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Q. I have swollen lymph nodes and sore throat even after a month of wisdom tooth removal. Why?

Answered by
Dr. Penchilaprasad Kandikattu
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 25, 2020 and last reviewed on: May 08, 2020

Hello doctor,

I had aggressive damaged wisdom teeth removal about a month ago. And since then I have a swollen lymph node in my neck on the side of the removal which sometimes it hurts and feel swollen and sometimes normal but it does not go away. But for the last two days, both sides are swollen and my throat is sore and hurts when I swallow or smoke. Is this something serious?

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#

Hello,

Welcome to icliniq.com.

I have seen the image. (attachment removed to protect patient identity). It is showing right follicular tonsilitis with keratitis of the right buccal mucosa and attrition of the teeth with discoloration of the teeth present.

For tonsillitis, you have to use antibiotics like Amoxicillin and Clavulanic acid 625 mg twice a day for five days, and tablet Azithromycin 500 mg first day followed by 250 mg once a day for five days. Avoid cool drinks and alcohol. Avoid smoking and tobacco chewing. Use water vapor inhalation and salt water gargling thrice a day.

For keratitis, avoid smoking and use capsule vitamin A once a day for one week. Eat green leafy vegetables and fruits. Please consult with your oral pathologist, he will examine and if possible will take a biopsy and treat you accordingly.

I would like to some details. How old are you? Since when you are smoking? Is lymph node feeling hard or soft? It is possible that lymph node enlargement in case of any infection in the oral cavity, nose, or ears. If the lymph node is soft, painful, and easily moving means it is inflammatory pathology. But if it is hard, matted, and non-movable means a malignant pathology.

Thank you doctor,

I am 31 years old. I have been smoking for over 10 years. The lymph node feels a little hard.

#

Hi,

Welcome back to icliniq.com.

Please avoid smoking.

Thank you doctor,

I remember having tonsillitis three years ago, and it has always been there with no problem. Is this common?

#

Hello,

Welcome back to icliniq.com.

Tonsilitis leads to repeated throat infections which may lead to complications like uncontrolled pharyngitis, lymphadenopathy, ear pain of that side (middle ear infection), eustachian tube block, sleep apnea, dysphagia (difficulty in swallowing), Peri tonsilar abscess, etc.

Usually, we may treat tonsillitis with medication. If it is not improved and causing repeated pharyngitis more than six times a year along with the above complications, you may need surgery. For tonsilitis, treatment is already mentioned above.

Thank you doctor,

I want to go back to swollen lymph nodes as that is worrying me the most. Is it possible that the swelling for about a month after surgery indicates non-healing of the wound? Do you suspect a malignant pathology?

#

Hello,

Welcome back to icliniq.com.

We will suspect malignancy in old patients with risk factors or young age patients with smoking and tobacco chewing history.

In your case, smoking history is there with mild keratosis, that is why we have to confirm the pathology. I told you to go to an oral pathologist and he will take a biopsy and confirm the diagnosis. But 95% of keratosis reverted became normal after the elimination of risk factors.

I didn’t get the chance to buy the medicine yet, hopefully tomorrow. But today this thing appeared and it feels annoying, it’s marked in the picture. Please Dr tell me what u think I smoked only 1 cigarette today as I took ur advice and I’m trying to stop smoking.
# Hello

Dear I didn't get your image so please send me once again.

Thank you.
Sorry, also I got a bad taste in my mouth
# Hello

Dear I saw the image. It may be mucoele. Don't worry nothing will happen.when you undergone tooth extraction? Have you completed antibiotics? Why sutures not removed? Have you feeling pain at the tooth extraction site? Is there any lymphnode enlargement around the neck?

The area that you marked is it like a bubble with fluid..did it burst anytime or is it the same from when it appeared?
do you feel particular pain when you press that area?


Use rexidine mouth wash in one table spoon in 100 ml water mouth gargling twice a day.

Use tablet moxikind cv 625mg twice a day for five days. Tablet Azithromycin (Azee) 500 mg first day followed by 250 mg once a day for four days.

Answer above questions.

Take care.
It’s been about a month and a half since extraction and yes sometimes the area get painful and around the neck I got a little bubble under the extraction area that feels swollen and hurt sometimes specially when sleeping. I don’t feel no pain when I press the area. The little bubble that I marked just appeared yesterday it’s look like a piece of skin and still there
# Hello

Dear some times the tooth extraction site may be carrying a infection may cause this problem. To know this may need x ray of that site or need to examined by dentist. Some times need surgical extraction of the infectious focus. so please consult a dentist he will examine and treat you accordingly.

Take care.

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