Dental infection: on antibiotics but pain is worse? Watch

Anonymous #1
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Hi, so usually I wouldn't be worried when on antibiotics as they can take 48 hours to work. But I haven't had a dental infection before (dentist didn't specify if it was my tooth or gum)...I was put on antibiotics yesterday... but today I feel like my cheek looks/feel swollen and the pain is a lot worse... like I would have expected no change but are they not working if I am worse? My body acts like it's immuno suppressed (autoimmune disease + current vit D definecy) and I've been put on 500mg of amoxicillin for 5 days...I wonder if I should have a bigger dose (as that's the minimum).
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SiminaM
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I had an abscess(after extracting a very deep wisdom tooth) a few weeks ago and I took 2grams(2000mg) of amoxicillin for a week or so. It didn't hurt at all though. Talk to your doctor. Also, for me they made a small cut in my gums so it would drain quickly. I still feel like it's swollen though
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HygieneTherapy15
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If the Amoxicillin isn't working go back to see your dentist and they'll probably prescribe a more specific antibiotic, like Metronidazole.

In the meantime try taking Ibuprofen.

Hope you get well soon xx


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InArduisFouette
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i assume you are taking optimal analgesia as well ... ?

paracetamol or co-codamol and an NSAID as recommened by your dentist or after speaking to a pharmacist
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InArduisFouette
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(Original post by HygieneTherapy15)
If the Amoxicillin isn't working go back to see your dentist and they'll probably prescribe a more specific antibiotic, like Metronidazole.

In the meantime try taking Ibuprofen.

Hope you get well soon xx


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ok ...

i don;t think you are in a position to be giving advice on the choice of antibiotic especially if you think metronidazole is 'specifc' ...
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Etomidate
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(Original post by Anonymous)
Hi, so usually I wouldn't be worried when on antibiotics as they can take 48 hours to work. But I haven't had a dental infection before (dentist didn't specify if it was my tooth or gum)...I was put on antibiotics yesterday... but today I feel like my cheek looks/feel swollen and the pain is a lot worse... like I would have expected no change but are they not working if I am worse? My body acts like it's immuno suppressed (autoimmune disease + current vit D definecy) and I've been put on 500mg of amoxicillin for 5 days...I wonder if I should have a bigger dose (as that's the minimum).
A little more patience may be required here. It's only been one day and the symptoms worsening in that time doesn't necessarily mean they're not working.

In the mean time, make sure you're taking decent painkillers regularly. Go to the pharmacy and get some co-codamol. You can also supplement that by taking a dose of ibuprofen at the midpoint between co-codamol doses (assuming there is no reason you cannot take ibuprofen).
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Anonymous #1
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(Original post by Etomidate)
A little more patience may be required here. It's only been one day and the symptoms worsening in that time doesn't necessarily mean they're not working.

In the mean time, make sure you're taking decent painkillers regularly. Go to the pharmacy and get some co-codamol. You can also supplement that by taking a dose of ibuprofen at the midpoint between co-codamol doses (assuming there is no reason you cannot take ibuprofen).
I'm a patient person... but in the 20 or so times I've been prescribed antibiotics in the last 4 years, I have not got worse whilst on antibiotics before getting better. Hence, the concern.

I've actually been managing okay without pain relief except at bedtime.
I dislike co-codamol because of the side effect. I find co-proxamol much more effective and without side effects (doesn't make me drowsy or constipated) Unfortunately apparently because a lot of people who committed suicide used it, it's no longer available on the NHS.
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HygieneTherapy15
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(Original post by zippyRN)
ok ...

i don;t think you are in a position to be giving advice on the choice of antibiotic especially if you think metronidazole is 'specifc' ...
I gave it as an example, hence why I said 'like', and advised the OP to see a dental professional.


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Sean3000
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If your face is newly swollen I would go back. If there is a source of infection then drainage/removal of tooth might be needed to resolve the infection. As a poster above said, metronidazole might be added as its a good antibiotic for covering 'anaerobes' ie bacteria that live in deep seated tissue without the need for oxygen to reproduce. 500mg of Amox is usually adequate, I assume that is 3 times daily? Either way, with something like this, its impossible to advise effectively over forum.
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Anonymous #1
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(Original post by Sean3000)
If your face is newly swollen I would go back. If there is a source of infection then drainage/removal of tooth might be needed to resolve the infection. As a poster above said, metronidazole might be added as its a good antibiotic for covering 'anaerobes' ie bacteria that live in deep seated tissue without the need for oxygen to reproduce. 500mg of Amox is usually adequate, I assume that is 3 times daily? Either way, with something like this, its impossible to advise effectively over forum.

Yeah I started vomiting this morning and had a fever so insisted it got drained today. Dentist seemed suprised I was worse and seemed to think antibiotics should make infections go away without drainage, but from everything I've read that's not true. She said to maybe see my doctor about more antibiotics as she had limited prescribing power...but again I know my mum has been prescribed a higher dose from a dentist. So confused, still feel feverish but most the pain has gone now

Going to get a root canal on mon. Never had it done before, my mum said since it's a back tooth why do the not just extract it as root canals can go wrong. I didn't know they could go wrong. What's the chances it won't work/ disadvanatge of just having the tooth out? She said as well as the infection I had irreversible pulpitis.
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minor bun engine
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(Original post by Anonymous)
Going to get a root canal on mon. Never had it done before, my mum said since it's a back tooth why do the not just extract it as root canals can go wrong. I didn't know they could go wrong. What's the chances it won't work/ disadvanatge of just having the tooth out? She said as well as the infection I had irreversible pulpitis.
Root canal treatments are around 90% successful, that is not requiring any subsequent retreatment/extraction. It's generally preferable to try and preserve teeth, especially since you are young, and you may find missing a back tooth more uncomfortable than you expect - extraction is always an option down the line if the infection recurs.
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Browniesandcoke
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I'm in the same situation and had to see an emergency dentist today to be told my tooth is dead and I can either have it removed or root canal!!! It's a tooth at the back of the top teeth so I'm tempted to just get it removed as its really painful!!!! I'm scared about root canal! But I don't want to loose my tooth because I'm only 19!
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Anonymous #1
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(Original post by Browniesandcoke)
I'm in the same situation and had to see an emergency dentist today to be told my tooth is dead and I can either have it removed or root canal!!! It's a tooth at the back of the top teeth so I'm tempted to just get it removed as its really painful!!!! I'm scared about root canal! But I don't want to loose my tooth because I'm only 19!

Mine wasn't right at the back (number 5) so I chose the root canal. But my boyfriend had an extraction in november, and he was completely pain free afterwards Good luck!
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Anonymous #1
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(Original post by minor bun engine)
Root canal treatments are around 90% successful, that is not requiring any subsequent retreatment/extraction. It's generally preferable to try and preserve teeth, especially since you are young, and you may find missing a back tooth more uncomfortable than you expect - extraction is always an option down the line if the infection recurs.
Did I just get my parents conned out of money?
I ended up getting the root canal done today privately...
It was a different dentist to who I saw last week as I felt I could afford to miss one day of uni but wasn't planning on travelling back till revision week cause it's quite a trek.

The dentist today said if he did it on the nhs there was only between about a 50 percent chance of it working...if it failed then I was looking at spending upwards of 800 quid for specialist treatment. However, if I got it done privately they used better materials and it was a 90 percent rate. The dentist last week didn't mention this at all? Wish uni wasn't so far away so I could have slept on it/ had a chance to get more informed. I would have gotten it free on NHS with my HC2 certificate. Payed 275 pounds.

I'm on more amoxicillin and metronidozole now... was too out of it to understand why, but looking up there's possibly infection in the bone? In pain (was pain free before root canal) ... my mum kissed me on the cheek goodbye and I pretty much screamed... how long till it subsides?
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Anonymous #1
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(Original post by Browniesandcoke)
I'm in the same situation and had to see an emergency dentist today to be told my tooth is dead and I can either have it removed or root canal!!! It's a tooth at the back of the top teeth so I'm tempted to just get it removed as its really painful!!!! I'm scared about root canal! But I don't want to loose my tooth because I'm only 19!
Oh but just to add... I don't think the actual procedure is that bad as they numb the area. The actual root canal bit hurt a lot less than when they removed the infection last week.... I would actually describe it as uncomfortable rather than painful....for some reason the xray after hurt though (so that was the worst bit).
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minor bun engine
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(Original post by Anonymous)
Did I just get my parents conned out of money?
I ended up getting the root canal done today privately...
It was a different dentist to who I saw last week as I felt I could afford to miss one day of uni but wasn't planning on travelling back till revision week cause it's quite a trek.

The dentist today said if he did it on the nhs there was only between about a 50 percent chance of it working...if it failed then I was looking at spending upwards of 800 quid for specialist treatment. However, if I got it done privately they used better materials and it was a 90 percent rate. The dentist last week didn't mention this at all? Wish uni wasn't so far away so I could have slept on it/ had a chance to get more informed. I would have gotten it free on NHS with my HC2 certificate. Payed 275 pounds.

I'm on more amoxicillin and metronidozole now... was too out of it to understand why, but looking up there's possibly infection in the bone? In pain (was pain free before root canal) ... my mum kissed me on the cheek goodbye and I pretty much screamed... how long till it subsides?
Has to be said, it sounds like he told you that to get you to pay privately. Standard root filling materials can be highly successful when done properly. There are some newer ones which private practices may use but there isn't much research indicating they are all that superior. Certainly no where near 50% vs 90% divide.

You would have likely had an chronic abscess surrounding the root of the tooth, although did you have any fever/general signs of illness? Usually antibiotics are prescribed when there is an accompanying fever and such, but if the infection was large it may have been necessary regardless. The area may be swollen and painful for a bit, if it continues after a few days it is probably worth calling up.
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Anonymous #1
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(Original post by minor bun engine)
Has to be said, it sounds like he told you that to get you to pay privately. Standard root filling materials can be highly successful when done properly. There are some newer ones which private practices may use but there isn't much research indicating they are all that superior. Certainly no where near 50% vs 90% divide.

You would have likely had an chronic abscess surrounding the root of the tooth, although did you have any fever/general signs of illness? Usually antibiotics are prescribed when there is an accompanying fever and such, but if the infection was large it may have been necessary regardless. The area may be swollen and painful for a bit, if it continues after a few days it is probably worth calling up.

Well hopefully there won't be a next time, but thank you for that information. I haven't seen evidence for the divide he quoted anywhere either...feel really stupid for believing him. How do you find a good dentist?

(We were with one pretty much all my life but my parents weren't happy with the procedures she did (I'd never had a filling at that point so can't comment). Then the one they moved to, I really didn't get on with (I have TMJD) and she was pretty much yelling at me full volume why couldn't I keep my mouth open wide. So I changed based on online reviews to this practice. I've seen two dentists there...

One doesn't seem very good, not taking xrays at checkup despite the fact I was complaining of a bit of pain where my deep filling was (it was touch and go whether I'd need a root canal two years ago and hadn't had xrays since then) she said it was just my wisdom teeth were coming through (despite that being a different area). So I then came back a week later with the abscess pain. Then the other, I was happy with him last couple of years, but obviously not happy that he seemed to misrepresent the information between private vs nhs... now that I think about it... also two years ago said I needed a scale and polish but had to pay for it privately. The female dentist did it on the NHS.

I had a fever / muscle tiredness last week (they gave me antibiotics then but finished the course sat morning) my glands in my neck are currently tender if that's relevant.
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Anonymous #1
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(Original post by minor bun engine)
Has to be said, it sounds like he told you that to get you to pay privately. Standard root filling materials can be highly successful when done properly. There are some newer ones which private practices may use but there isn't much research indicating they are all that superior. Certainly no where near 50% vs 90% divide.

You would have likely had an chronic abscess surrounding the root of the tooth, although did you have any fever/general signs of illness? Usually antibiotics are prescribed when there is an accompanying fever and such, but if the infection was large it may have been necessary regardless. The area may be swollen and painful for a bit, if it continues after a few days it is probably worth calling up.
Also, is it a normal reaction for my cheek to have swelled up/ pain now in my jaw?
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minor bun engine
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(Original post by Anonymous)
Well hopefully there won't be a next time, but thank you for that information. I haven't seen evidence for the divide he quoted anywhere either...feel really stupid for believing him. How do you find a good dentist?

(We were with one pretty much all my life but my parents weren't happy with the procedures she did (I'd never had a filling at that point so can't comment). Then the one they moved to, I really didn't get on with (I have TMJD) and she was pretty much yelling at me full volume why couldn't I keep my mouth open wide. So I changed based on online reviews to this practice. I've seen two dentists there...

One doesn't seem very good, not taking xrays at checkup despite the fact I was complaining of a bit of pain where my deep filling was (it was touch and go whether I'd need a root canal two years ago and hadn't had xrays since then) she said it was just my wisdom teeth were coming through (despite that being a different area). So I then came back a week later with the abscess pain. Then the other, I was happy with him last couple of years, but obviously not happy that he seemed to misrepresent the information between private vs nhs... now that I think about it... also two years ago said I needed a scale and polish but had to pay for it privately. The female dentist did it on the NHS.

I had a fever / muscle tiredness last week (they gave me antibiotics then but finished the course sat morning) my glands in my neck are currently tender if that's relevant.
(Original post by Anonymous)
Also, is it a normal reaction for my cheek to have swelled up/ pain now in my jaw?
A lot of the benefit in private practice is that dentists generally have much more time to spend with you (unlike a busy NHS practice where they see 30-40 patients a day) and any treatment may as a result be more meticulous. They do sometimes have superior technology (eg. microscopes for root canal treatment) which may improve the outcome to some extent, but you're mostly paying for the clinician's time. Up to you whether you think it's worth it over NHS.

Flare ups do happen after root canal treatment, and it can range from mild discomfort to quite severe pain and swelling. Just see if it starts to go down over the next couple days, usually they do. If not, make an appointment and get it looked at.
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Anonymous #1
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(Original post by minor bun engine)
A lot of the benefit in private practice is that dentists generally have much more time to spend with you (unlike a busy NHS practice where they see 30-40 patients a day) and any treatment may as a result be more meticulous. They do sometimes have superior technology (eg. microscopes for root canal treatment) which may improve the outcome to some extent, but you're mostly paying for the clinician's time. Up to you whether you think it's worth it over NHS.

Flare ups do happen after root canal treatment, and it can range from mild discomfort to quite severe pain and swelling. Just see if it starts to go down over the next couple days, usually they do. If not, make an appointment and get it looked at.

Thank you! Most informative! I wish I could give you more rep
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