Using Antibiotics to Treat a Tooth Infection

Infected teeth are a major inconvenience, and they’ve historically been a cause of not only suffering, but also even death. As a publication in the NIH’s National Library of Medicine notes, “Dental infections originate in the tooth or its supporting structures and can spread to the surrounding tissue. Dental infections were, historically, a common cause of death. Fortunately, due to improved dental hygiene, modern dentistry, and antibiotics, dental infections are rarely life-threatening today.” Indeed, Alexander Fleming’s discovery has done much to transform modern life. 

But just because an antibiotic for tooth infection is often an effective treatment doesn’t mean that it is the best course in every situation. In this article, we will explain how antibiotics help some tooth infections, the best antibiotic for tooth infections of different types, and an antibiotics list for tooth infections. 

Orange bottle of antibiotics spilled on tabletop

Will antibiotics help treat my tooth infection? 

Tooth infections occur when bacteria get into either an injured gum or a damaged tooth. As an infection spreads, it can lead to all sorts of unpleasant symptoms, such as: 

  • Oral pain, including discomfort that radiates into your head and neck 
  • A throbbing sensation 
  • Sensitivity to high or low temperatures 
  • Gum swelling and bleeding 
  • Loosening teeth 
  • Difficulties with chewing or opening one’s mouth 

If that weren’t bad enough, an untreated infection may lead to an oral abscess, which is a pocket of pus caused by natural immune response. Left untreated, an abscess can cause serious (and, in some cases, life-threatening) conditions such as sepsis. So, it makes sense to immediately prescribe antibiotics for a tooth infection — right? Well, not always. In many cases, other treatment options provide better outcomes. 

The American Dental Association published a review of how well antibiotics worked to address oral infections in immunocompetent adults (i.e., those with a properly working immune system). The conclusion? “Evidence suggests that antibiotics for the target conditions may provide negligible benefits and probably contribute to large harms. The expert panel suggests that antibiotics for target conditions be used only when systemic involvement is present and that immediate [definitive, conservative dental treatment] should be prioritized in all cases.” That treatment involved steps such as the following: 

  • Numbing the affected area and draining the pus 
  • Conduct a root canal if the infection has set into the middle of a tooth 
  • Remove an affected tooth if the infection has progressed too far and drain the pus afterward 

Which antibiotics will treat tooth infections? 

While the American Dental Association report’s dental infection antibiotic guidelines suggest restraint and the use of other methods, it does state that antibiotic use has its place. Still, every prescription has its advantages and disadvantages, and one good antibiotic for tooth infection might not excel in every situation. This is because most infections are polymicrobial, meaning that different kinds of pathogens have worked in combination to create the infection.  

The most commonly prescribed antibiotics for tooth infections include: 

  • Penicillin and Amoxicillin: This oldest of all antibiotics is actually the preferred drug for most kinds of dental infections. In fact, when the American Dental Association recommends antibiotics, it’s first suggestion is for oral amoxicillin or oral penicillin V potassium. It’s both common and effective. However, it has some drawbacks. There is a growing number of bacteria strains that show resistance to these antibiotics, and a significant portion of the population is allergic to drugs in the penicillin family. 
  • Amoxicillin-Clavulanate: This combination drug is still in the penicillin class and is often used for slightly more serious infections where amoxicillin alone might not prove effective.  
  • Clindamycin: Another commonly prescribed antibiotic, clindamycin is generally the next choice when a patient cannot tolerate penicillin or is dealing with a resistant bacterium. Clindamycin targets multiple types of bacteria. 
  • Metronidazole: Metronidazole is typically employed to combat penicillin-resistant bacteria. Sometimes physicians will prescribe it along with penicillin when attempting to combat a broad number of bacteria. 
  • Erythromycin: This antibiotic is typically only used for patients with serious allergies to other antimicrobial agents. 

Different antibiotics for different types of tooth infections 

For those wondering, “What is the best antibiotic for gum infection?” or “What is the best antibiotic for a toothache?”, the answer depends as much on the individual as the infection. The most preferred and typically most effective antibiotic for tooth infection and pain is amoxicillin. For some infections, a doctor may combine it with clavulanate or metronidazole. Really tough cases or a history of extreme allergies may call for clindamycin or erythromycin. 

How long should I take antibiotics for a tooth infection? 

The amount of time that you should take antibiotics for a tooth infection will vary based on your specific case. However, these sorts of medications are usually only intended to be for a short period. Best practices generally recommend taking antibiotics for infected teeth and/or gums for anywhere from three to seven days.  

How long does it take for antibiotics to work for a tooth infection? 

Antibiotics can begin to work within a single day, reducing inflammation and pain significantly. However, that doesn’t mean that your problem has been adequately addressed. You should continue to take all of your antibiotics over the prescribed period to ensure that the bacteria have been eliminated. Additionally, your infection may owe to certain structural issues with your teeth. If so, you may need additional dental work to ensure that the infection is eradicated. 

Some things to take into the consideration before taking antibiotics 

Although many patients have become accustomed to taking antibiotics for any and every infection, understand that scientific evidence suggests that they often don’t perform well for specific dental infections. Dentists usually only prescribe antibiotics when the infection has migrated from your mouth and become systemic. In such cases, your symptoms will likely include at least some of the following: 

  • A fever 
  • Chills 
  • Elevated heart rate 
  • Dizziness 
  • Headache  
  • Trouble thinking clearly 
  • Decreased energy level 

Once you begin to show signs of a systemic infection, the use of antibiotics becomes appropriate.  

Additionally, do not try to “tough it out” when you suspect that you have an infection. As mentioned in the introduction, tooth infections have been a significant cause of death historically, and they rarely resolve themselves on their own. Go see a qualified dental professional and address the problem. 

Can you get antibiotics for a tooth infection over the counter? 

Antibiotics cannot be purchased over the counter. Aside from triple antibiotic cream (which is typically used for minor cuts and scrapes), you must always have a prescription in order to purchase an antibiotic. However, there are a number of natural and over-the-counter remedies you can try if your dentist doesn’t believe that antibiotics would benefit you. These include: 

  • Rinsing with salt water 
  • Gently applying baking soda to the tooth 
  • Taking a mild pain reliever such as ibuprofen or acetaminophen  
  • Applying essential oils such as oregano or thyme  
  • Applying a clove of garlic to the affected area 
  • Applying a cold compress externally 

When you need to deal with inflamed gums or a painful tooth, contact us here at Westend Dental! We have a patient-focused approach, and your good is our goal.