Antibiotics for Tooth Infections: What are Your Options?


Tooth Infection Summary
  • It is estimated that 3.5 billion people worldwide are affected by oral diseases, which include tooth infections.

  • A very deep cavity, gum disease, or a cracked tooth increases the chances of getting a tooth infection.

  • There are three different types of dental infections, namely gingival, periodontal, and periapical.

  • To treat tooth infections, your dentist will examine the infection and advise you on the best course of treatment.

  • A tooth infection can spread to other parts of your body if it is not treated promptly. Untreated tooth infections can give rise to complications such as breathing and eating difficulties, fever, and more.

According to the World Health Organization (WHO), an estimated 3.5 billion people worldwide are affected by oral diseases.

The average person may get a tooth infection only once in their lifetime, but this shouldn’t downplay the seriousness of these infections.

A bacterial infection may recur due to poor oral hygiene or several other factors.

In this article, we’ll cover tooth infections, what they look like, what causes them, how to prevent them, and how antibiotics can help.

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What Causes a Tooth Infection?

The average person has hundreds of bacterial species living in their mouth. Many of them are harmless, but some have the potential to cause an infection.

Normally, your teeth’s hard enamel coating prevents bacteria from getting inside the tooth and infecting it.

However, if a person has a very deep cavity, gum disease, untreated tooth decay, or a cracked tooth, they can get a bacterial infection.

Even small cracks should be monitored as they widen each time you bite down, allowing bacteria to enter. If the tooth's enamel is broken or decayed, harmful bacteria can get inside and reach the pulp of the tooth.

Key Point: What is the Pulp of the Tooth?

The pulp is in the middle of the tooth that contains the:

  • Tooth nerves
  • Connective tissues
  • Blood vessels

The pulp extends into the root of your teeth through root canals.

When you get an abscessed tooth or tooth infection, the most common symptom is tooth pain. Most of the bacteria causing tooth infections can also cause a weakened immune system.

What are the Types of Tooth Infections?

There are three types of tooth infections, or abscesses, are: gingival, periodontal, and periapical.

  • Gingival abscess: The abscess is only in the gum tissue and does not affect the tooth or the periodontal ligament.

Key Point: What is the Periodontal Ligament?

It is a soft connective tissue between the cementum and the inside of the alveolar bone socket that helps hold the teeth in place.

  • Periodontal abscess: This abscess starts in the supporting bone tissue structures of the teeth.

  • Periapical abscess: This abscess starts in the soft pulp of the tooth.

Key Point: What is the Supporting Structure for the Teeth?

The periodontium, the supporting structure for the teeth, consists of the:

  • Periodontal ligament
  • Cementum
  • Gingiva
  • Alveolar bone

Tooth Infection Symptoms

The type of tooth infection you have will determine the severity and the symptoms. Most tooth infections cause the following signs and symptoms:

  • A long-lasting, severe, throbbing toothache that can spread to the jaw, neck, or ear

  • Sensitivity to hot or cold temperatures

  • Sensitivity when chewing or biting

  • Difficulty breathing or swallowing

  • Fever

  • Painful, swollen lymph nodes under the jaw or back of the neck

  • A sudden rush of foul-smelling and -tasting, salty fluid in your mouth after the dental abscess ruptures

  • Swelling of the face or cheek

Treatment Options for an Infected Tooth

To treat a tooth infection, your dentist will do an oral exam and, if necessary, take an x-ray to locate your infection, assess its severity, and see if it’s spread. Based on what they find, you'll have several options for treatment.

  • Root canal treatment: Your dentist will give you an anesthetic and then drill into your infected tooth to expel the pus that has accumulated inside. Afterwards, they'll clean, fill, seal, and cap the tooth to keep bacteria out.

  • Draining the abscess: Your dentist or doctor will give you a local anesthetic and then cut open the dental abscess to drain the pus.

  • Extracting the tooth: Getting rid of the tooth might be your best option if it's too damaged. After your dentist removes your tooth, they will drain the area of any remaining pus to ease the pain.

Tooth infection antibiotics might be recommended if an infection has spread or is at risk of spreading. More severe and systemic infections can be prevented by taking tooth infection antibiotics.

Tooth Infection Antibiotic Types and Purposes

Antibiotic

When It Is Used

Penicillin and amoxicillin

A common first choice, because they are safe and effective for the majority of tooth infections.

Amoxicillin-clavulanate

These are used for more severe tooth infections and can also be effective if your tooth infection is resistant to amoxicillin or penicillin.

Clindamycin

Used for tooth infections that might be resistant to penicillin or amoxicillin or for patients who have allergic reactions to penicillin or other first-line antibiotics.

Metronidazole

Used with another antibiotic, like amoxicillin, to get rid of very specific types of bacteria that can cause a tooth infection in the sockets of the teeth. It is rarely used for simple tooth infections.

Erythromycin

Prescribed as an alternative for patients with allergies to other antibiotics or medicines.

What are Common Antibiotics for Tooth Infections?

The antibiotics you get will depend on:

  • The type of bacteria in your body

  • How bad the infection is

  • Whether you have allergies to the medicine

The most common antibiotics used for a tooth infection, include:

Antibiotic

When it is Used

Penicillin and amoxicillin

A common first choice, because they are safe and effective for the majority of dental infections.

Amoxicillin-clavulanate

These are used for more severe tooth infections and can also be effective if your infection is resistant to amoxicillin or penicillin.

Clindamycin

Used for tooth infections that might be resistant to penicillin or amoxicillin or for patients who have allergic reactions to penicillin or other first-line antibiotics.

Metronidazole

Used with another antibiotic, like amoxicillin, to get rid of very specific types of bacteria that can cause a tooth infection in the sockets of the teeth. It is rarely used for simple tooth infections.

Erythromycin

Prescribed as an alternative for patients with allergies to other antibiotics or medicines.

How Many Antibiotics Should I Take and for How Long?

Some tooth infections require antibiotics that will be taken for about a week. If you're using an antibiotic, you'll need to take a dose two to four times a day, depending on the type of antibiotic. However, you should get specific instructions from your pharmacy. The pharmacist can help if you have any further questions.

Depending on your type of tooth infection, you may need a few courses of antibiotics before they start to work. It's important to remember that you shouldn't stop taking your antibiotics early, even if your symptoms go away.

Are There Any Good Over-the-Counter Antibiotics for Tooth Infections?

You should always visit your dentist if you have a toothache. A tooth infection can quickly spread to other parts of your body, especially your brain.

There are a few things you can do at home before your appointment to help you feel better.

  • Take over-the-counter pain relievers, such as ibuprofen (Nurofen, Advil) or acetaminophen (Tylenol).

  • Gently rinse your mouth with warm salt water.

  • Avoid hot or cold foods where possible.

  • Try to chew with the non-infected side of your mouth.

  • Brush around the affected tooth with a soft toothbrush.

What Happens if You Don't Treat Tooth Infections?

A tooth infection can spread to other parts of your body if not treated quickly.

Many serious complications, such as a fever, difficulty breathing, or difficulty eating, may result from untreated tooth infections. In extreme cases, complications from an untreated tooth infection can even result in death.

Where Can I Learn More About Tooth Infection and Oral Health?

If you’re experiencing some of the tooth infection symptoms that we’ve covered in this article, or if you have any concerns about your oral health, make a video appointment at LifeMD.

LifeMD is your direct connection to U.S. based, board-certified physicians and nurse practitioners from the comfort of your home.

Dr. Jean-Phillip Okhovat

Dr. Okhovat completed medical school at the David Geffen School of Medicine at UCLA and an MPH in Quantitative Methods at the Harvard T.H. Chan School of Public Health. He completed his internal medicine training at Beth Israel Deaconess Medical Center.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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