Many times we associate tooth pain with serious cavity or the growth of a wisdom tooth, but what we tend to ignore is that tooth pain can also be caused due to abscess teeth or dental abscess.

A tooth infection also called abscessed tooth or periapical abscess generally occurs due to a tooth decay or poor oral hygiene.

It can also be caused due to a previous dental work or an injury. When an infection occurs, it starts causing a buildup of pus in your mouth because of bacterial infection.

Your mouth is filled with bacteria and therefore it is important to brush, floss and rinse your mouth a number of times daily. When bacteria start building up in your mouth, they attack your gums or teeth which creates abscess – a bag filled with pus and bacteria.

Different types of abscess

There are different types of abscess depending on the location.

The most common types are –

Periapical abscess this type of abscess form at the tip of the tooth’s root.

Periodontal abscess this forms on the gum next to the root of the tooth. It can also spread to the tissue and bone surrounding the affected tooth.

Gingival abscess this type of abscess forms on the gums.

Symptoms of tooth infection

Throbbing pain near your tooth or gums is the most common symptom of tooth infection. However, pain is not only confined to tooth. As your tooth is connected to many nerves, pain from your infected tooth can reach up to your neck, jaw and face.

  • Tooth infections can cause sensitivity, pain and swelling.
  • It can also cause tenderness around the infected tooth.
  • Tooth infection can cause swelling of mouth, jaw or face.

Sometimes if your dental abscess bursts open, you might sense a strong fluid coming out of it. You get a salty taste and the fluid can smell bad.

When infected tooth is left untreated

Tooth infections do not go away on their own and if left untreated, they can spread to nearby areas, even to your brain.

Dental infections or cavities are very common. Experts say that upto 90% of people between the age of 20 to 64 years have cavities. Also, about 27% people between 20 and 64 years of age have tooth decay that is untreated. If tooth infections are treated on time and early, then it is easy to prevent complications.

If you get an infection in your teeth, consult a doctor immediately in order to prevent it from spreading. The doctor will prescribe an antibiotic to kill the bacteria that is causing the infection. You need to be very careful as your mouth is close to your brain and any infection in your mouth can quickly reach your brain.

Antibiotics for tooth infection

You won’t need antibiotics for all infected teeth. In case of some infections, your doctor might be able to drain out the abscess and in other cases; you might require removal of the tooth or a root canal. He will prescribe antibiotics only if it is absolutely needed such as if your infection is severe or spreading or if you have a weakened immune system.

The doctor might prescribe antibiotics if you have a weakened immune system or your infection has spread to other areas or if your infection is severe.

The type of antibiotic to be taken in such cases will depend on the type of bacteria that is causing the infection. Antibiotics belong to different groups and different type of group of antibiotic attacks the bacteria differently. The doctor will decide which type of antibiotic is best suited for your infection.

According to a study published in the Dentistry Journal, around 150 strains of bacteria are there in our mouth which can multiply and cause tooth infection.

Antibiotics such as penicillin and amoxicillin are the most commonly used medicines to treat tooth infection.

Pencillin

Although pencillin is the most commonly used antibiotic for tooth infections, many people are allergic to this class of antibiotics. So, if you are one of them, make sure to tell your doctor about the allergic reactions you have had in the past.

Some doctors also prescribe amoxicillin with clavulanic acid as it helps to get rid of stronger bacteria.

Typically 500 mg of amoxicillin is given every 8 hours or 1000 mg is given every 12 hours. The dosage of combination of amoxicillin and clavulanic acid are 500-2000 mg every 8 hours or 2000 mg every 12 hours. However, some bacteria may resist these drugs which make them not very effective. Many doctors prefer other antibiotics as their first line of treatment.

Clindamycin

Clindamycin works against a wide variety of infectious bacteria. According to a study in the International Dental Journal, some experts say that clindamycin is their first choice of drug to treat dental decay as the chances of bacteria resisting this drug is less likely than the drugs based on penicillin. A typical clindamycin dosage is 300 mg or 500 mg every 8 hours. It depends on which ever dosage is effective.

Azithromycin

Azithromycin is usually helpful against a wide variety of bacteria. It helps to stop their growth. Although azithromycin is effective in treating some tooth infections, doctors recommend it to people only when they are allergic to drugs based on penicillin or to those who do not respond to them or drugs like clindamycin. Azithromycin is typically given in a dosage of 500 mg every 24 hours for 3 consecutive days.

Metronidazole

Metronidazole is another antibiotic that is given for certain bacterial infections. It may not be suitable for everyone. It is not the first choice of treatment. Usually around 500-750 mg of metronidazole is given every 8 hours.

Sometimes metronidazole is given with pencillin for covering a wide variety of species of bacteria.

Duration of antibiotics

You will need to take antibiotics for at least one week to feel better. Duration of your treatment depends on the type of antibiotic that you are taking. In some cases, you will have to take a dose two to four times per day.

The doctor will give you instructions regarding the same and if you are not sure about how to take the medication, make sure to ask your doctor.

Remember that you will need to take couple of doses to let the medicine get into your system and start working on the infection. According to International Dental Journal, most of the acute infections get better in 3 to 7 days.

Make sure to complete the course of antibiotics even if your symptoms get better. If you stop the medicine in the middle of your treatment, some bacteria may survive and then it will be harder to treat the infection as the bacteria will become stronger and get resistant to the antibiotic.

Side effects of antibiotics

The antibiotics that are given for clearing up tooth infection to prepare a person for dental work do not have any possible side effects. The side effects vary with each type of drug. If you suffer from any side effects, it is important to talk to your doctor before getting on with any particular treatment.

Treatment with over-the-counter medicines

You should see your dentist in case of any tooth infection. As your teeth are close to your brain, you should be very careful about treating it immediately as there are chances of the infection spreading to nearby areas.

You will not get antibiotics without prescription. There are few things that you can do at home to ease your symptoms.

  • Take over-the-counter pain killers like ibuprofen, naproxen or aspirin.
  • You can try and chew on the side of your mouth rather than chewing with your tooth.
  • For brushing your teeth around the affected area, use a toothbrush with soft bristles.
  • Avoid hot or cold foods whenever it is possible.
  • Avoid chewing hard or sharp foods that might get stuck or bump into the sensitive area.

Home remedies for tooth infection

Some home remedies can also help relieve the discomfort caused by the infection.

  • Gently rinse your mouth with warm salt water. Mix ½ teaspoon of normal table salt with ½ cup of warm water. Swish it around in your mouth for two minutes. Repeat this three times a day.
  • Gently rinse your mouth with baking soda. Mix ½ tablespoon of baking soda with ½ cup of water and a pinch of salt. Swish it in your mouth for 10 minutes. Repeat this two times per day.
  • Gently rinse your mouth with hydrogen peroxide.
  • Use oregano essential oil. Mix a few drops of oregano essential oil to 1 ounce of carrier oil. Apply a few drops of this mixture to a cotton ball. Hold the cotton ball on the infected area for two or three minutes. Repeat up to three times a day.
  • You can also try cold compress on the affected area. Place ice cubes in a dry towel and hold the compress against the infected area. Use the compress every 15 minute intervals. Repeat this multiple times every day.

Treatment on immediate basis is required to stop the infection from spreading. Home remedies may help you manage your symptoms while you are on antibiotics and preparing your dental procedure.

Adopting good oral hygiene practices such as brushing and flossing each day will help you keep the infections at bay.

Regular checkups every six months may help you prevent tooth decay and their complications.

Other treatments for tooth infections

If the abscess does not burst open on their own, your dentist might drain it out. If the abscess is not in a very bad state, you might need a root canal or tooth removal.

It is important to get rid of the abscess. Even after getting done with the abscess, you might need antibiotics for getting rid of any bacteria still surviving in the area.

You may need to undergo some treatments or procedures in the area, depending on the severity of your abscess.

The treatment options include 

Draining the abscess

First your dentist will make a cut in the abscess to drain out the pus. Then they will clean the area using a saline solution.

Filling the cavities

Your dentist might fill the cavities.

Undergoing a root canal

a root canal treatment involves drilling into the affected tooth to drain out the abscess and remove the pus. Your dentist by follow it up by filling and sealing the pus chamber and the root canal. He might also cap your tooth with a crown to make it strong. A crown procedure is done during another appointment.

Extracting the tooth

If your tooth is badly damaged, then your dentist might recommend extracting the tooth before draining out the abscess. If your tooth can’t be saved, he will remove it and then drain the abscess.

Removing foreign object

If your tooth abscess is caused due to a foreign object in your gums, your dentist will remove it.

Abscessed tooth usually clears up within few days of treatment. If it doesn’t drain out on its own, then it is important to follow up with your dentist to make sure that your infection doesn’t spread to another area.

Antibiotics may help you clear up tooth infections, but in reality majority of the tooth infections need work on the affected tooth to clear up completely.

Ways to tell if your tooth infection has spread

Untreated tooth infections can easily move up to your brain. When abscess reaches your brain, it is called brain abscess or brain infection. Symptoms of a brain abscess could include –

  • Fever
  • Chills
  • Stiffness in neck
  • Changes in vision, mood, or consciousness

When tooth infections are left untreated can spread to your blood. This can cause a life threatening illness called sepsis.

Signs of sepsis are 

  • Temperature higher or lower than normal
  • Chills
  • fever
  • Extreme drowsiness
  • Confusion
  • Severe pain
  • Feeling unwell

If at all you feel that your infection has spread, contact your doctor immediately.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858730/
  2. https://www.dovepress.com/antibiotic-prescribing-practices-by-dentists-a-review-peer-reviewed-article-TCRM
  3. https://www.mdpi.com/2079-6382/7/2/38
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