I'm baffled--can't figure out if I got injured working dish or have a tooth problem

[UMP25]

This one has me puzzled. Here's the scoop...

Sometime Monday (I honestly cannot remember during what part of the day, but I think I first noticed pain during the evening or something) I began experiencing pain on the left side of my face in the area of the lower cheek, around the mouth. The pain grew more intense as time went by, so much so that by Tuesday I was taking Vicodin every 6 to 8 hours. That helped immensely, but that schit made me loopy.

Wednesday morning I awoke to a scary sight in the mirror--the left side of my face was swollen. I looked like a frickin chipmunk or like I had a mouth full of marbles on the left side. So, I take a finger and start prodding around in my mouth, wondering if it's a tooth problem of some sort. There was no pressure pain on my teeth; that is, when I pressed hard against my teeth, or even when I chewed on something, the pressure exerted created no pain or adverse reaction. Even pressing the lower gum around all the teeth resulted in no pain. However, pressing the very upper part of the gum, the part where essentially the cheek muscle began, caused me to wince in pain and jump out of my seat, so to speak.

Realizing that a tooth's roots are high in the gum, as are the nerves to the teeth, I went to the dentist Wednesday afternoon, then, in an emergency appointment. He took some X-rays, not noticing anything from a visual, exterior inspection. He said the X-rays showed what he thought was a tiny black spot indicating a possible infection beginning in the root area of tooth # 14, a tooth on which I had a root canal done several years ago. Consequently, he prescribed amoxicillin and referred me to an endodontist for a more thorough examination. Just my luck that all the endodontists to which he referred me left town for a dental conference the next day and won't return until Monday at the earliest, so I have to wait until sometime next week to get in. In the meantime, I take the amoxicillin antibiotic.

Since Wednesday's dental visit, however, the pain has steadily DEcreased, and the only area highly sensitive to deliberate pressure by me is the part of my mouth where the cheek muscle literally begins at the top of the gum line. In addition to decreasing pain, the swelling of my face's left side has lessened about 75% since its worst point, that being Wednesday morning.

So why do I bring up the question of whether this is tooth related or an injury umpiring? Well, I started wondering why my swelling went down, but more so why the pain has decreased dramatically, to the point where I stopped taking Vicodin early Thursday morning (after having taken it Tuesday and Wednesday). Because I haven't yet been to an endodontist, nothing other than a simple antibiotic has been done to cause a possibly infectious tooth root to improve. Moreover, the customary and expected pain one would incur from chewing, especially hard food items, doesn't really exist and did so only initially briefly and mildly.

The big however, though, is that Monday afternoon I worked a D3 conference doubleheader and had the dish in game 1. In the middle of the game I took a foul ball off the facemask, off the left lower side, in fact. I use the Titanium New View mask with the wraparound pads. When the foul ball banged off my mask, it caused my mask to be dislodged, but the mask didn't fly off. At the time, I experienced no pain; rather, just the typical being shaken up by a fastball being fouled off into one's face mask. I've experienced worse hits before, including ones with immediate pain. This hit didn't seem at the time that big of a deal.

So, I'm wondering if in some way I got injured in that hit. If so, wouldn't the swelling, if it was, in fact, caused by such a hit, be accompanied by common discoloration--the usual black & blue then purple color? There was none of that. Nor were there any cuts or anything else that might resemble an injury. Of course, it was impossible to tell if such discoloration or injuries occurred to the inside of my cheek, because as hard as I tried, I couldn't see in there, even with the aid of a small, bright flashlight. It was too hidden.

I think one of the reasons I'm wondering, other than sheer curiosity, is that I really don't want to go to the endodontist and have him tell me that he must retreat tooth # 14, which basically means a cleaning out and a re-root canal. In addition to this reason, I just find the probability of this being tooth related difficult to accept, primarily because having experienced cavities, root infections, and related teeth problems before, those all had pressure pain and other characteristics this situation has lacked.

I'm sure that like me, there's probably no one here who's a dental or endodontic expert. However, deductive reasoning and a little common sense sometimes solve medical puzzles.

If the pain recurs or re-intensifies over the next few days, and/or if the swelling recurs, then it's probably tooth related. If not, then it's got to be just a freaky result of that mildly jarring foul ball hit.

[Steven Tyler]

From my personal experience, I've had a cracked root after a root canal. You can't save the tooth. It will have to be cut out. Amoxacillian is a good antibiotic, especially if you have an abscess. You may later mash around your gum where the infection is, and a ton of pus will come out.

A cracked root is usually caused by the way you bite. I don't think a shot to the mask would crack something, but I couldn't say for sure.

Good Luck. I hope you have some type of dental insurance, or deep pockets. Hope everything is okay though, and nothing major.

[SAump]

The pain went away after you began antibiotics, not the painkillers which only mask the pain. I doubt a blow would cause an immediate infection. If there was infection, there is a tooth problem. Do not wait for the infection to return.

Your dentist should have answered the second question. Now if there wasn't any infection, there is another problem there that may have been caused by a severe blow, followed by clenching of the teeth and muscle strain, and possible tooth pain. But only the expert or followup visit to a dentist can determine the proper way to correct it. Mention it to them before they begin and ask them to explain your options. People choose to have teeth pulled when other options are available and sometimes they refuse the proper treatment when the symptoms disappear.

[UMP25]

Originally Posted by Steven Tyler

From my personal experience, I've had a cracked root after a root canal. You can't save the tooth. It will have to be cut out. Amoxacillian is a good antibiotic, especially if you have an abscess. You may later mash around your gum where the infection is, and a ton of pus will come out.

A cracked root is usually caused by the way you bite. I don't think a shot to the mask would crack something, but I couldn't say for sure.

Good Luck. I hope you have some type of dental insurance, or deep pockets. Hope everything is okay though, and nothing major.

But the dental X-rays Wednesday revealed no crack in the roots at all. Nothing out of the ordinary was noticed, except for a tiny black speck that the dentist said might be the beginning of an infection, but because he couldn't be sure, he referred me to the aforementioned endodontist.

Originally Posted by SAump

The pain went away after you began antibiotics, not the painkillers which only mask the pain.

Could that be more of a coincidence, though? Just wondering.

I doubt a blow would cause an immediate infection. If there was infection, there is a tooth problem. Do not wait for the infection to return.

Your dentist should have answered the second question. Now if there wasn't any infection, there is another problem there that may have been caused by a severe blow, followed by clenching of the teeth and muscle strain, and possible tooth pain. But only the expert or followup visit to a dentist can determine the proper way to correct it. Mention it to them before they begin and ask them to explain your options. People choose to have teeth pulled when other options are available and sometimes they refuse the proper treatment when the symptoms disappear.

I'm still going to the endodontist next week just to make sure. Hopefully they'll find absolutely nothing wrong. BTW, the swelling is now almost totally gone, thankfully.

[MikeStrybel]

PD, sorry to hear about the tooth. A quick Google about infections post root canal turned up plenty of hits. If the endo missed a canal or didn't get it completely then the infection will take hold, sometimes years later.

I wear the same mask and have never had a bell ringer or tooth issue. I wish you luck. Heal fast. See you around.

[UMP25]

Well, I'll find out in a few days. Thankfully, the pain has subsided greatly since its inception.

[Rita C]

I umpired two games behind the plate a week ago. This last week I've been to the dentist to have my teeth checked! Lots of pain, tension in muscles in the cheek. But no infection.

It's better now by taking ibuprofen all week. But for me it might be my bite has changed and I'm clenching my teeth as I umpire.

Don't know. Still deducing.

Rita

[UMP25]

The swelling is pretty much gone, and the pain has decreased to the point that it's virtually nonexistent. If this was tooth related, I would think the pain would still be quite present, especially since I don't see the endodontist for a few days.

[mbyron]

I, too, had an non-routine ("emergency") visit to the dentist this week, also because I thought #14 was causing me pain. It turned out in my case to be #12, and it also turned out not to be decay, fracture, infection, or any of the standard causes. I did not have swelling or such severe pain that I took anything for it.

My dentist noticed that my bite wasn't quite correct, and "adjusted" it by filing down some parts of my molars that should not have been making contact when I bite. His theory was that the pain was the result of what he called "bruising" of the tooth socket, which would not have shown up on x-ray or examination.

So far, it feels better, though not completely. I too have wondered whether a shot to the mask was the origin of the injury.

And I use the same mask as UMP25. Hmmm.

[treydawgmt]

I work fulltime in Fire/EMS, and have worked in hospitals. This means I am clearly NOT an expert in anything (! we are jacks of all trades, masters of none) but my experience in infections is antibiotics usually take right around 48 hours to begin having a good effect. If your pain was gone the same day or next as taking the antibiotic, that leads me to believe it was related to something else. Just please don't ask me what that something else is!

[pob14]

When I had shingles a couple of years ago, the pain started like a toothache. I went to the dentist first.

I'm not saying you have shingles (you'd probably have an obvious rash, and the pain wouldn't be gone yet), but I am saying there's a possibility of something wrong in the nerve itself. Go see a regular doctor.

[UMP25]

I happened to see my regular doctor about something else, and he checked out my mouth. He personally believes it looks more like a slight internal bruise from the foul ball hit.

BTW, all pain disappeared a few days ago, and everything is back to normal--all this without a re-root canal.

[Rita C]

Well it turned out I had a cracked tooth. I must have been bearing down on it that one day. It took a while to find out the issue because cracks don't necessarily show on x-rays.

Anyway, there was no saving the tooth because the crack was so big. I had it pulled today. There were signs on it that the pulp was dying. It was just a matter of time.

Time for more ibuprofen!

Rita

[knuckler]

Well, not only am I an umpire, but I am a dentist as well. Seeing how your swelling was almost a month ago, hopefully you have got to the bottom of it by now. I would highly recommend having the endodontist evaluate it, even if the Amox did the trick. It is not uncommon for a tooth like you described to respond to the antibiotics, but if it is a failing Root canal, it will eventually rear its ugly head again, usually at the most inopportune time!

[UMP25]

I canceled my endodontist appointment because several days before it was scheduled--there was no way I could get in any earlier--the swelling disappeared, along with all pain and discomfort. This led me to conclude it was from that freak foul ball to the mask than a tooth problem.