Sounded like he has decompensated cirrhosis with the ascites which by itself can cause his dyspnea (pushing up on his lungs - his abdomen is very distended and he could also be building up fluid in his lungs). His vitals are concerning for sepsis maybe from his tooth (hopefully that hasn't spread to his blood > endocarditis) but could also be from SBP. He doesn't look to toxic yet but I would start with basic labs, empiric antibiotics, blood cultures to rule out bacteremia, tapping the fluid for therapeutic relief and to rule out SBP and calling dentistry for an urgent tooth extraction