I had terrible tooth and gum pain on the right side of my mouth with both upper and lower teeth? Dentist doesn’t see anything wrong?

27, Female, Married with 3 children. (No major medical history beyond giving birth) Currently I take a medication called buprenorphine (generic subutex) and have taken it for 6 years. It is for opiate dependency maintenance. I am tapering off buprenorphine and have been for over 4 months. I am on the last month of tapering off, right now. I dont believe my issue is due to the buprenorphine at all. I am also taking clindamycin which has been in my system over 90 hours right now. My issue started about 8 days ago. I had terrible tooth and gum pain on the right side of my mouth with both upper and lower teeth. A couple days later the pain was in my front top two teeth.. The pain has been honestly horrible at times to where i feel like im going to pass out. 1 night i described it as possibly worse than child birth and as stated gave birth to 3 children naturally. About 5 days ago i slept with a heating pad on my face and woke up with a very swollen upper lip, mustache area, and nose.. I went to the ER that day because no dentists were open. They prescribed the clindamycin at 300mgs caps, 4 times a day. The swelling spread to my lower cheek/jaw area by the next day and has been swollen around both side of my lower cheek and jaw/ nose/ upper lip/and mustache line area for a few days now. I went to the dentist yesterday and they took xrays of my teeth but told me there were no abscessed teeth that they could see. They prescribed me an antibacterial oral mouth wash but i do not know what the problem is. I anticipated there to be an infection in my teeth somewhere and possible abscess but also anticipated the swelling and pain to go away at least by 3 days of being on the antibiotic. I dont know what to know nor what could be causing this pain and swelling. I read about it possibly being a sinus infection but i dont have any swelling around my eyes nor forehead. just my lower nose, upper lip, mustache line, and lower cheeks on each side accompanied by pain in my front top tooth. I did have a filling done in between both front teeth about 7/8 weeks ago followed by another filling done in the left bottom side of one of my molars about 1 month ago.. Other than a sinus infection i am worried about the cause of this pain and swelling. Ive read different things about thyroid issues and only bring them up because ive also read that buprenorphine can cause thyroid issues. Any help as to why i would have swelling and pain in so many different areas. I have so much to do because ofchristmas and i dont know if i should go back to the ER, dentist, or a MED express type place. Thanks for reading this.


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Dr Ahmed Fawzy
Member
Dr Ahmed Fawzy

In my opinion you have trigeminal neuralgia
I recommend seeing a neurologist which will order MRI and MRA magnetic resonance angiogram

Good Luck

Dr Mahaveer
Member
Dr Mahaveer

hi,
these symptoms do not seem to be related to dental issues.
get a mri done to find out the underlying cause.
take gabapentin and pregabalin tablets.
low dose steroids will help.
thanks

shw12
Member
shw12

HI
THIS MAY BE DUE TO TRIGEMINAL NERVE INFLAMMATION,COMMONLY REFERRED TO AS TRIGEMINAL NEURALGIA.
THE PAIN IS OFTEN UNBEARABLE IN THESE CASES.
IF AN MRI BRAIN CONFIRMS THE DIAGNOSIS, RADIOFREQUENCY ABLATION CAN HELP.
CONSULT A NEUROLOGIST.

mrsshalini14
Member
mrsshalini14

hello there
dentist is correct. i do not see any cause related to the teeth.
nerve inflammation seems to be the cause.
neurotransmitter tablets and a dose of steroids will be helpful in your case.

Dr. Ayman Darrag
Member
Dr. Ayman Darrag

Getting a brain and sinuses CT scan will rule out some possibilities ..but if dentistry is not related as your doctor examined I will go more with trigeminal neuralgia specially if the symptoms are associated with numbness or electric sensation or related to stress.
A neurologist can examine you and confirm this

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