What Are The Most Common Symptoms Of A Tooth Infection
If youve never had an infected tooth before, you might be wondering how youd know if your tooth was infected. Pain is often the most common sign of a tooth infection. Unfortunately, this pain isnt always confined to the tooth itself. Because our teeth are connected to so many nerves, pain from an infected tooth can extend into the jaw, face, and neck. Talk about discomfort!
Other signs to look for include:
Tooth sensitivity to heat, cold, and/or pressure
Tenderness around the tooth
Swelling of the mouth, jaw, or face
If you have a dental abscess that bursts open on its own, you might taste a strong, salty fluid that could also smell bad.
Do Antibiotics Actually Work For Tooth Pain
The simple answer is there is really no simple answer. Prescribing antibiotics for toothaches is somewhat of a contentious issue, mainly because first and foremost, the recommended treatment for tooth pain is actually intervention. From your dentists perspective, it will involve examining the tooth, cleaning the gums, removing dead nerves and associated bacteria, or in some cases a dental extraction or root canal treatment.
From a patients perspective, it involves pain control, either with the use of analgesics or other over-the-counter dental treatments that can help relieve some of the symptoms.
Many dentists believe that antibiotics should only be prescribed in worst case scenarios where severe infection has actually spread further from the tooth itself. But lets look at why the over-prescribing of antibiotics is an issue in the first place.
Should You Prescribe Antibiotics For Pain And Swelling
The JADA Nov 2019 ADA guideline on antibiotic use for pain and swelling says that:
- If patients have pain only, dont prescribe antibiotics.
- If they have pain and swelling, prescribe amoxicillin 500 mg TID for three to five days. Reevaluate in three days with a phone call. Instruct patients to stop using antibiotics 24 hours after their symptoms resolve.
Completely painless procedures.
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When Should A Dentist Use Antibiotics Treatment
Americans are very health conscious. Antibiotics have been used profusely in all aspects of our lives whether or not we are aware of it. Livestock are given antibiotic treatment in order to keep disease in check. The antibiotics used in these animals transfers to humans as they ingest the meat. Even at small doses this can be a problem.
Do I Need An Antibiotic For My Tooth
When patients ask what to do about tooth infections, antibiotics may be the wrong answer. They are important but not always the solution.
Dentists have been prescribing antibiotics for ages. But is that the right thing to do when dental problems arise? Maybe. The basis for prescribing antibiotics is the belief that many dental issues are infectious in nature and antibiotics will prevent or minimize pain and other symptoms as well as wipe out the infection. It is clear that symptoms that appear to be relieved by antibiotics are actually resolved by proper dental treatment. In other words, antibiotics may often be unnecessaryand in some cases could be counterproductivewhen dental care is what is really called for.
Why, then, do dentists prescribe antibiotics? And if not antibiotics, whats the solution?
If your dentist prescribes an antibiotic, its generally to relieve an infections symptoms and prevent it from turning into something more serious until proper dental treatment can solve the problem. The pain may decrease or temporarily go away, but since antibiotics dont penetrate an abscess effectively, the bacteria can linger or return if the cause of the infection isnt addressed. And once a nerve becomes infected, a root canal treatment is the only way to remove the infected nerve and save the tooth. Thats when an endodontist should get involved.
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Best Antibiotic For Tooth Infection
Which antibiotic is used for a tooth infection depends on the type of bacteria causing the infection and whether youre allergic to any antibiotics.
Common antibiotics prescribed for tooth infections include:
- Penicillin is the most common antibiotic for tooth infections. Depending on the type of bacteria and location of the infection, penicillin alone may not be effective. It is commonly prescribed alongside another antibiotic, such as Flagyl.
- Amoxicillin is often given to adult patients with mild tooth infections that dont display signs of sepsis.
- Clindamycin is usually given to penicillin allergic patients.
Remember, even if you start to feel better, you must always take the full course of antibiotic prescribed to you. Despite improved symptoms, failing to take all of your antibiotics could allow for the development of antibiotic resistance and the reemergence of a much worse infection.
Other Uses For Antibiotics In Dentistry
If your dentist detects signs of an acute or chronic infection in your mouth, particularly when accompanied by fever, swelling or other signs, you may be prescribed antibiotics. Tooth infections occur when bacteria enter a tooths root, causing pain, tissue death and buildup of pus. Called an abscess or abscessed tooth, this kind of infection can spread to other areas of the head. Treatments for abscesses can include antibiotics, root canals and tooth extractions. Periodontal disease can also lead to serious gum abscesses.
Antibiotic prophylaxis before typical periodontal, third molar or other surgeries is usually not necessary. Depending on your personal medical history, however, you may still be a candidate for premedication. For example, antibiotic prophylaxis might be useful for patients undergoing invasive dental procedures, who also have compromised immune systems, due to, for instance, diabetes, rheumatoid arthritis, cancer, chemotherapy and chronic steroid use.
Finally, always provide your dentist or physician with a complete medical history and discuss whether antibiotic prophylaxis before dental treatment is right for you. Also, remember that brushing, flossing, good diet and visiting your dentist regularly help maintain good oral health, prevent tooth and gum infections, and avert the need for more aggressive dental procedures and medications.
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Certain Medical Conditions Call For Antibiotics Before A Dental Visit
If you have certain health conditions, your medical doctor may prescribe an antibiotic for you to take prior to a dental visit. The reason why is a story that dates back to the mid-20th Century.
In the early part of the last century, a theory became popular that bacteria in the mouth could migrate to other parts of the body and cause systemic illness or disease. During the 1930s and 1940s evidence arose that indicated a connection between dental procedures that caused bleeding and two serious health conditions: bacteremia and infective endocartitis. The latter is the inflammation of inner tissues of the heart caused by infectious agents, most notably bacteria. It became common then to prescribe antibiotics to patients susceptible to these conditions as a preventive measure. Later, patients with prosthetic joints or poor immune systems were added for this kind of treatment.
For many years, the American Heart Association recommended pre-visit antibiotic treatment for a wide array of heart patients. After several years of research that indicated the treatment wasnt necessary for most people and might even be detrimental, they updated their guidelines in 2007 and reduced their recommendation list to just a few conditions. They now recommend the antibiotic treatment for patients with artificial heart valves, a history of infective endocartitis, heart transplant recipients with valve problems, and certain congenital heart conditions.
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Heart Problems That Call For Antibiotics In Dental Procedures
Virtually all guideline committees around the world recommend antibiotic prophylaxis for those individuals at high risk of an adverse outcome from infective endocarditis and who are undergoing invasive dental procedures. Today, the AHA only recommends antibiotics before dental procedures for patients with the highest risk of infection, those who have:
If youre not sure about the guidelines for your heart condition, check with your heart specialist. If you have one of these conditions, always tell your dentist. Also, alert your dentist if – you are allergic to any antibiotics or other medications.
Are Antibiotics For Toothaches Effective
Dental pain and toothache are common problems and can arise from a number of issues including progressive decay, nerve damage or mouth trauma. When tissues around the end of a tooths root become inflamed and arent treated, they can become infected and lead to acute pain.So its an obvious solution that you should see your dentist as soon as pain occurs, however, should you be prescribed antibiotics for toothaches? Lets look at some of the debate around the issue.
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The Dentists Role In Overprescription
According to surveys of antibiotic prescriptions in the U.S., dentists write one in 10 antibiotic prescriptions. In a study done on prescription rates in Australia, England, the U.S. and British Columbia, dentists in the U.S. were found to be the most prolific antibiotic prescribers. American dentists prescribed twice the amount of antibiotics that Australia, the least prolific, did per 1000 population. Studies reveal that almost 81% of antibiotics prescribed by dentists are used against stewardship guidelines.
Antibiotics are a vital tool in dental health, especially when treating patients with comorbidities that can increase the danger of an infection, like heart disease. The American Heart Association recommends that only patients at the highest risk for adverse outcomes from infections should be prescribed antibiotics. They should absolutely be prescribed when necessary. But before you prescribe, take a moment to consider whether antibiotics are necessary.
There isnt a one size fits all approach to managing antibiotic use. The reason antibiotic overprescription is so prevalent is also the reason its difficult to change: medical decision-making is incredibly complex. To tackle overprescription in your own practice, you can:
Use the tips above to be antibiotic aware and to inform your colleagues and patients about the importance of antibiotics stewardship.
The Difference Between An Abscess And An Infection
A tooth infection can take the form of a cavity, pulpitis, or an abscess. Yes, a dental cavity is an infection. It causes the enamel, or hard surface, of the tooth to begin to break down. This can be painful, if it happens quickly, but many cavities dont cause symptoms.
If the infection extends into the middle of the tooth the pulp it causes pulpitis. This usually causes a toothache, which can be aggravated by hot and cold foods and liquids.
Finally, if the infection is not treated and continues to spread, it can form an abscess. After the infection has spread through the middle of the tooth and has nowhere else to go, it forms a pocket of pus, which is an abscess.
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Antibiotic Prophylaxis For Patients With Infective Endocarditis
Patients with a previous episode of IE or who have prosthetic valves/materials must receive antibiotic prophylaxis. Certain patients with congenital heart disease and/or cardiac transplant recipients likely need antibiotic prophylaxis. Discuss this with the cardiologist.
Review your screening forms to make sure you ask whether your patient has a history of IE. A recent lawsuit stated that on a patients medical history form next to heart disease, she checked yes and wrote in IE.’ Dental staff didnt recognize the term IE and cleaned her teeth without antibiotic prophylaxis. She developed IE and she sued the dentist.
Why Should You Treat A Bacterial Tooth Infection With Antibiotics
Any infection that is in your head or neck, such as a tooth infection, should be taken very seriously. This is because the infection may spread to your braina potentially life threatening condition.
Bacterial infections are unlikely to go away on their own. Most oral bacterial infections need antibiotic treatment to fight off the infection. Without antibiotics for a tooth infection, you risk allowing the infection to spread.
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Can I Get A Prescription From My Dentist
As a Doctor of Dental Medicine or Doctor of Dental Surgery, your dentist can prescribe medicines as needed for dental care, just like a medical doctor. This includes antibiotics to fight infection, muscle relaxants for jaw pain, anesthetics and sedatives to help during procedures and other drugs that help us keep you and your mouth healthy, including pain medications. At one point, it was fairly common for dentists to prescribe opioids for dental pain because of a lack of understanding in the overall medical community about the negative long term effects and prevalence of addiction. Fortunately, this is changing as we come to fully understand the severity of our nations opioid crisis. Dentists are leading the way in taking a more mindful and cautious approach in prescribing opioids. If opioids are needed, our focus is on making sure theyre used responsibly and on a very temporary basis.
Therapeutic Antibiotic Prescribing By Dentists
Most oral diseases presented to the dentist are primarily inflammatory conditions that are associated with pain. These inflammatory conditions and their associated clinical features are shown in . A considerable percentage of dental pain originates from acute and chronic infections of pulpal origin, which necessitates operative intervention, rather than antibiotics. Non-indicated clinical cases for antibiotic use include acute periapical infection, dry socket, and pulpitis. Chronic inflammatory periodontal conditions are also not indicated for antibiotics systemic antimicrobials should only be used in acute periodontal conditions where drainage or debridement is impossible, where there is local spread of the infection or where systemic upset has occurred.
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Can You Get Antibiotics For Tooth Infection Over The Counter
No, you cannot get antibiotics for tooth infection over the counter. In order to get antibiotics to help treat a tooth infection, you will need to receive a prescription from a licensed doctor.
PlushCare can help you get antibiotics for tooth infection. You can book a convenient virtual appointment with one of our expert online doctors and discuss your symptoms. If the physician determines that you need antibiotics to treat your tooth infection, a prescription will then be electronically sent for you to pick up at a nearby pharmacy of your choice.
How To Get Antibiotics For Tooth Infection
You can buy antibiotics for tooth infection by making a doctors appointment, either online or in-person.
Here is how you can request tooth infection antibiotics online at PlushCare:
- First, book an appointment with a PlushCare doctor through your phone or computer.
- During your virtual appointment, discuss your tooth infection symptoms and medical history with your physician.
- If the doctor decides that antibiotics would be an appropriate treatment for your tooth infection, then a prescription will be sent to a pharmacy for pickup, where you can get the antibiotics needed for your tooth infection treatment.
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Antibiotics Used In Dentistry
- Penicillin: A common class of antibiotic with minor side effects that treats a broad range of bacterial infections
- Amoxicillin and ampicillin: Antibiotics in the penicillin family that treat a greater variety of infections
- Metronidazole: An antibiotic with antimicrobial properties that is regularly used to treat acute ulcerative gingivitis and is frequently used in conjunction with penicillin
- Erythromycin: A broad spectrum antibiotic administered to patients allergic to penicillin
- Cephalosporin: An antibiotic appropriate for those with penicillin allergies and used to treat a range of bacterial infections
- Tetracycline: An antibiotic used to treat a spectrum of infections, can cause grey stains on erupting teeth, and should not be prescribed to pregnant women or children under 12
- Sulphonamides: A group of antibiotics that can penetrate cerebrospinal fluid, often prescribed as a prophylactic to prevent bacterial meningitis for those with high infection risk
- Co-trimoxazole: An antibiotic that targets specific bacterial infections and requires a bacteriological sensitivity test
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al.
Circulation 2007 116:1736-54.
Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al.
J Am Dent Assoc 2008 139 Suppl:3S-24S Accessed July 2018.
What is antibiotic prophylaxis. American Dental Association. J Amer Dent Assoc. 2016. Vol. 147 p. 526.
Do You Need Antibiotics Before Your Dental Visit
Antibiotics treat bacterial infections. Antibiotic prophylaxis is the taking of antibiotics before a surgery or other procedure that may release large numbers of bacteria into your bloodstream to decrease the chance of infection in another part of your body. During dental procedures that may cause bleeding, such as tooth extractions, large numbers of bacteria from the mouth can enter the bloodstream. In persons at high risk of infection or with certain heart conditions, there is concern that these bacteria may cause infection in other parts of the body . The immune system normally kills these bacteria, but antibiotic prophylaxis may offer these people extra protection. The American Heart Association recommends that antibiotics be used prior to some dental procedures for persons with certain heart conditions, who may be at risk for developing an infection of the heart.
Numerous studies have pointed out that blood bacteria may occur during normal daily activities, such as chewing, tooth brushing and flossing. It is likely that these daily activities induce many more bacteremias than typical dental procedures. While studies do show a strong association between certain dental procedures and bacteremia, they dont show good evidence that there is a direct link between dental procedure associated bacteremia and infections in the heart or prosthetic joints.
Heres what the experts say.
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