Urgent Dental Problem - Abcess?

Elle7

1jim wrote: »

Does your area have an out of hours dentist... To find out call your dentist and listen to message, if not recall nhs direct from landline tonight

The voicemail gives the number for the dental access centre. The NHS man has left a message there for me, and I've left two. Apparantly they usually call back within an hour but I left the first message at 3.30pm, and another at 6pm.

I'm working my way through the dentist list within 25 miles, but most are closed.

The out of hours NHS dental advisor is calling me every 45 minutes to check I'm okay. His latest suggestion was preparing a large cotton handkerchief and stabbing it with a pin. He said it'd bleed, but if it was overly bloody, to take myself to A&E.

My face is getting blotchier on that side, and the skin is pulling. It feels disgusting and is only getting worse. Not to mention that my OH is angry that no one seems to want to help - I've been in two counties today and neither could help!

brook2jack

The overall responsibility for out of hours dental emergencies is with the pcts, they are also responsible for emergency treatment if you are not in the middle of a course of treatment with a dentist because in England there is no such thing as registration any more.

Because of this most pcts do not have much out of hours service, nhs direct should be able to put you in touch with such out of hours services as exist. Most dental access centres work on an appointment system via nhs direct but a few are sit and wait. Very few open in evenings.

If none exist at this time of the evening your options are wait until morning to see your own dentist if they can fit you in , or pay privately if someone will see you ,which local to me is around £120 for a call out.

A and E will only prescribe antibiotics , however if the swelling is such it starts to block your airway or you have an underlying medical condition that it affects then if you get no joy elsewhere then you need to go to a and e.

This is not much help but is a common problem since pcts took over responsibility for dental emergencies in 2006 as most define dental emergencies as swelling that compromises airways, trauma or bleeding following an extraction that won't stop.

Elle7

Thanks Brook2Jack.

It seems a crazy system! I've been told £160 for a call out but I'll do it if I have too.

Was just applying saltwater with a q tip and the abcess burst. It seemed to be mainly blood. It's now flat to run my tongue over, but it's a bit sore!

Should the facial swelling go down now? It's that that is really painful. I can't take any extra painkillers due to other medical conditions and I've got chronic overbreathing syndrome that this doesn't help, so I'm hoping the swelling will ease up now. I've got important meetings in the morning!

brook2jack

If the pus is draining the swelling shouldn't get worse but there is still an underlying problem which urgently needs sorting just draining or antibiotics wont sort the problem on their own. First priority should be in the morning getting this sorted. This may well need more than one appointment and involve a bit of treatment.

I dont know if this applies to you but routine dental treatment will stop 75% of dental emergencies occurring, so once this is sorted it is important to maintain regular visits.

Elle7

Just in case anyone is following this/going through the same thing...

After continously talking to NHS advisors, I found one who seemed to understand that this wasn't "slight swelling". She made me an appointment at A&E. I arrived and was seen about 40 minutes later, and the doctor was shocked. He said I have the most swollen face he'd ever seen.

He, and three other doctors, have looked at my face all over. They have looked at the abcess, and believe it to be okay. They have prodded the swellings. They wanted to admit me last night for suspected orbital cellulitis.

I came home to get some things, as I only live 20 minutes away, but fell asleep So now I'll call them and try to explain. No idea if they'll want to admit me again. Regardless, I'm seeing a dentist at 10.40am - Not my dentist, but a dentist who seems to understand.

I suppose if they agree that it isn't caused by the abscess, I'll go back to hospital. If they don't, I hope they'll be able to do something to help. I've had no tooth pain or anything since it became flat, the only discomfort is in my swelling. Which is hideous.

The NHS Hertfordshire did phone back just now, and ask if there was anything they could do to help after my message yesterday morning. No idea if they would have been able to recommend anything but at least they did get back to me, unlike the emergency dentist!

perrinos

Wow thank goodness u have been seen at last it's awful u had to wait so long but sadly I'm not surprised hope it all resolves soon xxx

joyfull

Elle, thanks for update. Really hope you're on the mend. This read a bit like a horror story. Very impressed with your stoical courage. Give yourself a good pat on the back . Unfortunately this does not bode well for anyone with dental emergencies and doesn't surprise me.

I had a somewhat similar experience when I fell, knocking out front teeth & no-one (a&e) knew what to do with me, so did nothing. My own dentist eventually, once he was open for business, was wonderful & got me sorted but I spent a gruesome 18hrs or so somehow having to cope.

brook2jack

The moral is make the complaint to the PCT. They alone are responsible for out of hours dental emergencies.

Pre 2006 dentists were responsible and in our area had to cover 24 hours a day 7 days a week. Since 2006 most PCTs just have an emergency clinic open at weekends for a few hours. In our local area this has continued despite dentists protests because not enough patients complain, therefore the service is seen as satisfactory.

If you have problems complain , in writing, to the PCT whose responsibility it is to sort dental emergencies out, both out of hours and when you are not seeing a dentist for a course of treatment. That will prevent others suffering in the same way.

Elle7

Thanks everyone, it's nice not to feel like I'm going through this on my own!

Someone from the PCT is supposed to be calling me back to discuss my complaint - we'll see. It might be a bigger complaint if they take much longer!

The dentist wasn't my usual person, but had a good look around. No visible signs of infection, and X-rays were clear. He was a bit baffled. Two more dentists were called in, they whacked my teeth with some metal :eek: but no issues. Eventually decided that there isn't a lot they can do, dentally, but they did prescribe amoxicillin and metronidazole just in case. They told me to stop the co-amoxiclav and replace with this, the pharmacist told me to take them both. Confusing!

Now have an emergency doctors appointment at 4:10. Hospital is still packed, nurse admitted that they could admit me but I wouldn't get a bed for a good few hours, and it's unlikely anything would happen until they could find a specialist to see me - tomorrow afternoon, she thinks.

I'm petrified of hospitals and have panic attacks whenever I go in, so I'm hoping to avoid that. I could go and have IV antibiotics if they promised they'd let me out at night, but they don't seem to want to actually do anything. Hoping the doctor can help - most of the time it seems okay, but at times it does blur my vision and make seeing rather uncomfortable.

Have been targeted by domestic violence groups today, who obviously think I've been beaten up. Embarrassing and awkward!

Have taken first two of my new tablets, and am now sucking a Dequadin whilst holding a cold compress to my face. Hopefully, something will help soon.

coldstreamalways

How are you getting on now?