Antibiotics for Tooth Pain: When Are They Needed?

November 7, 2020

The most common cause of toothache or tooth pain is an infected tooth. The pulp of the tooth is found at the inner portion of a tooth, protected by the hard bony outer layers (enamel). The pulp contains the soft connective tissue, blood vessels, and nerves. When the enamel is damaged because of cavities, or a broken tooth, bacteria can enter into the pulp. This can lead to heat, cold, or pressure causing intense pain. Once the pulp gets infected, the pain can become constant and can even spread to the whole side of the face or cause headaches.

Early Infections

When a toothache first strikes, a nonsteroidal anti-inflammatory drug (NSAIDs) such as Aspirin, Tylenol, or ibuprofen can ease the discomfort. Holding an ice cube wrapped in a washcloth up to your cheek for about 15 minutes per hour can help too. Then it is time to see a dentist to solve the underlying problem—which sometimes means either a root canal or pulling the diseased tooth. Antibiotics may sometimes be helpful to treat an early infection and prevent it from becoming more serious–however they do not treat the underlying problem.

More Severe Infections

Pulpitis–this condition forms when the pulp becomes inflamed because of bacterial inflammation and swells, putting pressure upon the nerve.

Signs and symptoms:

  • Swollen lymph nodes
  • Painful rash
  • Fever
  • Chills
  • Difficulty swallowing
  • Difficulty opening mouth

Treatment may involve antibiotics (which is only a temporizing measure), getting a filling, removal of the tooth, possibly removal of pulp (root canal).

Periapical Abscess–takes place when an infection forms at the root of the tooth.

Signs and symptoms:

  • Severe pain, throbbing, can radiate to jaw, neck, ear
  • Sensitive to hot and cold
  • Sensitive to pressure of chewing or biting
  • Fever
  • Swelling in cheek
  • Swollen, tender masses under jaw or in neck
  • Sudden pain relief if abscess bursts, releasing foul, salty fluid throughout mouth
  • Difficulty swallowing or breathing

Treatment usually consist of antibiotics, removing the tooth or performing a root canal, and in some cases incising and draining the infection.

Antibiotics for Tooth Infections

  • Amoxicillin, a type of penicillin, may be given with clavulanic acid, 500 to 2,000 mg every 8 to 12 hours.
  • Amoxicillin with clavulanate, another antibiotic, may be taken in a dosage of 875 mg/125 mg twice a day.
  • Clindamycin, an antibiotic able to treat more types of bacteria, may be prescribed in a dose of 300 or 600 mg every 8 hours.
  • Azithromycin is given to patients who are allergic to penicillin, in a dose of 500 mg every 24 hours for 3 days.
  • Clindamycin in a dose of 150 mg may be taken 4 times a day.

It is a good idea to take probiotics while taking antibiotics for dental infections. Probiotics help avoid antibiotic-associated diarrhea.

Did you know? QuickMD can help you diagnose the cause of your dental pain via telemedicine and prescribe you antibiotics online–if needed.

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