Antibiotics Won’t Cure Your Tooth Infection

What an abscessed tooth really is 0:00

If you've ever been prescribed an antibiotic for an infected tooth, for a toothache, or had your child experience the same thing, you might be surprised to know that antibiotic actually doesn't treat the abscess. What do I mean by this? All right, we're going to jump into this today. Really, we are going to talk about what is an abscess? Why is an antibiotic simply a band-aid for it? And what is a long-term solution? And why would you perhaps need an antibiotic even if it's not a long-term solution?

Let's get into this and really figure this out. First of all, what is an abscessed tooth? If your tooth has had a toothache, or sometimes it doesn't even have a toothache, it always surprises me when this happens, when the nerve inside of the tooth dies, that infected nerve actually starts extending out beyond the end of the root. So that infection spreads like every infection does. As that infection spreads, it starts to irritate all of the supporting structures around the tooth. There's something called the periodontal ligament.

It's the ligament that connects the tooth to the bone. That ligament starts to get inflamed as bacteria spread through the end of the root and into that ligament. The bone starts to get inflamed. The gums can sometimes start to get inflamed, and that is when you really feel the toothache. That's when it swells, that's when it's tender to bite on, when it starts to hurt and it doesn't stop for minutes or even hours.

Why antibiotics only temporarily help 1:32

That is a sign that you have an abscessed or dead tooth. Now, at that point, a dentist may prescribe an antibiotic. Let's talk about that antibiotic. What is it actually doing? Well, as antibiotics do, they go and they fight bacteria, right? That's their job. They're going to go and they're going to tackle that bacteria and they're going to sometimes win. They're going to take over that bacteria. They're going to push them back and the tissues around the tooth are going to subside. Things are going to start feeling better.

Maybe you can start chewing on it again and things feel okay. And you might be tempted to think the antibiotic did it. It took care of the problem. But remember, the bacteria weren't the start of the problem. The start of the problem was the dead nerve inside of the tooth. Any time there's dead tissue, bacteria are going to find it again. So typically what happens with an antibiotic is you take it, the infection goes down, the tissues resolve, the pain goes away, you feel like you're good to go, and then 10 weeks, 12 weeks later, you start to get some symptoms back and it comes back with a vengeance.

Why? Because the dead tissue is still there inside of the tooth. This goes for adult teeth. This goes for children's teeth. It doesn't fix the root cause of the problem. So many people ask me this, well, why can't I just take an antibiotic for my infected tooth? Why can't I just take an antibiotic for my infected root canal tooth? The answer is always the same. The dead tissue is the problem, and an antibiotic can only temporarily subdue the bacteria that have found that dead tissue. The bacteria will be back as long as the tissue is there.

This is why taking an antibiotic is just a band-aid.

When a tooth infection becomes an emergency 3:25

It's a band-aid for the symptom. Now, sometimes it may be required. There are actually stories, you can watch them on the news, about people who have died from tooth infections. do not let this be you or any of your friends and family. If you have an extensive abscess, and let's talk about what that means, if you have facial swelling, if you can see it from the outside, if it's moving up towards your eye and your brain, or it's moving down towards your throat and your breathing, if you are feeling changes with breathing, with swallowing, If you have noticeable redness and heat and fever, any of those things mean it is time for an antibiotic.

You're not fixing the underlying problem, but you're quieting down the infection. Why? So it doesn't spread somewhere that you don't want it to go. Upper teeth will spread to the brain. Lower teeth will spread to the airway. There are some significant problems that can come from infected teeth. So for an adult or a child, if any infection is starting to have any outward presentation at all or interfering with, like I said, eyes swelling here, swallowing, breathing immediately. That's an emergency room visit.

That's an antibiotic. And they may be doing IV antibiotics. Why would they choose an IV antibiotic over an oral one? Because it gets into the system faster. An IV antibiotic goes directly where it needs to go. An oral antibiotic goes through the gut and then goes to where it needs to go. So it's delayed. So, an antibiotic is necessary to save lives, to protect you from potential life-threatening situations. If you've been recommended by a dentist to have an antibiotic and you have swelling that I've just talked about, absolutely, you're going to take it.

Now, I have a lot of people that say, but I don't want to take an antibiotic. I hate what it does to my gut. Understood, however, there's some situations that require it to be able to preserve your life and to safeguard your life. You can rebuild your gut over time if that's what's necessary, but don't say no if you have the symptoms I've described.

Root canal vs extraction and implant 5:30

So you take an antibiotic, things subside, what do you do then? Well, if you've listened to anything I've said, when a tooth is completely dead, when already all the nerve tissue is dead, it's infected, there's bacteria already throughout the tooth, my recommendation is always, let's remove the tooth and replace it with a dental implant. Why do I make that recommendation? Because I see so many root canals fail. And if your tooth is already full of bacteria because the tooth is already dead, it even gives you a lower chance for that root canal to be successful.

It's always an option, and standard of care requires that if you were to come here to my practice, I would tell you, you have an abscess tooth, you can get a root canal. However, I'm going to recommend removal and replacement with a dental implant to ensure that this doesn't reinfect. The issue with reinfection, that first infection hurt. Your nerve's still there, everything's inflamed, it's ticked off. Oftentimes, the second infection doesn't hurt as much. And that's what's really tricky about this.

When you have a root canal done, it takes out the nerve tissue, takes out the early warning system. So oftentimes those infections spread into other areas, create systemic problems that we have no warning about because that nerve tissue is gone. So if you have an abscess tooth, if you have swelling, if you are having anything affecting your eyes, your breathing, your swallowing, go to the ER, get an IV, get an antibiotic immediately. If this tooth you just have been told it's dead, there's no more sensation, it's gray, you have a great big cavity, any of those things, You can choose a root canal knowing what you're choosing.

You may be removing that tooth in the future and you need to watch symptoms closely or you can have it removed and replaced with a dental implant now. That's always been my recommendation. Hopefully this makes sense. Hopefully this clears up why and when an antibiotic would be needed but also the limitations of that antibiotic. It is so important to protect your body to protect your wellness.

Final advice and where to get help 7:35

And hopefully all this information will help you. If you are local, please come and visit us here at Total Care Dental or Total Care Kids in Ortho. We'd love to see you. Or check out the directory at livingwellofdrmichelle.com for a dentist near you. My goal is to give you all of this information so your teeth and mouth can be well, so that you can live well.