There is no way to tell because it can be days, weeks, or months before your tooth infection comes back after taking antibiotics. It really depends on your condition and how severe the infection was but there is no way to guesstimate when the swelling may return.
However, if it does return what is certain is that you've a complication. Taking a second round of antibiotics may not help this time around and your only option may be to see a dentist.
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Can an abscess really come back?
Dental infections can certainly come back and when they do, it means that you have a complication. Call it what you will but you've an official complication if your abscess swells back up!
When it can come back:
After completing full course of antibiotics.
After finishing antibiotics with proper dental treatment.
Returns after antibiotics
It is very likely for a tooth infection to come back after taking antibiotics, especially if that is the only treatment you've done for it.
The reason is because the vast majority of dental conditions require intervention with a dentist procedure. That is the only way to treat the source of the infection and get rid of it permanently. The medication that you're prescribed afterwards is considered adjunctive therapy. It is meant to assist with the healing after your dental treatment.
Therefore, if you only took the antibiotics without getting proper treatment, it is highly likely for the infection to come back at some point in time. Essentially, you haven't done everything that you could to ensure that it wouldn't come back.
Returns after antibiotics with dental treatment
It is less likely for a tooth infection to come back if you take antibiotics after receiving proper treatment with a dentist.
The reason is because the dental treatment should've adequately eliminated the source of your infection or abscess. The purpose of the antibiotics is to ensure that you heal up without any hiccups and that includes the infection returning.
When does the infection return?
It is impossible to predict how long it takes for an infection to return after you finish taking your antibiotics. It is highly variable and depends completely upon your unique situation and how bad the infection was.
Nevertheless, we can tell you what we've personally seen with our patients at our dental practice. Perhaps that will give you an idea of what to expect for your situation.
How quickly can the infection come back?
The fastest that we've seen an infection come back is one day. Yes, you read that correctly we've had situations where the patient was taking the antibiotics but the infection just simply did not want to go away at all.
In fact, they were still swollen even after taking the antibiotics and remained swollen for the next few days. It wasn't until after they returned for a definitive dental procedure that the infection finally dissipated.
What this patient needed in addition to taking antibiotics:
Incision and drainage. Big infections with massive swellings will need to be drained in order for any antibacterial medication to even work.
Tooth extraction. Once the swelling subsided, then your dentist can properly identify the culprit of the infection and remove the tooth permanently from the mouth.
How long can antibiotics keep the infection away?
The longest time that we've seen antibiotics keep an infection away would be a couple of months. Although that only applies to wisdom teeth infection and pain. Typically it'll be for an impacted third molar where it swells up and goes away but then it comes back.
However, if you've a different type of infection, the longest that it can potentially keep it at bay would be a few weeks at most. This includes all dental conditions except for wisdom teeth pain.
Essentially, you can think of antibiotics as a form of temporary measure to manage the infection. For permanent pain relief and to get rid of it forever, you will need to see a dentist.
Antibiotics won't work the second time
If taking antibiotics cannot get rid of your infection the first time around, it means that it probably won't work the second time.
Two reasons why taking more medication won't help:
The bacteria develop antibiotic resistance.
Systemic therapy was not the right course of treatment.
Perhaps the infection came back because the bacteria developed a resistance to the antibiotic that you took. If it did, the swelling and abscess will come back with a vengeance. In other words, taking more won't necessarily help you.
You can keep taking more pills but the swelling won't go away and neither will the pain. Your only option left at this point would be to see your dentist.
Wrong type of treatment
The fact that taking antibiotics did not get rid of the infection permanently only goes to show that it wasn't the correct treatment for your condition. It means that taking pills was insufficient in treating your condition.
It doesn't make a lot of sense to try a second round of antibacterial medication and praying that it works this time. The end result will most likely end up the same.
When to see a dentist
If your infection returns, you need to seek professional help by seeing an emergency dentist immediately. Clearly the situation is out of your control and it makes no sense waiting to see if it'll go away or attempting home remedies to alleviate the pain. Delaying your dentist visit will only prolong the time that you'll be suffering in pain.