In mid March, the familiar dull ache in my lower jaw turned into a throbbing pea-size nodule, I knew I needed a dentervention. The dental x-ray technician took one image, then another and let out a low whisper, “Ohhh nooo—Wait! you didn’t hear that—I’m not a doctor, but…” She showed me the x-ray with a large dark shadow blurbing down from my molar—#30 in ‘dental-ease’. My dentist made an immediate referral to an endodontist—I’ve seen a lot of ‘ists’ but this was a new one!

A few days later, the blurb expanded and pounded and side-sleeping was impacted, so the visit with an endodontist was expedited—I was leaving on a Mexican adventure the next day. The appointment involved a fancy 3D x-ray that outlined the dental abcess; a tip of the molar’s root cracked off and got angry—-irate. The endodontist explained that these little cracks can be immediately painful or lay dormant for months or years. For me, the inciting cause of #30’s tip-off was a Benadryl-induced sleepwalking incident a year earlier. In full-on sleep mode, I tripped and fell, unfortunately reflexes stay asleep, and the full brunt of the fall was to my jaw. In 2023, the official diagnosis was a sprained jaw; the endodontist dubbed it ‘weird trauma’, which kind of sounds like a movie title

So I wouldn’t have to visit a Mexican pharmacy, I was prescribed antibiotics for worsening pain and made an apicoectomy appointment for the day after I returned. Several days into Spring Break, the little pea-sized blurb turned into a peapod so I started taking antibiotics. My mast cells kicked into overdrive, and I endured continuous frustrating flares. My allergist-immunologist explained that anytime I have an infection, or my body is bungled up, my mast cells* will overreact—kind of like a drama queen!

The rest of my trip was uneventful, as was the treatment for the abscess. The apicoectomy procedure involved cuttting through my gum below the irritated tooth, cleaning out the pus pocket and inserting a bone graft into the recently vacated area. The nurse assured me mine was no where near the worst she’d seen.

Unfortunately, four days later, the night of my birthday, I was awakened with sneezing, wheezing, a rumbly tumbly, and nauseousness—an all too familiar mast cell reaction. I did a mental checklist of possible triggers, noted the organ systems involved and took recovery meds. A quick peek at my gums rendered a red and angry incision—beefy with some yellowish spots, so I swished around a generous amount of prescription mouthwash. It wasn’t horrifying and certainly didn’t justify an early morning visit to emergency department. The meds worked and I went back to sleep. The next day, my jaw was itchy while the rest of my body endured mild mast cell mayhem.

But wait…the next night…at the same time, I was awakened by searing gum pain, tightening in my throat and wheezing. I took recovery meds…but the reaction increased and I was moments away from an ED visit…”What did I do before I went to bed? The reactions were at the same time…I brushed my teeth, went swishy-swishy with the mouthwash…the mouthwash — I’m allergic to the prescription mouthwash.”

Over the next 24 hours, I had appointments with my primary care physician and endodontist. The new treatment plan was to discontinue the mouthwash and take a high dose of ibuprofen for a couple of weeks—evidentially prednisone is not as good for your body as it makes you feel. In less than 24 hours the pain and swelling dissipated, but because the reaction was so intense and sustained, I continued to flare for several weeks.

My hope is that my 2025 birthday is incident free.

*Mast Cell Activation Syndrome is a condition that causes mast cells to release an inappropriate amount of chemicals into the body. There can be an abundance of allergy symptoms without a clear cause and recurring and episodes of anaphylaxis involving more than one organ system. Mast cell activation syndrome is unpredictable and reactions can occur moments or hours later with ongoing flares.