"I have a toothache and my face is swollen. Why?"
When you have a swollen face and a toothache you probably have one of the following:
-infected gums around a tooth, usually either an impacted (or partially impacted) tooth or gum disease (gum infection).
-recently received trauma to the mouth.
If you were hit in the mouth then you need to be examined and x-ray'd for broken teeth or roots and for broken jaw bones. The sooner you can see the dentist the better the odds you will be able to keep your injured teeth.
If you have an infection you need to be examined and put on antibiotics right away. Antibiotics will start helping with the swelling within 24 hours. Also a warm salt water rinse may help. If you can't get in to see a dentist for an antibiotic, you can see a medical doctor. The reason it is better to see a dentist is the dentist has been trained to identify and remove the cause of the infection. Just like the gunshot wound doesn't heal until you get the bullet out, an infected tooth doesn't heal until you get the tooth out, or get the infected tissue out of the tooth (root canal). If possible the dentist will try to do this at the emergency visit. Sometimes beind swollen can inhibit you abilility to get numb. There are a lot of ideas as to why this happens, I will just say here that it happens. Sometimes you just have to let the antibiotic work for a few days before trying to get the infected tissue removed. I have seen people get worse even while on the antibiotics. In that case the tooth needs to be fixed ASAP. That may mean you see an oral surgeon that can sedate you while he extracts the tooth, or an endodontist that can sedate you.
Swelling can be life threatening. If the swelling grows under you chin and in to the neck area it can close off your airway. This is called Ludwig's Angina in the dental world. It is a real, life threatening complication. If you have swelling growing under your chin or neck you need to see the oral surgeon ASAP, or go to the emergency room to get IV antibiotics. The oral surgeon and ER doctor can place a breathing tube if your airway closes off. A general dentist is not trained to place a breathing tube (intibation).
Also swelling that grows up into the eye can spread into the brain. Your brain is only a few inches from your mouth. With sinuses and the type of blood vessels in the head/neck infection can travel to the brain. Usually antibiotics will stop this, but if you are on antibiotics and the swelling continues you need to see an oral surgeon or go to the ER for IV antibiotics right away. An easy rule here is, if your eye is swollen shut, you're in trouble.