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Antibiotics for a Tooth Infection

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I had a tooth infection a couple of weeks ago. I went to see my dentist who prescribed me antibiotics. I’ve taken them. Things were fine at first, but now I think the infection is back and it seems to be getting worse. The point from my tooth is swollen to halfway up my cheek toward my eye. Do I need a refill on the antibiotics or a different antibiotic? I’m not sure what to ask for when I call them.

Liz

Dear Liz,

Woman grabbing her cheek in pain, in need of an emergency Dentist

I am hoping there was some type of miscommunication here between you and your dentist. He should have scheduled a follow-up appointment with you to deal with the infected tooth. Unlike with other infections in the body, antibiotics alone are not enough. Your dentist has to go in there and physically remove the infected pulp. That can be done one of two ways.

Ideally, the tooth is saveable and all your dentist will have to do is a root canal treatment. Sometimes, however, the infection goes too far and the tooth has to be extracted. You may be wondering what the point of the antibiotics were if they would not solve the problem. They are used to help hold the infection at bay until your dentist can do the physical work necessary to obviate the infected pulp. This is why you started to feel better, but then once the antibiotics ran out, your infection returned full force.

I would consider this a dental emergency and call your dentist. If for some crazy reason he thought antibiotics were all he needed to do than you need a different dentist. My guess is he mentioned scheduling a follow up but you were in so much pain you missed it. It’s time to get the work done and get rid of this infection once and for all.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

She Needs a Second Opinion

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I had a toothache for about a week. I know I should have gone sooner, but just to be honest, the dentist makes me quite nervous. When I arrived, he did an x-ray and discovered a tooth that already had a filling had become re-infected. He said only 10% of the tooth is viable and wants to extract it and replace it with a dental implant. I have to admit this idea terrifies me. Is there no way to just do another filling?

Kellie

Dear Kellie,

person hiding behind chair in fear

How would you like to never fear the dentist again?

There are a couple of things going on here that concern me. To answer your question, if your tooth were really that far gone, then an extraction would be the only avenue left to you. Replacing a lost tooth with a dental implant is the best option in that case. However, and this is a big however, I don’t think that is your case. If your tooth were truly that far degraded, he would not have needed an x-ray to determine it. Such a substantial amount of decay would have been visible with the naked eye. In addition to that, the filling you currently had would have fallen out and there would be a gaping hole there. In all honesty, I think you need a second opinion before moving forward.

Let’s say that by some crazy set of circumstances your dentist ends up being right. I doubt it, but let’s just roll with it. Then, you would need the tooth extracted. Leaving it in, turn a dental emergency into a life-threatening one as the infection spread throughout your body.

Dealing wiht Dental Anxiety

It distresses me to see patients in your situation. You want dental care, yet that anxiety keeps you from getting it. The good news is there is a solution, which will enable you to get past that anxiety, caught up on your dental care, and even look forward to going to the dentist.

When you get that second opinion, look for a sedation dentist. This isn’t a specialty, but rather a dentist who offers at least two levels of dental sedation. For a check-up and cleaning, using nitrous oxide is usually enough to relax you. If you need a more extensive treatment, such as a root canal treatment or tooth extraction, you can request oral conscious sedation. This is so powerful, you will need someone to drive you to and from your dental appointment. You will be so completely relaxed that you could sleep through your appointment if you wanted to.

This blog is brought to you by Hilton Head Dentist Dr. Bonnie Rothwell.

Twelve Shots to Get Numb & then More Problems

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I’ve had a nightmare of a tooth extraction. First, it took twelve shots to get me numb. Then, I developed a bone spur after the extraction. I went back to have that removed and now I’m still in pain. There’s also what seems like a bony ridge by the site. What’s going on?

Lucy

Dear Lucy,

Woman asleep in the dental chair from dental sedation

It’s fairly common for sharp edges to surface during the healing process. When your tooth is removed, the socket will have a sharp edge to it. It’s not as noticeable in the beginning because your gum tissue is over it. As it heals, the gum can shrink down and the sharp edge will then be on the surface. If it’s causing pain, your dentist can smooth it over.

I’m a little concerned about the twelve shots of Novocain that were required for you to be fully numb. This can happen for one of two reasons. First, the dentist could have a problem missing the proper injection site. Second, and the more likely scenario, is you have underlying dental anxiety.

Some dentists don’t yet realize how anxiety affects a patient’s ability to get and stay numb. This isn’t your fault and is likely caused by a traumatic experience you had at the dentist in your past. When you get in the dental chair for a procedure, your anxiety kicks in. This, in turn, ratchets up your metabolism enough to burn off your numbing medication. This can make it almost impossible to get numb.

Fortunately, there is a solution.

The Solution to Dental Anxiety

I’m going to recommend you ask your dentist if he or she will provide you with dental sedation. There are usually two levels of sedation available. The first is nitrous oxide. This is a gas you breathe in with a nose piece. It is fairly mild but enough to relax you. For some patients, this is enough to enable the medication to work for you. Once the procedure is over, your dentist will simply switch the gas from nitrous to oxygen and you’ll be up and ready to go in just a few moments. You can carry on with your day as normal.

Other patients, with more extreme anxiety, require a sedation a bit stronger. That is where oral conscious sedation comes in. This is a pill you will take before your appointment. This is very strong. Because of that, you will need someone to drive you to and from your dental appointment. It should be someone you trust because they’ll need to stay with you after your appointment for a few hours, until you are lucid again.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

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