Swelling of jaw/cheek- mumps, abscess or something else?

[Whatisthisarghhh]

DD, 6, woke up in a lot of pain on Sunday night saying she had a sore tooth and her head hurt. Had emergency dentist appointment on Monday- dentist was quite dismissive, said she couldn't see any sign of infection and was going to let us to but I reiterated how much pain she was in and she had another look. Said DD had a very small amount of decay (on a baby tooth she has previously had some filling paste on). Dentist put a small amount of paste on and home we went. She woke up on Monday night again in pain. Tuesday came home from school on Tuesday and one side of her cheek/jaw area had swollen considerably. Went to GP who asked if dentiat had dkne an x-ray to confirm no infection (she hadnt) and GP said maybe mumps but to go back to dentist if still swollen in the morning. DH took DD to dentist today who said maybe abscess, she has given antibiotics and said to come back in 48 hours if still there. She didn't do an x-ray.
GP has called back to check on DD and said if no improvement once I'm antibiotics to let her know.
All in all, great NHS care. But just wondering if anyone has had similar experience? GP was very honest and said she just wasnt sure what it was.
DD has a very low grade temperature on and off. Jaw is red and tender. She is cranky but well in herself. Don't know if I can face another sleepless night with her! She does have a bit of cake/biscuits/ sweets bit never any fizzy drinks and only drinks milk and water. We still brush her teeth. Any thoughts?

If she's had mmr can't be mumps?

When you say jaw is red and tender do you mean inside her mouth or outside?
You're giving her calpol and ibuprofen I imagine for the pain?

Sounds dental they should do an xray

@EdwardCullensBiteOnTheSide GP said that MMR isn't always effective, especially for mumps. Her lower cheek/jaw and chin are swollen on one side and jaw area is pink.

Sorry meant jaw area is pink/red on outside

Could be a blocked saliva gland - have a look under her tongue

Hmmm, with the redness on the outside I doubt it's dental?

It could be dental, could be mumps, could be salivary gland

She needs an xray to exclude dental cause. Tbh if she has a tooth with obvious decay and is complaining of tooth ache then it is quite likely dental

If its one side and extending to the chin then its unlikely to be mumps

If its a dental abscess or salivary gland infection then antibiotics should treat it, but if dental in the long run she will need the tooth out

The problem with and X-ray at this age is it is often difficult to see an abscess due to the large number of follicles containing developing adult teeth. It looks chaotic even to the trained eye. Also if it is an acute (early stage) abscess there may be no evidence of it on X-ray.
It does sound like a dental abscess and the antibiotics will eventually settle it down. It could be food or foreign object stuck in the gum - for example finger nail or pop corn kernel.
Mumps is a possibility, most GPS under 50 will have never seen a case so would struggle diagnosing it. With a dental abscess you usually can’t see the outline of the lower jaw, with mumps the swelling is in the salivary glands which lie in the tissue compartment below the jaw so the jawline can still be seen. Obviously in young children this can be very subtle. I have seen a few cases of mumps over the years and GPs have often misdiagnosed. Due to MMR they just don’t consider it but not everyone develops immunity otherwise it wouldn’t still be around.
If the antibiotics have not made any difference after 48 hours have one of the senior GPs take a look they will have seen more cases of mumps.

It is possible to have mumps with swelling on just one side. Oh and check any older/adult males have had mumps or MMR, it’s not an infection they will want to catch!

Thats quite a nasty swelling for a child, it looks the wrong place for salivary gland definitely looks more dental. Bur obviously I havent seen her in person

I agree mumps can be unilateral but it makes it less likely

Keep a really good eye on her, if its going down thats a good sign. Is she eating okay? Make sure you are giving her calpol as well

Its possible as well there was infection draining through the tooth and the dentist filling it has blocked the path of drainage leading to swelling

Bless her, my jaw swells like that when I get a blocked salivary gland

Mumps. Mmr doesn’t always keep mumps away

My nephew had mumps one sided just like that

Crikey. When you said swelling, that's not what I pictured. But that does look like mumps. Poor wee soul.

mumps is more neck than cheek ime

she needs to be seen in person to check where it's coming from. you've been to the dentist who says dental issues are ruled out.

how does the inside of her mouth look? any ulcers?

poor dd, I hope she is better soon.

Thanks everyone. She's at home again today. 3 doses of antibiotics so far. Think it has gone down a bit. Have been giving her regular pain relief. She's eating, not as much as usual though. No mouth ulcers that I can see.

It looks decidedly like mumps. I’ve seen a lot of mumps in my early career. Impossible to tell from a photo but looks fairly classic.

Poor little thing! I agree that does look like mumps.

Its more cheek, mumps is more under the jaw or further back, can spread up to cheek or forewards but cant just be cheek there. Its classic dental abscess position but it could be the angle of the photo, Im not ruling out mumps. The dentist hasnt ruled out dental cause because theres no xray.

Make sure shes drinking plenty, its good shes eating something.

The parotid gland sits in front of the ear on or just above the jawline. Mumps can spread under the jaw but doesn’t originate there.

Thanks so much @CherryPavlova , that's really helpful. GP is in her late 40s and seemed pretty knowledgeable about mumps but admitted she just wasn't sure. She is very thorough and I have a lot of confidence in her. She has requested a test through PHE. Interestingly the swelling seems to have moved under her jaw more now. Fun times!