Facts to Consider About Antibiotics for a Tooth Infection

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A tooth infection is a pus-filled pocket (abscess) caused by bacterial growth. An abscess usually develops in the pulp (the soft, living tissue inside a tooth).

A periapical abscess occurs when an infection in the pulp causes an abscess at the root of a tooth, whereas a periodontal abscess occurs when an infection develops between the tooth and the surrounding gum tissue.

A tooth infection can cause a severe toothache, sensitivity to heat and cold, swollen glands, gum swelling, foul-smelling breath, and pain while chewing. If the infection spreads to the surrounding bones, it can be fatal.  

Antibiotics may be prescribed by your dentist to treat your tooth infection. Discover more about antibiotics for tooth infections, such as why they are used and how quickly they work.

Moment / Getty Images / Athima Tongloom

Antibiotics are not always required for tooth infections. They may clear up on their own in many cases. To relieve tooth pain and swelling, rinse with warm saltwater or take over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs).

Due to potential side effects, the American Dental Association (ADA) recommends that dentists avoid prescribing antibiotics for most tooth infections. Sometimes dental treatments, such as drainage, deep cleaning, or a root canal (removal of infected pulp from the tooth), are required.

However, if you are immunocompromised (have a weakened immune system) or if your tooth infection is spreading, your dentist may prescribe antibiotics. Some signs that your tooth infection is progressing include:

  • Fever
  • Fatigue
  • Malaise (a general "bad feeling")
  • Jaw or neck swelling
  • Intense pain or swelling that persists

A tooth infection, if left untreated, can spread to the surrounding bones and tissues. This can result in serious health complications such as:

If you have a severe tooth infection, your dentist may prescribe antibiotics to keep the infection from spreading. Antibiotics may help to prevent tooth loss and other serious health problems.

If you suspect you have a tooth infection, you should seek treatment right away. If you have a toothache that won't go away, your gums are red and inflamed, or you notice a pimple-like bubble along your gum line, see your dentist.

With a thorough physical examination, your dentist can diagnose you with a tooth infection. To assess your level of pain, your healthcare provider may tap your teeth or ask you to bite down. They might also perform imaging tests like dental X-rays.  

Your dentist may prescribe antibiotics if your tooth infection is severe or persistent. Antibiotics are used to treat tooth infections in order to prevent tooth loss and other serious health complications.  

According to the American Dental Association, the first-line antibiotics for a tooth infection are:

  • Amoxicillin taken orally
  • Penicillin V potassium oral

Amoxicillin and penicillin V potassium are both antibiotics in the penicillin-type drug class. They fight infections by killing bacteria or preventing their growth. Penicillin-type antibiotics will not treat viral infections.  

If you are allergic to penicillin-type antibiotics, your dentist may instead prescribe one of the following antibiotics:

  • Azithromycin (oral)
  • Clindamycin taken orally
  • Cephalexin taken orally

Bacterial infections are commonly treated with azithromycin, clindamycin, and cephalexin.

The following are the current ADA recommendations for antibiotic dosage for tooth infections:

  • Amoxicillin 500 milligrams (mg) orally three times per day
  • 500 milligrams of oral penicillin V potassium four times per day
  • Oral azithromycin: 500 milligrams on the first day, followed by 250 milligrams every four days for four days.
  • Clindamycin, 300 milligrams four times per day, orally
  • 500 milligrams orally, four times per day

The following are the current ADA recommendations for the duration of an antibiotic course for a tooth infection:

  • Amoxicillin (oral): three to seven days
  • Oral penicillin V potassium: 3 to 7 days
  • Five days of oral azithromycin
  • Clindamycin (oral): three to seven days
  • Three to seven days for oral cephalexin

After two to three days, some of your tooth infection symptoms should subside. However, it is critical to complete the entire course of antibiotics prescribed by your dentist.

Even if you feel better quickly, it is critical to take antibiotics exactly as prescribed. If you discontinue antibiotics too soon, your infection may worsen. You may also increase your chances of developing an antibiotic-resistant bacterial infection.

Penicillin-type antibiotics, such as amoxicillin and penicillin V potassium, are commonly prescribed by dentists to treat tooth infections.

However, penicillin allergies are common. Inform your dentist if you have a history of allergy symptoms (such as hives, swelling, or low blood pressure) after taking penicillin-type drugs. They may suggest a macrolide antibiotic to treat your infection, such as clindamycin  

In some cases, your dentist may recommend a different antibiotic, such as:

  • Augmentin (amoxicillin and clavulanic acid)
  • Flagyl (metronidazole) is an antibiotic.

These medications are typically prescribed if other antibiotics fail to relieve your symptoms or if your tooth infection spreads.

Some of the most common antibiotic side effects include:

  • Nausea
  • Headache
  • Diarrhea
  • Infection with yeast
  • Taste changes  

Seek immediate medical attention if you experience any serious side effects while taking antibiotics, such as:

  • Rash
  • Having trouble breathing
  • Wheezing
  • Hives
  • Blisters or peeling skin
  • Face, eye, and mouth swelling
  • Cramps in the stomach
  • Joint pain
  • Signs of a tooth infection worsening
  • Fever

A cracked or chipped tooth, an injury, or failed dental work can all result in a tooth abscess. However, tooth decay is the most common cause of tooth infections.  

Good oral hygiene is the most effective way to avoid a tooth infection. Here are some methods for preventing cavities and gum disease:

  • Brush your teeth at least twice a day with fluoride toothpaste.
  • Floss or use interdental brushes on a regular basis to remove plaque from between your teeth.
  • Reduce your sugar intake, particularly between meals.
  • Schedule regular cleanings and check-ups with your dentist.

A tooth infection is a pocket of pus that forms inside the pulp of a tooth as a result of bacterial growth. Tooth decay, failed dental work, broken or chipped teeth, or injury are the most common causes of tooth infections.

Not all tooth infections require antibiotic treatment. A dentist may, however, occasionally prescribe antibiotics to save the tooth and prevent the infection from spreading.  

Penicillin-type antibiotics (such as amoxicillin and penicillin V potassium) are the most commonly used to treat tooth infections. If you have a history of penicillin allergies, you can take clindamycin, azithromycin, or cephalexin. If the first-line drugs do not work, metronidazole may be prescribed.

Nausea, diarrhea, yeast infection, taste changes, and headache are all possible side effects of antibiotics for tooth infections. Serious side effects, such as rash, hives, swelling, joint pain, and fever, necessitate prompt medical attention.

When tooth pain begins, you may be tempted to put off seeing a dentist. However, if left untreated, a tooth infection can lead to serious health complications. If you suspect you have a tooth abscess, contact your dentist right away.

Questions and Answers

  • How long does it take for antibiotics to reduce tooth infection swelling?

    In most cases, you'll feel better two to three days after starting antibiotics for a tooth infection. However, you must complete the entire course of antibiotics. For a tooth infection, your dentist will usually prescribe an antibiotic for three to seven days.

  • How can I tell if the antibiotics for tooth infection are effective?

    If your antibiotics are effective, your tooth infection symptoms will begin to improve. Fever, fatigue, pain, and/or swelling will subside. Contact your dentist right away if your symptoms persist or worsen.

  • Are there any natural antibiotics available for tooth infections?

    A warm saltwater rinse is the most commonly used natural treatment for a tooth infection. Baking soda, garlic, hydrogen peroxide, aloe vera gel, herbal tea, or essential oils (such as oregano or tea tree oil) are some other home remedies for tooth infections. However, if you have a tooth infection, you should still see your dentist.

  • Where can I get tooth infection antibiotics?

    Amoxicillin, penicillin, azithromycin, clindamycin, cephalexin, and metronidazole are the most commonly used antibiotics for tooth infections. Antibiotics must be prescribed by a medical professional, such as a dentist. A telehealth visit may allow you to get a prescription more quickly.

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