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Why is there no improvement in tongue and lower jaw pain even after the treatment?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At May 28, 2022
Reviewed AtSeptember 5, 2023

Patient's Query

Hi doctor,

My problem started five years with my tooth (the third one from the back –right lower jaw) began with painful swelling. The doctor said it was an abscess around the tooth's root; he prescribed an antibiotic to treat the infection. After one week or so, he extracted my teeth, and they broke the teeth into fragments during a lengthy extraction work. It took a long time to heel. There has been hard jaw swelling that does not completely disappear after that.

After it healed, I noticed a small lump on the extraction site and gum swelling and irritation around the area. All that disappeared for a while without treatment, and now, for two months – I experience the following:

1. The lump appears again with painful gum swelling around the site.

2. Painful tongue (burning sensation, especially at the tip and right side). I also noticed a swelling under the tongue (left side). I do not know if it is the salivary glands that swell.

3. Black color gum.

I went to a dentist who said that:

1. There are tongue ulcers. He prescribed a substance in a bottle that bore no name to rinse my mouth with.

2. As for the other symptoms of my jaw and the lump. The x-ray showed the tooth near that extracted one has dental caries and should be filled. There is also an upper tooth with an abscess around the root- it opened by itself and drained; the doctor said it needs filling and root canal treatment.

3. The X-ray also showed multiple bony radiopaque buildups on the RT. Jaw and at the front lower teeth.

• They told me that these bony buildups are usually found in some ethnicities.

• They think that other symptoms might disappear with the ongoing teeth filling treatment.

The treatment started with the tooth near the extracted one; they drilled it and filled it with a temporal filling for two weeks, and then I should come for the permanent tooth fill.

The problem now is the painful tongue and lower jaw. And I am worried about these bony buildups as I do not feel any improvement.

Are these symptoms indicate any serious underlying cause?

Thank you very much for the help.

Hi,

Welcome to icliniq.com

I got about details of your chief complaint, and I suspect it is a case of some pathology. The burning sensation on the tip of the tongue, right side and swelling under the tongue, and ulceration doubt there might be some pathology apart from the carious teeth. However, after a traumatic extraction, such things may happen. As you say, the radiograph shows multiple radiolucencies; it needs attention. Can you please send your radiographs and photographs of the mouth where these changes are noticed so that I can help you better? You need attention and detailed examination.

Regards.

Patient's Query

Hi,

Thank you for the reply.

I wanted to add that recently my tongue became fixed, and I could not move it freely, which affected my swallowing and speech. It became very difficult for me to swallow solid food and hardly for semisolid food. And this has been worsening progressively over the past few months. I feel a mass below the tongue getting larger. CT done showed a subglottic mass. I will attach the CT scan of the neck and the photograph of the mouth you requested.

Regards.

Hi,

Welcome back to icliniq.com.

I am analyzing your files (attachment removed to protect the patient's identity) and will share details shortly. So be patient; I will send details after some time.

Regards.

Patient's Query

Hi,

Thank you for the reply.

It has been a long time since last we discuss my case. I have had really bad news, although I expected it. A biopsy was taken, and I attached the original report. A pet scan was requested, and the result is also attached. We would be grateful if you could give us your opinion about a management plan. Please find the attached files.

Thank you.

Hi,

Welcome back to icliniq.com.

Very unfortunate, do not worry, I am studying your reports (attachment removed to protect the patient's history), and I will forward you details and suggestions shortly.

Regards.

Patient's Query

Hi doctor,

Thank you for the reply.

I looking forward for your your opinion and advice.

Hi,

Welcome back to icliniq.com.

Do not worry; I have already shared your case with my oral medicine and pathology department, and we are discussing it. So you wait; I will forward you my final opinion shortly.

Regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Soheel Hussain Zargar
Dr. Soheel Hussain Zargar

Dentistry

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