Is a Tooth Infection Dangerous?

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I have been taking an antibiotic for a problem with what I think is my tooth, but it does not seem to be getting any better. A little over a week ago, I broke a molar. I thought it would be okay but I have been having a lot of pain in the jaw area. Then, it started to hurt in my cheek. Today, it started hurting in my sinuses. I don’t understand why this antibiotic is not working. Is this dangerous or should I just keep taking the antibiotic?

George

Dear George,

Man grabbing his cheek in pain

Yes, this is dangerous and I believe your tooth is infected and the infection is spreading. At this point, I would consider it a dental emergency because this seems to be spreading faster than I would expect. You do not want it to reach your brain.

I’m curious as to who prescribed you the antibiotic. If it was a dentist, he or she should have also made sure that you knew there would be a follow up appointment needed. Antibiotics alone do not cure a tooth infection. It is only truly dealt with when a dentist gets in there and removes the infected pulp.

This is done one of two ways. The first is with a root canal treatment. The second is by extracting the tooth. It is ideal if you can save the tooth by having a root canal treatment.

Please do not put this off. If for some reason your tooth cannot be saved and you have to extract it, it will also be important that you replace that tooth. Otherwise, the other teeth will drift or tip into the empty space. This will throw off your bite, which will lead to pain and possibly TMJ disorder.

The best tooth replacement is a dental implant. Hopefully, it will not come to that.

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Can I Put Off A Root Canal Treatment

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I don’t have a lot of money at the moment and it is even worse with the holidays at the moment. I know it is important to treat it and I will. I’m just hoping that I can put it off until maybe March, when my tax refund comes in.

Bernard

Dear Bernard,

Man grabbing his cheek in pain

It will be really hard to diangose this without seeing you. However, I can give you some basic principles that may help you navigate this. The first thing to remember is that if it is hurting you need to see a dentist right away. That’s important even if it stopped hurting but is hurting again. This is a sign of an active infection which is considered a dental emergency. You won’t need to go in today, but will want to get in fairly soon. An Active infection grows and can become life threating. Another sign of an active infection is if there is a pimple on your gums.

If it is not hurting, you may be able to wait. I could not tell you how long because each infection is different. I know of a patient who had an arrested infection for about eight years. She didn’t even realize it. Once we did the root canal treatment, she felt better. She had no idea that the unexplained achiness and general malaise she had been feeling was due to an infected tooth.

There is an additional risk to waiting that you should be aware of. In some cases, there is external resorption where the infection slowly eats away at the root of the tooth. This makes the tooth unsaveable. The only option you’ll have then is a tooth extraction and replacement.

If you are in a situation with an active infection, I suggest that you call around to some local dentists and see if they’d be willing to work with you on payments. This way you can get the treatment you need, but pay it out slowly until your refund come in.

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Antibiotics for a Tooth Infection

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I need some advice on what to do about my tooth. I went to the dentist last week because my tooth was infected. The swelling went all the way up to my eye. He gave me some pretty strong antibiotics, which I’ve taken religiously. Everything started to get better. However, since the medicine ran out things have gotten bad again, including the swelling. Do I call to get a refill or does this mean that I was on the wrong antibiotic?

Andy

Dear Andy,

Man grabbing his cheek in pain

I am hoping that there has been some miscommunication between you and your dentist. Otherwise, it means your dentist has a profound misunderstanding of how tooth infections work. That is not a good quality to have in your dentist. Antibiotics alone will not cure a tooth infection. The infected pulp has to be physically removed by the dentist. This is typically done by either a root canal treatment or a tooth extraction. A root canal treatment is preferable because it saves the root of your tooth. However, sometimes the tooth is not saveable. In that case, an extraction is necessary. You would also need to replace the tooth so you don’t end up with tipping or shifting that throws off your bite. Leaving it open could lead to painful TMJ Disorder. 

In your case, he probably prescribed the antibiotics in order to get your infection under control. That would not have been the treatment. Instead, they would schedule an additional appointment for you to have the root canal treatment. Hopefully, it is not too late and your tooth can still be saved.

In your place, I suggest that you call your dentist and schedule an emergency visit. If he just gives you more antibiotics, make sure that the appointment to treat the tooth is on the books for BEFORE your medication runs out. If they don’t do that, it means you need a new dentist. 

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can I Save My Teeth?

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I have a filling on two teeth which are adjacent to each other. I started having pain with those teeth. Eventually, the pain got so bad that I went to see a dentist. I will admit to not liking to go unless it is necessary. I do get one cleaning a year, but that’s about all I can handle. The dentist did an x-ray and told me that there is an abscess and the teeth will need to be pulled. I’m sort of a wreck over this. I don’t like the idea of not having those teeth. Is there any way to save them?

Kelly

Dear Kelly,

woman grabbing her jaw in pain

I am sorry you are in so much pain. What I would like you to do is get a second opinion on these teeth. Just because you have an abscessed tooth does not mean that the tooth has to be extracted. Unless the tooth is too far gone to be saved, the typical solution is to do a root canal treatment. This cleans out the infected pulp of the tooth. In most cases, you will also need a dental crown but this allows you to save your tooth.

I’m having some doubts that your teeth are as far gone as to necessitate an extraction. If they were that bad I do not think an x-ray would even have been necessary. To be honest, some dentists are just more willing to put in the work to save teeth than others.

You mentioned that you do not like going to the dentist. That is usually a sign of dental anxiety and is more common than people realize. When you get your second opinion, I would like you to see a sedation dentist. They can provide you with some medication which will allow you to feel completely relaxed in the dental chair.

If it does turn out that you need your teeth extracted, you will want to replace them as soon as possible. If you don’t, the adjacent teeth will drift and tip into the empty space, which can lead to painful TMJ Disorder. If it comes to that, the best tooth replacement is a dental implant.

Don’t put off getting this double checked. You do not want it to turn into a dental emergency.
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Should I Wait Until COVID-19 Passes to Get a Tooth Extracted?

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I’ve had a fractured tooth but was putting off getting the crown. Now there is an abscess. I heard we’re supposed to put off dental care until after the quarantine is over. Do I wait on this? I’m absolutely miserable. Now my face is starting to swell. Can I just take antibiotics? What is your recommendation?

Pam

Dear Pam,

Woman holding her jaw in pain in need of an emergency dentist.

The directive is to avoid the dentist for routine procedures, depending on the state in which you reside. However, in this case, you are not dealing with anything routine. This would be in the category of emergency dental care. I wouldn’t put off getting this dealt with. Your face is already swelling, which means it has spread past your gums. If it reaches your heart, lungs, or brain it will become life-threatening quickly.

Antibiotics and Dental Infections

As for using antibiotics as a solution without seeing the dentist, that won’t work. They are used as a temporary means of getting the infection under control, but will not rid your body of the infection completely. Instead, you’ll feel better for a while, but when the antibiotics are completed, your infection will blow back up. This is because as the infection spreads through the pulp of your tooth, the pulp dies and is no longer receiving any blood flow. Without blood flow, there is no way for the antibiotic to reach the root causes of the infection.

The only true way to remove a dental infection is for the dentist to go in there and physically removed the infected tissue. There are two ways to do this. The first is with a root canal treatment. The dentist will remove the infected pulp and usually cover the tooth with a crown because it will become brittle and need protection. The depth and location of the fracture on your tooth may determine whether or not this is a possible solution for you.

Your second option is to have the tooth extracted. However, that complicates the issue because you’ll need to replace that tooth. The ideal replacement would be a dental implant. Given the current pandemic, you’d likely have to wait on that until things calm down. You can temporarily get a dental flipper to hold it in place.

This blog is brought to you by Marietta, GA Dentist Dr. Cristi Cheek.