After a tooth extraction an abscess will go away because you've removed the source of the infection and also established a path of drainage. However, you can speed up the healing process and get rid of the abscess faster by popping it and taking the full course of antibiotics in addition to the extraction.
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Extracting the tooth removes the source of infection
The source of the abscess comes from the tooth itself or more specifically, the infected nerve. Extracting the tooth from the mouth will get rid of the abscess because it eliminates the source.
An extraction is one of the only two permanent cures to a dental abscess because it is able to address the source of the infection. The other method would be a root canal, which removes the infected nerve but leaves the tooth intact within the mouth. All other treatments and home remedies will do no such thing as fix an abscess and that is an inviolable principle.
Since only extractions and root canals can get rid of an abscess, it is also the reason why taking antibiotics without any other treatment won't make it go away.
How to identify the source of the abscess
Getting a tooth extraction is an irreversible procedure so you definitely want to make sure that you are treating the correct tooth! One method of identifying and verifying the correct tooth, which is causing the abscess is by tracing it with gutta percha.
Identify dental abscess.
Insert gutta percha into abscess as far as it can go.
Take a dental x-ray.
The abscessed tooth is the one where the gutta percha points to.
Gutta percha is the root canal filling material but it could also be used in a creative way, which can pin point the source of tooth abscesses. This method only works if the infection has progressed through the stages of tooth abscesses where it forms a pimple on the gums.
This is what a parulis or pimple on the gums (gum boil) looks like:
Here is a photo of what it looks like to trace the abscess with gutta percha:
Now here is an x-ray of what the gutta percha tracing to the abscessed tooth looks like:
As you can see on the x-ray, the gutta percha leads straight to the source of the abscess. The abscess is the big black circle on the x-ray.
An important point that we want to make is that this technique to identify the source of an abscess is EVIDENCE that the entire source of the infection comes from the tooth. That is why an extraction will permanently eliminate the abscess afterwards. Home remedies cannot extract the tooth and thus, cannot get rid of your tooth abscess.
Popping and draining the abscess gets rid of it
Extracting the tooth only removes the tooth but it leaves the abscess or pimple on your gums untreated. The infection will most likely resolve on its own eventually since the source is gone but you can help speed up the healing by popping and draining the remaining abscess in your mouth.
Therefore all dentists will usually extract the tooth AND pop the rest of the abscess even though they may not explicitly say it. It is part of the standard of care to do both together. I mean if you can speed up the healing why not do it right?
Here is a video of a tooth abscess being popped:
As the infection is being drained you can see all of that pus and blood ooze out of the pimple. It is absolutely necessary for the abscess to be drained in addition to having the tooth extracted. That is just good practice.
Taking antibiotics clears out the abscess faster
Antibiotics may not be the primary method of treatment for a tooth abscess but taking them in conjunction with an extraction and drainage will certainly speed up the healing process. It ensures that any remaining bacteria will get eliminated and also helps in preventing the infection from recurring.
There are instances where after treatment, the infection comes back and using antibiotics can help decrease the chances of that happening.
With that being said, it is not always necessary to take antibiotics so your doctor may not prescribe it for you. That is the case if your healthcare provider is absolutely certain that they cleared out the abscess with an extraction and drainage. If they have any doubts about all of the infection being removed, they will give you a course of antibiotics.
Therefore whether you need antibiotics or not afterwards will all depend on the severity of the abscess. As healthcare professionals, we not only have to take into account risk of infection but also risk of developing antibiotic resistance. We cannot over prescribe medications because it could be detrimental to your health in the future. It is a more holistic approach to treatment.
What happens to a tooth abscess after an extraction is that it will go away eventually. Nonetheless, there are extra treatments that you can utilize to speed up the healing process and get rid of the infection faster. You should pop the abscess and drain it directly. Then you should take the full course of antibiotics to ensure that every last bacteria which was causing the infection is killed off.
Author: Written by Dr David Chen, a dentist in long island city.