Cheek swelling occurs with dental diseases, some types of allergies, traumatic injuries, skin, otolaryngological, endocrine, ophthalmic, neurological, and some other pathologies. More often it is unilateral, it can be local or widespread. Sometimes accompanied by pain, weakness, local and general hyperthermia. The cause of swelling is established by clarifying complaints, anamnesis of the disease, general, dental, otolaryngological or ophthalmological examination, radiography, and other methods.
Why does the cheek swell
Periostitis of the jaw
It is the most common dental cause of the symptom. It develops against the background of dental diseases: periodontitis, pulpitis, alveolitis, periodontitis, festering jaw cyst. It is provoked by open fractures of the jaws, infected wounds of the face, operations, extraction of teeth. In some cases, it becomes a consequence of hematogenous or lymphogenous spread of infection from distant foci. Depending on the form, it is accompanied by the following manifestations:
- Acute serous periostitis. A moderate swelling of the soft tissues of the cheek, redness of the mucous membrane, and an increase in regional lymph nodes are revealed. The general condition suffers slightly, sometimes there is an increase in body temperature to subfebrile numbers.
- Acute purulent periostitis (flux ) . The contours of the face are sharply changed, the predominant localization of edema is determined by the location of the inflammatory focus in the periosteum. Patients complain of a sharp pain radiating to the temple, eye, ear, neck. General hyperthermia, chills, weakness, headache, regional lymphadenitis are observed. When examining the oral cavity, a swelling zone with a fluctuation in the center is found - a subperiosteal abscess.
- Chronic periostitis. Slight swelling of the cheek, thickening of the jaw, enlargement of the submandibular lymph nodes are typical. The patient complains of periodic moderate pain. The mucous membrane of the affected area is edematous, hyperemic, with a bluish tint.
Other dental diseases
Other possible dental causes of swollen cheeks include:
- Periorbital abscess. It occurs as a result of infection of the soft tissues of the perimaxillary zone with boils, tonsillitis, wounds, abrasions, and some dental diseases. Swelling is preceded by toothache, aggravated by biting. Then a dense edema appears, the temperature rises, appetite disappears. After spontaneous opening of the abscess, the condition improves, but in the future, the pathology may recur.
- Stomatitis Vincent. It develops with a decrease in immunity against the background of diseases, injuries, stressful situations. The leading symptom is the formation of multiple ulcers on the mucous membrane. Swelling of the cheek is found in severe pathology.
- Noma. There is a site of ulcerative-necrotic lesions of the lip or oral mucosa. Necrosis covers the gums, tongue, cheek tissues, facial bones. The tissues around the area of necrosis are edematous, in severe cases, swelling from the cheek extends to the chin, infraorbital zone.
- Salivary gland adenoma. The parotid gland is more commonly affected. Local swelling with clear boundaries is formed along the outer surface of the cheek, in the parotid zone, passes to the angle of the jaw, the zone under the earlobe. Characterized by slow growth, painlessness at the initial stage, the progression of discomfort and dry mouth as the formation increases.
- Tumors of the salivary glands. Along with adenomas, benign connective tissue neoplasia, intermediate and malignant neoplasms can form in the area of the salivary glands. The area of swelling is located in the same place as with adenomas. Swelling increases slowly in benign tumors, spreads rapidly in malignant ones.
- Purulent parotitis. In the parotid region, edema occurs, which spreads to the adjacent part of the cheek. There is a sharp pain, difficulty in trying to open the mouth, severe intoxication, severe hyperthermia.
cheek swelling
Traumatic injuries
All facial injuries are accompanied by a rapidly growing soft tissue edema that spreads to neighboring anatomical structures. Swelling of the cheek of a traumatic origin can occur with the following injuries:
- Injury. Swelling without clear boundaries. Along with edema, soreness, hyperemia, and sometimes hemorrhages are determined. The pain intensifies when opening the mouth, active facial movements. Speech, the possibility of eating are preserved.
- Hematoma. Formed on the background of a bruise. In the area of diffuse puffiness, a seal appears, which, as a rule, resolves on its own within 1-2 weeks.
- Fracture of the upper jaw. The most pronounced edema is observed in fractures of the Le Fort 1 type, combined with neurological symptoms, hemorrhages in the conjunctiva, periorbital zone. Type 2 is manifested by edema, hemorrhages in the periorbital zone, changes in facial parameters. In type 1 fractures, swelling is more noticeable in the area of the upper lip, the medial part of the cheek.
- Fracture of the lower jaw. Branch injuries, lateral and angular fractures of the body of the bone are characterized by swelling of the lower or outer edge of the cheek. Facial asymmetry, hematomas, bruises, articulation disorders, dentition staggering are observed.
- Fracture of the zygomatic bone. The swelling appears in the cheekbone area, quickly spreading down the cheek, up the infraorbital region. Bruising, hemorrhages in the conjunctiva are formed. Along with the pain syndrome, the victims are sometimes disturbed by nosebleeds, double vision.
allergic reactions
Swelling of both cheeks is observed with angioedema, combined with swelling of the eyelids and lips, respiratory disorders. The condition develops acutely, within a few minutes, less often - hours. It is provoked by contact with an allergen, insect bites. Along with the listed symptoms, Quincke's edema in children may be accompanied by abdominal syndrome, sometimes with neurological symptoms.
The cause of swollen cheeks on the part of the mouth can be an allergy to prosthetic materials. The pathological condition occurs several months or years after the installation of prostheses, characterized by burning of the area of fixation of the prosthesis, tongue, cheeks, soft palate, changes in taste sensitivity, thirst, dry mouth. When using metal products, a metallic taste is noted.
Ophthalmic diseases
In patients with acute dacryocystitis, swelling of the lacrimal sac area is complemented by swelling of the cheeks, eyelids, and back of the nose. In the chronic form of the pathology, swelling is noticeable along the upper inner edge of the cheek, captures the inner edge of the lower eyelid. Phlegmon of the lacrimal sac is characterized by sharp pain and swelling along the inner edge of the eyelid, combined with fever, weakness, weakness, headache, swelling of the cheek, paranasal zone.
Neurological pathologies
Local symptoms of cavernous sinus thrombosis are exophthalmos, blurred vision, swelling and pain in the eyeball, swelling of the temple, part of the forehead, cheeks, upper lip, mastoid process. The clinical picture also includes headache, nausea, vomiting, with an infectious genesis of the pathology - hyperthermia, intoxication syndrome.
Swelling of the cheeks can be detected with one of the varieties of angioedema - rosacea. There is a constant redness of the cheeks, nose, forehead, chin, the formation of spider veins. The cause of swelling is persistent vasodilation, which, with a long course of pathology, leads to skin changes.
Skin lesions
Slight swelling of the cheek may be due to simple contact dermatitis. The severity of the symptom increases against the background of prolonged contact with the irritant, secondary infection. With allergic dermatitis, the swelling is more noticeable, combined with itching of the skin. Atopic dermatitis is characterized by mild swelling in combination with the formation of vesicles.
Due to the abundant blood supply to the face, the structural features of the soft tissues, the furuncle on the cheek is accompanied by significant swelling. In the center of the swelling zone there is a limited rounded or cone-shaped formation with a black rod in the center. After the furuncle matures, yellowish pus appears around the rod. Growing twitching pains are noted.
In young children, swelling of the cheeks is often provoked by superficial pyoderma, which occurs against the background of pustular rashes. A severe form of facial skin lesions in adults and children is erysipelas. The disease manifests itself with itching, swelling, burning sensation. Subsequently, the cheek swells, a focus of clearly defined hyperemia with jagged edges forms on it, resembling a geographical map. Fever, intoxication syndrome are observed.
ENT diseases
A slight swelling of the cheeks is possible with the development of acute sinusitis or exacerbation of chronic inflammation of the maxillary sinuses. Other symptoms include pain, nasal breathing disorders, nasal discharge, weakness, fever, signs of intoxication. Patients with large odontogenic cysts of the paranasal sinuses are disturbed by a feeling of tension and heaviness. Objectively, there is diffuse swelling of the cheek on the side of the lesion, protrusion of the bottom of the nasal cavity.
Other reasons
Swelling of one or two cheeks is noted in the following pathologies:
- Myxedema. The swelling is bilateral, uniform, covers the forehead and chin, which makes the face look puffy. In a severe case, the edema spreads to the entire body. There are symptoms of hypothyroidism.
- Parotitis. Due to inflammation of the salivary glands, the perimaxillary region, the outer part of the cheeks, swells. The deformation is bilateral, often uneven. The disease manifests acutely, accompanied by fever, chills, signs of general intoxication.
- Melkersson-Rosenthal syndrome. The leading manifestation is considered to be periodic swelling of the lips. Swelling of the tongue, cheeks, eyelids is possible. Neuritis of the facial nerve is often detected.
- Phlebolith. Calculi in the veins of the cheek are often asymptomatic, but can be manifested by pain and swelling, sometimes inflammation of the affected area.
Diagnostics
Dentists and maxillofacial surgeons are involved in determining the cause of swollen cheeks. According to the indications, the patient is referred to other specialists: otolaryngologists, ophthalmologists, dermatologists. To clarify the diagnosis, the following procedures can be performed:
- Interrogation, general inspection . The doctor finds out when and under what circumstances the cheek began to swell, establishes the presence and dynamics of the development of other symptoms. It reveals pain on palpation, changes in skin color and temperature. Assesses the prevalence of edema, tissue density.
- Dental checkup. The specialist assesses the condition of the teeth, gums, oral mucosa, bone structures. Detects signs of inflammation and suppuration, the causative tooth (if any).
- Ophthalmic examination. It is indicated for damage to the lacrimal sac, suspected thrombosis of the cavernous sinus. It is possible to carry out ophthalmoscopy, lacrimal-nasal test, probing of the lacrimal ducts, and other diagnostic manipulations.
- Otolaryngological examination . It is necessary for sinusitis, cyst of the paranasal sinus. It can be supplemented with echosinusoscopy, diagnostic puncture.
- Radiography. X-ray examination of the tooth is prescribed to clarify the condition of the teeth, radiography of the jaw or zygomatic bone - to detect fractures in injuries of the maxillofacial region, radiography of the paranasal sinuses - to confirm sinusitis, cysts of the maxillary sinus.
- Sonography . Ultrasound of the salivary glands is recommended for tumors, adenomas, and other pathologies. Allows you to assess the size and structure of organs, identify calculi, volumetric formations, signs of inflammation. With symptoms of ENT pathology, an ultrasound of the paranasal sinuses is performed to visualize fluid or a tumor.
- Laboratory tests . Most often, a general blood test is used to confirm the inflammatory process, a microbiological blood test to determine the pathogen. If a tumor process is suspected, a cytological or histological analysis of the biopsy is carried out.
Dental checkup
Treatment
Help at the prehospital stage
The vast majority of causes of cheek swelling require medical intervention and cannot be eliminated with self-medication. The exceptions are minor injuries: bruises, small hematomas of the cheek, to which cold should be applied in the first days, and then dry heat. With intense pain, increasing swelling, signs of general intoxication, a doctor should be consulted on an emergency basis.
Conservative therapy
The tactics of treatment is determined by the characteristics of the disease. With dental pathologies, a complex treatment of periodontitis or pulpitis is performed. Patients may be prescribed the following medications:
- NSAIDs . Medicines containing nimesulide are effective for toothache, trauma, and inflammatory processes. Reduce pain, swelling, inflammation. They are symptomatic, they do not eliminate the cause of the disease.
- Analgesics . Recommended for severe pain. Should be taken only as prescribed by a doctor, since they can to a certain extent level the manifestations of a purulent process.
- Antihistamines . Block the production of histamine, eliminating the manifestations of allergic reactions. 2nd generation drugs and their active metabolites have the least number of side effects.
- Antiseptics . They are used as rinses on their own or after surgery.
- Antibiotics . Indicated for purulent and non-purulent inflammatory processes caused by bacterial microflora.
Along with drug therapy, according to indications, physiotherapy procedures are carried out. Laser therapy, drug electrophoresis, UHF, and other techniques are used.
Surgery
Taking into account the characteristics of the pathological process, the following surgical interventions can be performed:
- Dental diseases : tooth extraction, opening of a submucosal or subperiosteal abscess, removal of a tumor of the salivary gland, opening, drainage for purulent mumps.
- Traumatic injuries : osteosynthesis of the zygomatic bone, upper or lower jaw, splinting of the jaw, ligature binding of teeth.
- Ophthalmic pathologies : dacryocystorhinostomy, extirpation of the lacrimal sac.
- Nervous diseases : thrombectomy, decompression hemicraniotomy for cavernous sinus thrombosis.
- Infectious processes : opening of the boil.
- ENT diseases : open or endoscopic sinusectomy, microgeniotomy, excision of the maxillary sinus cyst.