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Antibiotics to Treat Tooth Abscess

written by: Dr. Sloan, MD. • edited by: Diana Cooper • updated: 2/26/2011

When it comes to tooth abscess, antibiotics are usually prescribed. A collection of bacteria, dead tissues and white blood cells containing pus in the tissues surrounding a tooth as a result of bacterial infection leads to the formation of tooth abscess.

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    Tooth Abscess Antibiotics Treatment

    In the treatment for tooth abscess, antibiotics are often used to combat bacterial infection. Predisposing factors of tooth abscess include decayed tooth or a failed root canal.

    There are three distinct types of dental abscess:

    1. Gingival Abscess: Confined to the gingival (gum tissues) without affecting the tooth.
    2. Periapical Abscess: The abscess occurs in the root of the tooth or dental pulp.
    3. Periodontal Abscess: Abscess involving the supporting tissue and bone of the tooth.
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    Tooth Abscess Antibiotic Treatments

    When it comes to tooth abscess, medicines that the dentist prescribe are usually for pain relief, control of fever and antibiotics to prevent the infection from spreading. If there is a known allergy towards any antibiotics, you should alert your dentist.

    Best antibiotics for tooth abscess that are commonly used are:

    i) Penicillin (Pen-Vee K): Considered as the antibiotic of choice for treatment of dental abscess until the emergence of beta-lactamase producing bacteria which can potentially decrease it efficacy. This particular drug interferes with the bacterial cell wall production during cell division and leads to cell death. However, if the concentration is insufficient, then it may produce bacteriostatic effect-inhibiting the growth of the bacteria.

    ii) Amoxicillin and Clavulanate (Augmentin, Exclav, Synermox): Amoxicillin is a type of penicillin, while Clavulanate is a beta-lactamase enzyme inhibitor. These combinations of drugs widen the spectrum of action and restore the efficacy against amoxicillin-resistant bacteria producing beta-lactamase enzyme.

    iii) Clindamycin (Cleocin): For patient who is allergic towards penicillin group, Clindamycin is the drug of choice for tooth abscess. It does not kill the bacteria but helps in slowing or stopping the growth of the organism.

    iv) Metronidazole (Flagyl): It is excellent choice for fighting obligate anaerobic bacteria. It acts by inhibiting the bacterial DNA synthesis through interfering the helical DNA structure that eventually leads to breaking of DNA strands and cell death. Thus, it has bactericidal property.

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    Possible Side-Effects of Antibiotics Following Treatment

    Always remember to inform the dentist if there is history of allergy towards any antibiotics. Apart from this, it is also helpful to mention what medicine the patient is currently taking to avoid any drug interactions between those medicines.

    Generally, side-effects of the antibiotics to treat tooth abscess are gastrointestinal disturbances (nausea, vomiting, poor appetite, unpleasant metallic taste in the case of Metronidazole), skin rashes and some form of headache or giddiness. There is a risk to develop oral thrush (white patches in oral cavity) or vaginal yeast infection if prolonged use of clindamycin or amoxicillin. Once the patient notices any of these symptoms following antibiotic treatment, medical attention must be sought without any delay and suspected antibiotic shall be withheld.

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    Dental Follow-Up After Antibiotic Treatment is Crucial

    Dental follow-up is crucial after tooth abscess antibiotics treatment even though the pain and swelling may be reduced. The dentist would then determine if the antibiotic treatment has been successfully treating the abscess. Otherwise, tooth extraction or surgery might be considered if infection is serious and not well controlled.

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    References

    1) Dental Abscess: Treatment & Medication by Jane M Gould, MD, Section of Infectious Diseases, St Christopher's Hospital for Children

    2) Tooth Abscess-Treatment by Jason S. Baker, DMD, Oral and Maxillofacial Surgeon, New York

    3) What should I do if I get a dental abscess? By Ms Lisa Taylor, dentist