• Infections

Amoxicillin for Tooth Infection: What Should I Know?

Medically reviewed and edited by Harmony Vance, APRN

That nagging tooth pain could be more than a passing nuisance. If you’ve been putting off going to the dentist, you’re definitely not alone.

Studies show 50–80% of all Americans struggle with dental fear.

This article can ease your anxiety and help you learn more about tooth infections.

How do you know you have one, and can you treat it at home or by taking antibiotics? We’ll answer these questions and more to help you ensure optimal oral health.

What is Amoxicillin?

Amoxicillin is a type of antibiotic used to treat bacterial infections. It falls under the penicillin class of antibiotics.

It kills bacteria by binding to a part of its cell wall, preventing it from forming and ultimately causing bacteria to die.

Amoxicillin can be used alone or in combination with clavulanic acid. This combination drug is called co-amoxiclav (Augmentin®) and it can fight bacteria that have developed resistance to certain other antibiotics.

Amoxicillin can be administered via capsules, syrup, and injections (usually in hospital settings). A doctor or dentist may prescribe this antibiotic.

What is a Tooth Infection?

There are over 700 different species of bacteria that live in your mouth, covering surfaces like your teeth, tongue, and gums.

These microbes normally don’t pose any risk if they remain on the surfaces in the mouth, but when they invade structures like the teeth, they can cause infection.

Most dental infections are caused by bacteria.

An example of a tooth infection is a dental abscess — a bacterial infection that occurs when bacteria enter through a tooth cavity or break in the gum tissue and gather in a pocket at the infected tooth’s root.

We’ve defined the main types of tooth infection below. A severe tooth infection will require more than antibiotics to treat.

Gingival

The word gingival refers to the gums. Most people are more familiar with the term gingivitis, which refers to inflammation of the gums.

Gingivitis is the first of the three phases of gum disease. Estimates show that over 50% of adults in the U.S. have had gingivitis in 3 to 4 teeth.

When plaque — consisting of bacteria, saliva, and food particles — builds up on your teeth, bacteria can invade your gums and cause this infection.

Symptoms include reddened or swollen gums, with pain and/or bleeding when brushing your teeth. A receding gum line may also indicate gingivitis.

Periapical

The term periapical refers to the area around the root of the tooth, specifically the tip of the root. A periapical infection results from bacteria entering the dental pulp (the tissue in the center of the tooth).

This bacterial infection affects the gums and the tooth’s root. It’s the result of a structural breakdown within the mouth, for example, a tooth cavity.

Then, a collection of pus begins building up at the root of the tooth. This is known as periapical tooth abscess.

Periodontal

The term periodontal refers to the tissues that surround and support the teeth, primarily the gums and bone.

Periodontitis is the inflammation of these tissues, and can lead to a periodontal abscess — a localized collection of bacteria and infected cells along the side of your tooth’s root.

This stage represents an advanced progression of gum disease, evolving beyond initial gingivitis and periapical inflammation.

This suggests that the mouth would’ve been inflamed for some time, and prolonged inflammation anywhere in your body can cause tissue damage.

For example, the periodontal ligament, which secures a tooth to its surrounding tissues, can degrade and disintegrate due to sustained inflammation.

The periodontal phase poses serious risks, including potential tooth loss and jawbone deterioration.

Complications of periodontitis

Necrotizing periodontal diseases (NPDs) are characterized by necrosis (death) of gingival tissues.

These are severe diseases that may require debridement — the medical removal of dead tissue.

If left untreated, they can lead to rapid loss of gums, teeth, underlying bone, and even lips and cheeks.

This usually occurs when a person with a weakened immune system, for example, someone living with HIV, undergoing chemotherapy, or fighting a severe illness, gets periodontitis.

What are First-Line Treatments for Dental Infections?

A mild tooth infection may be treated at home by diligently brushing your teeth, using proper flossing techniques, and rinsing with good mouthwash.

Chlorhexidine mouthwashes are recommended as they have antiseptic and antibacterial properties. They coat the teeth with a protective film to help treat and prevent infections.

If you have a more serious infection that doesn’t respond to chlorhexidine mouthwash and improved oral hygiene, your dentist may prescribe antibiotics.

A typical first-line antibiotic treatment for dental infections is amoxicillin. For those allergic to penicillin, other antibiotics, like azithromycin or clindamycin, can be used.

Some health care providers may prescribe cephalexin, but people with penicillin allergies may also react to this medication.

Metronidazole (Flagyl®) is another antibiotic that may be taken alongside azithromycin or clindamycin if these fail to completely treat the infection.

When Should I Use Amoxicillin for a Tooth Infection?

Amoxicillin is most commonly used in combination with metronidazole .

Together, they work against streptococcus mutans and lactobacilli, the most common bacteria responsible for dental infections.

How long does it take for a tooth infection to resolve with amoxicillin?

The time it takes for amoxicillin to clear a tooth infection depends on its severity. You’ll typically start to feel better in the first few days of taking amoxicillin.

If your symptoms don’t improve with amoxicillin, your medication may need to be reviewed by a healthcare professional.

Be sure to follow up with your doctor or see your dentist if antibiotics don’t work for you. Regular dental appointments can also help detect a silent tooth infection.

How Do I Use Amoxicillin to Treat Dental Infections?

Amoxicillin and metronidazole, as mentioned before, are commonly used by dentists or other health care providers to treat more severe tooth infections. Some providers may use co-amoxiclav.

The typical dosage of the medication in adults is:

• 500 mg of amoxicillin, 3 times per day for 7 days

AND

• 500 mg of metronidazole, also 3 times per day for 7 days

Tooth Infections: What Happens During an Emergency?

Before treating a tooth infection during an emergency, the area, depth, and source of the infection must be identified. There are typically two types of tooth infections that may require emergency medical attention:

Localized infections

Once an abscess is identified, your endodontist or dentist may perform a procedure to cut open and drain the abscess before fully removing it.

This is called an incision and drainage (I&D) and it’s performed under local anesthesia.

Deep facial infections

Advanced infections might progress from the gums to the deep neck muscles and surrounding connective tissues.

For these infections, a referral to an oral and maxillofacial surgeon may be necessary. This specialist will employ a range of techniques to drain and remove the infected tissue.

To ensure your safety, they might secure your airway through methods like tracheostomy or intubation. Fibreoptic intubation via the nose and down the trachea has been identified as the most straightforward method.

Can Serious Infections Be Treated With Only Antibiotics?

Those with abscesses or deep infections require debridement — surgery that removes dead or infected tissue.

Without surgical treatment, no amount of antibiotics will remove the infection, because bacteria will continue to grow in these areas.

Dead tissue also has no blood flow, and therefore won’t receive any of the oral or intravenous medication (injectable drugs).

Abscesses have a wall surrounding an area of pus. Antibiotics struggle to penetrate it and may be deactivated by the conditions inside the abscess.

Medical treatment

If required, an endodontist or periodontist — a dentist specializing in gum disease — is able to perform the following procedures for tooth infections:

• Scaling: Removing of plaque and dental buildup

• Root planing: Removing any infected parts and smoothing out the teeth

• A root canal: Going down to the root of the tooth, removing the infected pulp, and sealing the cavity with a filling or a crown

• Gingivectomy: Surgically removing the gum tissue

• Gingivoplasty: Smoothing and shaping the gum tissue

Can a Tooth Infection Go Away on its Own?

Gingivitis is the only tooth and gum infection that can be remedied without medical attention.

As it’s caused by plaque buildup, practicing good dental hygiene may be sufficient in treating gingivitis.

A good oral health regimen may include:

• Brushing your teeth twice a day

• Using an antibacterial or chlorhexidine prescription mouthwash

• Flossing daily

• Limiting sugar

Visiting your dentist regularly and having routine cleanings will help manage and prevent infections. Once a tooth infection progresses, it won’t go away on its own, and medical intervention will be required.

Where Can I Learn More About Using Amoxicillin for Tooth Infections?

Contact LifeMD to find out more about how to treat and prevent tooth infections. If you’re interested in using amoxicillin to treat your infection, or if you require specialist dental care, we can help.

Book your appointment today. Our team of licensed medical professionals are waiting to answer all your questions.

Harmony Vance, APRN

Harmony is a family nurse practitioner and has been caring for patients for over 20 years through various roles in the medical field. She graduated in 2018 with a Master's Degree and a focus on family care.

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