Antibiotics for Tooth Infections

Antibiotics are medicines your dental provider may prescribe to help treat bacterial infections affecting your teeth. A tooth infection, or tooth abscess, is a pocket of pus that may feel painful and look red or swollen. Without treatment, abscesses get worse. The infection can spread throughout your mouth and (in extreme cases) nearby vital organs, like your brain.

Your mouth is home to over 700 species of bacteria. Any opening in your teeth or gums — from a cavity, a cracked or injured tooth or even gum disease — creates an avenue that bacteria can use to seep in and set up shop.

When this happens, you may need antibiotics, in addition to a dental procedure, to stop the infection.

Types of antibiotics that treat tooth infections

There are several classes of antibiotics. Each class contains specific drug types that work in much the same way to destroy bacteria. Some kill several strains of bacteria, while others target a specific type. The best antibiotic for you depends on which bacteria are causing your tooth infection.

Common antibiotics dental providers prescribe include:

• Penicillin-type antibiotics: Providers usually prescribe common types of penicillin, like amoxicillin or penicillin V, first. They kill a wide range of bacteria. They may prescribe clavulanate (a beta-lactamase inhibitor that helps penicillins work better) alongside amoxicillin.
• Cephalosporins: Common types dental providers prescribe include cephalexin.
• Nitroimidazoles: Common types include metronidazole.
• Macrolides: Common types include azithromycin and erythromycin.
• Lincosamides: You may need a lincosamide, like clindamycin, if you have a stubborn tooth infection that hasn’t responded to other antibiotics.

Less commonly prescribed antibiotics in dentistry include fluoroquinolones and tetracycline.

When do I need antibiotics for a tooth infection?

Dental providers typically prescribe antibiotics:

• To treat severe infections.
• To treat infections that are spreading.
• To prevent infections after a dental procedure.

Antibiotics alone won’t get rid of tooth infections, but you may need to take them in addition to having a dental procedure. For example, draining the abscess, doing a deep cleaning, performing a root canal and pulling a tooth that can’t be saved are all primary treatments for a tooth infection. Often, these procedures clear tooth infections without antibiotics.

But you may also need antibiotics in certain instances. For example, dental providers are more likely to prescribe antibiotics if you’re immunocompromised. Having a weakened immune system puts you at risk of a mild infection becoming serious. It’s best not to chance it.

How should I take them?

Most antibiotics are tablets or capsules you take by mouth with a glass of water. Take them until every single pill is gone, exactly as prescribed. Read the instructions carefully when you get your prescription.

The instructions will tell you:

• How many days you’ll need to take the antibiotics.
• How many times a day you’ll need to take them.
• Whether you should take them with food or on an empty stomach.

Ask the pharmacist or your provider any questions you have about how to take your medicine for infected teeth.

What are the benefits?

Antibiotics can kill bacteria so a tooth infection doesn’t spread. They can help prevent infections from worsening so they don’t cause serious health issues.

What are the risks?

Some antibiotics for tooth infections can cause side effects or, on rare occasions, allergic reactions.

Side effects

Side effects may include:

• Dizziness.
• Nausea.
• Diarrhea.
• Yeast infections.

Most side effects are a short-lived nuisance, but severe or long-lasting symptoms may be a sign of a serious condition.

For example, severe diarrhea (diarrhea that worsens or doesn’t improve after a few days) may be a sign of a Clostridiodes difficile (C. diff) infection. This happens when antibiotics kill bacteria in your colon but leave behind too much C. diff bacteria. You’ll need a different antibiotic to clear this infection.

Allergic reactions

Allergic reactions to antibiotics, like a penicillin allergy, aren’t common. But they can happen. Some allergy symptoms, like a rash or hives, aren’t usually an emergency, but you should still inform your provider that you’re having a reaction. Severe allergic reactions, on the other hand, require emergency treatment.

Symptoms of a severe allergic reaction include:

• Blisters.
• Swelling on your face, lips, tongue or throat (your throat may feel like it’s closing up).
• Wheezing or trouble breathing.

Call 911 or your local emergency number if you’re experiencing symptoms of a severe allergic reaction.

How long will it take for the antibiotics to work?

The time it takes to feel better depends on how severe your tooth infection is. Some people feel better quickly after starting antibiotics — even on the first day.

But there’s a difference between the time it takes to notice symptom improvements and the time it takes to clear an infection for good. This is why you should take the full course of your medicine even if you start to feel better. Usually, it takes at least a full week to finish a course of antibiotics for tooth infections.

Taking all of your medicine reduces the risk of an ongoing infection. It also helps curb the more widespread problem of antibiotic resistance.

Is there anything I can do to make treatment easier for me?

Take it easy on your mouth while you’re waiting for the infection to get better. You can:

• Take over-the-counter pain medicines.
• Place a cold compress on your jaw to numb the pain.
• Use a soft-bristled toothbrush to brush your teeth.
• Avoid hard or crunchy foods, or food or drinks that are too hot or cold.
• Chew on the side of your mouth opposite the abscessed tooth.
• Try natural remedies to remove some bacteria, like rinsing with warm saltwater.

When should I call my healthcare provider?

All tooth infections require treatment — if not with antibiotics, then with another treatment like a root canal. It’s essential to see a healthcare provider if you’re noticing signs of an infection so you get the treatment you need as soon as possible.

Will a tooth infection go away with antibiotics?

Tooth infections won’t go away with antibiotics alone. This can be confusing because most of us think of antibiotics as the “cure” for bacterial infections.

Think of it this way. Antibiotics travel through your bloodstream. Once bacteria get trapped inside a tooth, they destroy the surrounding tissue, including the blood vessels that would otherwise provide the route antibiotics use to reach (and kill) bacteria. This is why removing the dead tissue and the bacteria trapped inside your tooth is the most important treatment.

Are there natural antibiotics for a tooth infection?

No. The only antibiotics that treat tooth infections are by prescription. There are home remedies that can help with pain, like placing a cold compress on the side of your face with the abscess. Some home remedies may prevent bacteria from building up in the first place. For example, some studies show that swishing coconut oil in your mouth (oil pulling) works much like mouthwash. It can help wash away some bacteria.

But there aren’t any natural antibiotics (or remedies) that will improve a tooth infection.

Can I get antibiotics without seeing a dentist?

All antibiotics are prescription medicines. So, you’ll need to see a dental care provider, like a dentist or endodontist, to get a prescription.

Remember that tooth infections don’t go away on their own — even with antibiotics. It’s essential to see a dental care provider to get treatment to kill the bacteria and keep the infection from spreading.