Last Updated on: 5th December 2024, 10:40 am
Generally, antibiotics for tooth infections are consumed orally, that is, through the mouth in the form of syrup or solids such as capsules and tablets. The oral cavity is the beginning of the digestive system. As it is exposed to outside the body, it is not an aseptic cavity, that is, free of microorganisms. On the contrary, it is an area rich in oral flora that generates a biofilm that adheres to teeth, facilitating bacterial multiplication in ideal conditions of temperature, humidity, and certain nutrients. However, saliva contains a large proportion of antimicrobial agents (they control the growth of bacteria, viruses, and fungi) that modulate this flora and maintain a balance, contributing to the healing of any infections
Odontogenic Infection
Infections or abscesses in the oral cavity are common dental problems caused by caries, bacterial infections, injuries to dental tissues, or certain dental procedures. They are one of the main causes of a dental consultation and a prescription for antibiotics.
Infections or dental abscesses (the formation of a bag filled with pus in the mouth due to an untreated infection) manifest certain symptoms:
- Severe pain
- Sensitivity to changes in temperature
- Intraoral Or extraoral inflammation
Dental caries, pulpal necrosis, dental trauma, and periodontal diseases can lead to dental infections which can spread. Some have serious consequences that affect both the soft and hard tissues of the oral cavity. If left untreated, dental infections can spread to surrounding tissues, increasing the severity of the problem.
Therefore, if you have a tooth infection, see your dentist as soon as possible. He or she may prescribe antibiotics. The following conditions can be generated by a dental infection:
- Caries and pulpitis
- Gingivitis
- Pericoronitis
- Periodontitis
- Dental abscess
When to use antibiotics for a tooth infection
The treatment for an infection is not always managed with antibiotics; however, there are two cases where your dentist may indicate such management:
- When a dental procedure is performed that requires special care due to the risk of bacterial spread or growth. It is indicated as prophylaxis, a minor pre-procedure treatment. This usually occurs in patients with a weakened immune system (HIV, AIDS, cancer, lupus, arthritis, infective endocarditis, and diabetes, among others).
- For the treatment of odontogenic or dental infections, when other treatments fail as in cases of acute infection such as necrotizing ulcerative gingivitis or trench mouth, aggressive periodontitis, abscess, cellulitis, among other infections.
Taking into account the recommendations of the WHO regarding the proper use of antibiotics and the great microbial resistance to these medications, dentists and doctors now tend to limit use to only necessary cases.
What antibiotics used for tooth infection?
There are currently more than 150 different strains of bacteria that can grow in the mouth. Thus, the type of antibiotic prescribed depends upon the specific bacteria causing the infection. The various classes of antibiotics for tooth infection have been found to be effective in attacking bacteria in different ways.
We have alternatives: a series of antibiotics for tooth infection such as penicillins, metronidazole, clindamycin, and azithromycin, among others. The health condition and age of each patient should always be taken into account with a focus on pregnant women, children, and those with kidney failure, among others since this will modify the choice of antibiotic treatment.
Generally, the treatment time for infection is between 7-10 days, and for prophylaxis 3 – 7 days. Depending upon each case of dental infection, it is possible to extend it from 14 to 21 days on average.
Penicillin for dental infections
This is the most common antibiotic for tooth infections. It is a group called beta-lactams, which include amoxicillin and penicillin, to name a few. Due to increasing bacterial resistance to antibiotics, amoxicillin has been combined with clavulanic acid to increase its efficacy; however, some studies indicate that they have the same efficacy. These are the choices when it comes to antibiotics for tooth infections.
It is possible that some people have allergies when consuming this class of antibiotics, so you must discuss your medical history with your dentist so he or she can choose a different antibiotic.
The average therapeutic dose of amoxicillin for a dental infection is 500 mg every 8 hours or 1000 mg every 12 hours by mouth. The average dose of amoxicillin with clavulanic acid could be 875/125 mg every 8 hours or 2000/125 mg every 12 hours. There are other beta-lactams, but their administration is intravenous (through the vein) and must be administered by a health professional.
Metronidazole
This type of antibiotic is a little more specific and intended for certain families of bacteria called anaerobes. It is usually prescribed for acute infections; however, it is not the first choice since it is not suitable for all patients. Special caution should be exercised when administered together with alcohol, sedatives, or medicinal treatments for depression, as well as anticoagulants and anticonvulsants. The recommended dose of metronidazole is about 500-750 mg every 8 hours, taken orally.
Azithromycin
This class of antibiotics for tooth infection works very well for patients allergic to penicillin. They belong to a family called macrolides and should not be administered together with clindamycin since it cancels the effect. It is contraindicated in patients with liver conditions. It works well against a wide variety of dental tissue bacterial infections. The usual dose of azithromycin is 500 mg every 24 hours for 3 days, taken orally.
Erythromycin
This antibiotic is in the same class as azithromycin and has a broad application. It is commonly prescribed for the management of cavities and plaque since it decreases bacterial growth. It is safe for children and is sometimes indicated for the management of abscesses. It is not the first choice, but it is a safe option for some patients. The indicated dose can range from 250 to 500 mg every 6 hours taken orally. It is contraindicated in certain diseases, so it is recommended to inform your dentist or pharmacist of your medical history.
Clindamycin
These antibiotics for tooth infection is widely used to treat a wide variety of bacterial infections, but it is not frequently prescribed for dental infections. It is considered an effective option due to its low cost and availability, as well as low bacterial resistance, especially compared to penicillin. The therapeutic dose of clindamycin is 300 mg or 600 mg every 8 hours taken orally.
Any of the aforementioned antibiotics indicated for a dental infection should be evaluated and prescribed by your dentist for greater safety. It is important to ask the pharmacist how it should be administered and what are the most common side effects to be aware of.
Which are the best antibiotics for tooth infection?
In general, the antibiotic of choice is amoxicillin, hence penicillin, due to its safety and the broad spectrum of action. It fights any type of bacteria and is easy to handle. When people are allergic to penicillin, metronidazole may be prescribed. However, it is not suitable for all patients, especially those with particular clinical conditions. Make any health conditions known to your dentist or pharmacist.
For safety and to avoid bacterial resistance in the future ( when bacteria are no longer sensitive to the antibiotic), antibiotics should always be prescribed by a health professional. The dentist may opt for another treatment protocol, rendering an antibiotic unnecessary.
The best antibiotic for the treatment of a dental infection depends upon the type of bacteria causing the infection. The success of the treatment reflects patient compliance with the dentist’s recommendation.
Can antibiotics stop tooth infection pain?
Antibiotics are effective in fighting infections, and, therefore, the symptoms will begin to decrease, such as pain, inflammation, and tenderness. However, this decrease is not the direct activity of the antibiotic, since complete treatment for a dental infection could include analgesics and/or anti-inflammatories.
Therefore, it is necessary to make it clear that antibiotics do not have an analgesic effect. On the other hand, studies have shown that antibiotics are primarily designed to stop or delay the growth of bacterial infections. Other options include using the natural way in dealing with a dental infection.
What if amoxicillin is not effective for tooth infection?
When amoxicillin is not effective for a dental infection, it may be due to several factors:
- How cute it is, thus mandating that other types of antibiotics with greater potency are to be prescribed.
- The type of bacteria is a determinant in the selection criterion of the appropriate antibiotic. A more specific antibiotic may be required for the elimination of the existing bacteria.
- The patient may present repetitive infections, did not carry out the treatment continuously or did not follow the indicated protocol. These factors can affect bacterial resistance.
Thus, it is recommended to inform your dentist if you have received treatment with amoxicillin before and discuss the results. This will serve to indicate the most appropriate treatment.
How quickly do antibiotics act in case of dental infection?
In some people and depending upon the degree of the infection, it is possible that after 36 hours of treatment, the symptoms will begin to diminish or become less frequent. Under no circumstance does this indicate that the infection has passed and treatment can be suspended. On the contrary, the medications prescribed for a dental infection should be continued for the established time.
In short, the antibiotics for tooth infection will be determined by the elimination of the infection within the treatment time, which on average is between 7-10 days. It is extremely important to complete the treatment in its entirety as indicated.
Note: It should be noted that in children, a pediatric dentist must prescribe the type of treatment for a dental infection. This treatment is to be followed to the letter per the recommendations and indications given by the dentist. When bacteria become resistant to drugs, infections become more difficult to treat. To prevent this, always complete antibiotic treatments (do not suspend them prematurely) and do not self-medicate since each one has a specific treatment time.
It is common to prescribe probiotics along with antibiotics in cases of dental infections to maintain a healthy intestinal flora. Antibiotics help reduce the infection, but they are not the complete solution. Although antibiotics work to reduce infection, it is still important to get the necessary dental work done to prevent recurrences.
It is not advisable to ignore the signs and symptoms of pain associated with a persistent infection. The patient should be thoroughly examined with the necessary X-rays taken to determine the cause of the infection and to plan the proper course of treatment. In case you have a dental infection with clear signs of infected oral tissues, it is important to see your dentist as soon as possible. In periodic visits, the dentist can make adequate diagnoses to prevent infections from spreading to other parts of the body.
Contact us:
If you have any questions about this or other topics, you can contact us at Channel Island Family Dental as well as our Facebook page. We look forward to your visit and we will make a timely diagnosis. Our Dentists in Oxnard, Saint Paula, Venture, Newbury Park, and Port Hueneme will be able to guide you toward the best treatment to take care of your health and give you back your best smile.
Bibliography
- Sanders JL, Houck RC. Tooth Abscess. [Updated 2022 Feb 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan, (consulted on Oct 03, 2022). Available from: https://www.ncbi.nlm.nih.gov/books/NBK493149/2
- Haque M, Sartelli M, Haque SZ. Dental Infection and Resistance-Global Health Consequences. Dent J (Basel). 2019 Mar 1;7(1):22. doi: 10.3390/dj7010022. PMID: 30823670; PMCID: PMC6473604. Consulted on Oct 03, 2022. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473604/3
- Ahmadi H, Ebrahimi A, Ahmadi F. Antibiotic Therapy in Dentistry. Int J Dent. 2021 Jan 28;2021:6667624. doi: 10.1155/2021/6667624. PMID: 33574843; PMCID: PMC7861949. Consulted on Oct 03, 2022. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861949/4
- Robles Raya P, Javierre Miranda A, Moreno Millán N et al. Management of odontogenic infections in primary care consultations: antibiotics?. Primary Care, ELSERVIER. 2017, Dec vol. 49 issue 10 (2017) pp: 611-618. DOI: 10.1016/j.aprim.2017.05.003. Consulted on Oct 03, 2022. Available from: https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-manejo-infecciones-odontogenicas-consultas-atencion-S0212656717301348
- Moreno Villagrana A, Gómez Clavel J. Antibiotic therapy in general practice dentistry. ADM MAGAZINE /July – August 2012/VOL. LXIX NO. 4PP 168-175. Consulted on Oct 03, 2022. Available from: https://www.medigraphic.com/pdfs/adm/od-2012/od124e.pdf
- Renad S. Nahas, Asmussen N. Dental Antibiotics for Tooth Infection and Abscesses: Types and Dosage. Denatly.org (Internet). Updated on 15 August 2022, (consulted on Oct 03, 2022). Available from: https://www.dentaly.org/us/oral-health/antibiotics-tooth-infection/
- Sellers A, Johnson J. What to know about antibiotics and tooth infections. Medical News Today (Internet). Updated on April 14, 2022, (consulted on Oct 03, 2022). Available from: https://www.medicalnewstoday.com/articles/3254708
- Freeland M., Vergnaud S. Tooth Infection: Symptoms, Causes, Treatment and More. GoodRx (Internet). Updated on January 11, 2022, (consulted on Oct 03, 2022). Available from: https://www.goodrx.com/conditions/bacterial-infection/tooth-infection-symptoms-treatments-antibiotics