes you know your own body better than anyone and have to push if you're not convinced by the initial assessments. I am prone to catastrophising though I suppose.

The dentist can say that there’s no dental cause. After that it’s for the GP to work out.
Either can refer you though, dental referral would be maxillofacial, GP to ENT