Updated: Apr 26
Antibiotics alone will not make a tooth abscess go away because it does not establish a path for drainage nor does it treat the source of the infection. The role of antibiotics is to assist with clearing up a tooth abscess but does not treat it directly. Therefore the medication is used as an adjunctive therapy rather than as a primary treatment for abscessed teeth.
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Antibiotics don't establish a path of drainage for abscesses
Using just antibiotics and nothing else will not create a path of drainage, which is necessary for reducing facial swelling associated with abscesses. The only way to drain it is via mechanical means and not by chemical means. This means that taking medication will not work because you need to physically drain the infection.
Abscesses are drained by making an incision directly into it with a sharp scalpel. Then the infection is squeezed out and irrigated afterwards. All of this requires your dentist to provide physical treatment.
Facial swelling will not reduce without drainage
Untreated dental abscesses will eventually lead to your face becoming swollen. Antibiotics cannot bring the swelling down without draining the abscess because the swelling is filled with pus. That abscess needs to be popped and drained in order for the pus to come out. As long as the pus remains in the swelling, your face will stay swollen.
If you simply try to take antibiotics without draining it first, you'll most likely notice that your face will stay swollen even after a few days of taking antibiotics.
Antibiotics don't treat the source of the tooth abscess
The source of a tooth abscess usually stems from an infected nerve, which requires physical removal from the tooth. Antibiotics are unable to get rid of the infected dead nerve from the tooth.
There are only two ways to remove an infected nerve from a tooth abscess:
Root canal. This procedure requires your dentist to separate the dead nerve from the tooth. The tooth stays in the mouth but the nerve leaves the tooth. The infected nerve tissue must be removed because if it stays inside the tooth, it will continue to produce more pus and that exacerbates the swelling.
Tooth extraction. An alternative would be to remove the entire tooth from the mouth. Since the infected nerve is inside of the tooth, it will come out during the extraction. This option is more aggressive and it is usually reserved for a tooth that is too infected to be salvaged.
An infected nerve from an abscessed tooth must be physically removed and antibiotics are unable to do that. The most that it can do is to kill the bacteria around the abscess to at least slow down the progression.
Unless you remove the source of the abscess, which is the dead tooth nerve the infection will continue to grow and cause more swelling.
Antibiotics are an adjunctive therapy for abscessed teeth
Despite antibiotics not possessing the capability to drain the abscess nor treat the source of it, it is still useful as an adjunctive therapy. This means that antibiotics should be used in conjunction with draining the abscess and treating the source of the infection.
Therefore you should have the infection drained first and then have the source of it treated with either a root canal or tooth extraction. However during the entire process, you can be on antibiotics in order to help the infection clear out faster.
Effects of taking antibiotics alongside other treatment:
Manage the swelling
Prevent the infection from getting worse
Clear out the existing infection
Assist in reducing the inflammation and pain
Just to reiterate the point, antibiotics ARE useful but only if they are used alongside other treatment. If you try to just use it on its own, it won't provide much benefit. Your face will simply stay swollen from the tooth infection.
How to prevent dental abscesses
A tooth abscess does not miraculously appear overnight because they typically start off as a small problem like a small cavity. These small problems are often left untreated and allowed to grow and progress. They eventually become a big problem by progressing through the stages of a tooth abscess and causing your face to swell up.
The best way to prevent it is to take care of your teeth and try to catch these small problems early to treat it. Here are some tips on how to do that:
Oral hygiene. Remember to stay diligent and brush your teeth for at least 2 minutes twice a day. Try your best to floss and use some mouthwash prior to going to bed. You want to keep your mouth as clean as possible before sleeping.
Minimize sugar. Try your hardest to avoid carbohydrates and sugar whenever possible. If you're unable to then try to reduce the amount that you eat. The reason is because all the cavity causing bacteria in your mouth all process sugar in order to form decay in your teeth. If you deny them the fuel to work then you will decrease the likelihood of getting tooth decay.
Dental check ups. It is of utmost importance to go in for your routine dental check ups so that you can catch all potential small problems. If you do manage to spot one, try to have it addressed and treated as soon as possible so that it Stay vigilantdoesn't grow into a big problem later on down the road.
Stay vigilant. If you notice something wrong with your teeth or in your mouth, don't just assume that it'll go away on its own. you should be proactive and schedule a dental consultation even if you're not due for an exam yet. It is better to have it checked out and know that there is nothing wrong, rather than wait to see if it starts to hurt you. Hope is not a strategy!
Unfortunately taking antibiotics by itself will not get rid of a tooth abscess. The only way to cure it would be to have the abscess drained along with getting either a root canal or extraction.
Nonetheless, that is not to say that antibiotics are completely useless because they are useful as an adjunctive therapy. You should be taking them (if your doctor recommended it) alongside the other treatments for the abscess. What it will do is help clear out the infection from your body a lot faster. It also has a lot of other benefits such as controlling the swelling and assisting in reducing inflammation.
The point that we are mostly trying to make is that you should see a dentist as soon as possible if you do have an abscess. Don't just try to take some left over antibiotics from the year before to see if it will do anything. It most likely will have very little effect.
Author: Written by Dr David Chen, an emergency dentist in long island city, NY.