Antibiotics and an abscess

September 5, 2007 3:34 PM

Tooth abscess and antibiotics question

I have a painful abscess on a tooth and have been given antibiotics. Will it speed up the healing if I up the recommended dose/take it more frequently? It hurts like hell.

posted by A189Nut to health & fitness (16 comments total)

That's odd, they usually have to surgically remove the abscess before the antibiotic treatment. Do not take your prescription in any way other than what the doctor prescribed. Taking your antibiotics more quickly can be dangerous at worst and very uncomfortable at best. It won't speed the healing significantly.
posted by IronLizard at 3:42 PM on September 5, 2007

Let me tell you how I know about the drilling. I had an abscess (turned out to be the size of grape) above my upper right incisor. I tried the antibiotics (having an entire bottle at my disposal). Didn't do a damn thing. My dentist later told me they always need to be drilled and drained, otherwise the infection never leaves. If left untreated long enough, these things can kill you (especially those under the top teeth, the infection can reach your brain quickly).
posted by IronLizard at 3:45 PM on September 5, 2007

My experience isn't exactly that of IronLizard's. I had an abscess (that indeed hurt like hell!) above the same tooth. The dentist just gave me an antibiotic script, and within a couple of days the relief was nearly total. Make sure you finish your script though - that's essential. And no, taking more won't help - you gotta take it as prescribed. But there's a good chance it'll help fairly quickly.
posted by Banky_Edwards at 3:55 PM on September 5, 2007

Thanks. My dentist tried to drain it, but it seems not easily accessible. Might need to drill through the tooth to get there, but trying 5 day dose of antibiotics first. Had to endure a flight home with it too.
posted by A189Nut at 3:58 PM on September 5, 2007

That's odd, they usually have to surgically remove the abscess before the antibiotic treatment.

In all the several cases I know of, including my own, antibiotics have been issued before any form of surgery, however minor. I imagine this practice perhaps varies by the severity, however.

In my case antibiotics killed the infection enough for it to calm down and so that anesthetic would work, so that the damaged tissue could be sorted out.

For the OP though.. almost certainly no. The dosage of antibiotics is set quite specifically. The /overall time/ you take it is very important, as if you don't keep it going for the whole time, the bacteria can develop resistance and come back worse! Take it as dosed.
posted by wackybrit at 4:11 PM on September 5, 2007

I was just going to chime in with "just take it as prescribed" when this caught my eye:

Had to endure a flight home with it too.

Christ on a bicycle. You have my sympathies.
posted by ambrosia at 4:19 PM on September 5, 2007 [1 favorite]

You wouldn't believe how well studied antibiotics are. If higher, and fewer, doses worked better, then believe me, that is exactly what you'd get. Doctors love higher & fewer doses, because people are more likely to take an entire 3-day course than, say, a 5 day course. Insurance loves higher & fewer because fewer generally equals cheaper. So take as directed, there is probably a very good reason you got what you did.
posted by selfmedicating at 4:57 PM on September 5, 2007 [1 favorite]

^ Eponysterical.
posted by eritain at 5:22 PM on September 5, 2007

Will it speed up the healing if I up the recommended dose/take it more frequently?

Hell no! The point of antibiotics, with all due respect, isn't to treat your pain; it's to kill the bacteria that are actively creating the abscess. And for this task you should take the drugs exactly as prescribed.

If you need pain relief in addition, go get it. Take loads of Ibuprofen, Tylenol, whatever helps. If nothing OTC helps, ask your dentist for some pain meds too. But don't mess with the antibiotics!

My experience with a dental abscess was a course of antibiotics followed by drilling, so I am less surprised than others that your dentist tried this first. Did he recommend that you come back for a checkup after taking the entire course of antibiotics? If so, of course you should go; if not, you should call him up and schedule such an appointment anyway, to really clean it out once and for all. You may have to get a root canal or even minor maxillofacial surgery - whatever it takes, get the job done, or this will come back to haunt you again and again.
posted by rkent at 5:28 PM on September 5, 2007

2nding it can kill you. And for the pain take 3 ibuprofen, and don't eat or drink anything hot. IANAD, but this is what mine told me.
posted by wafaa at 5:29 PM on September 5, 2007

Don't screw with the antibiotics. Take them as prescribed. They are usually prescribed prior to any dental surgery to try and limit any spreading of the infection, and to get a headstart of the healing process.

Take Ibuprofen regularly (4 OTC = 1Rx), ice your face/jaw if needed, don't chew on that side, etc. If that doesn't work, ask the dentist for stronger painkillers. Any humane one won't have a problem calling in a half dozen or so Percocet.

Your profile doesn't mention if you're male or female. If you're female, keep in mind that antibiotics will fuck with any birth control pills you may be taking. So, forewarned is forearmed. ;) Not that you'll be in the mood to be fooling around...

BTW, IANAD, yada, yada, yada, but recently had a major not-so-fun rootcanal on an abscessed molar. Blech.

Feel better.
posted by dancinglamb at 5:52 PM on September 5, 2007

Thanks folks. Pain developed (after twinges) just before an 8hr flight home to the UK on Monday. Quite intense experience, what with the air pressure in the ear canal thing. Oh, and my ride home from the airport went to Heathrow by mistake, not Gatwick, so I had a three hour train ride too.

Saw my dentist within hours of getting back and yes, he has called me back after the ABs and referred me to a maxillofacial surgeon.

One strange incidental - I bought a tube of oral painkilling toothache gel (benzocaine) and used it liberally on the way back. I just used a dab again and My God did it start the pain throbbing again (it has died down in the course of today.) Why would that be? Makes me wonder if it made it all worse, not better.
posted by A189Nut at 6:28 PM on September 5, 2007

Dentists will prescribe antibiotics for an abscess for two reasons: One is that it might do the trick by itself. The other is that if you end up needing more extensive work, you'll already be pre-treated and ready to go. (They prefer a course of antibiotics before procedures if possible.)

That being said, I've had two root canals over the past 4 years. They are not as bad as they are made out to be. Both were for infections, and once the doc was done, it felt a LOT better. Things hurt a bit from the work, of course, but not nearly as bad as what I'd been fighting with before.

Good luck, man. Dental pain sucks.
posted by azpenguin at 7:11 PM on September 5, 2007

Nthing take the antibiotics as per the doctor's instructions.

Pain-wise, last year I had some fairly hefty problems with dental abcesses myself. Pain-wise, I was prescribed / took a variety of things (paracetamol, ibuprofen, co-codamal, tramadol) (obviously not all at the same time!) but found that they didn't do much - the only thing I found relieved the pain was swishing cold water around the affected area - don't know how this worked but it seemed to work for me (for periods of a couple of minutes at a time).
posted by eb98jdb at 1:29 AM on September 6, 2007

IANAD, but I believe the dosing of antibiotics is related to a cycle linked to the time the liver needs to process the dose. If you take less or space further the time between intakes, the cycle breaks and you could very well be ruining the entire previous intake history (or worse). If you take more than needed, your body will not be able to process them anyway - and oral antibiotics do nasty things to your stomach.

Incidentally, the whole liver / cycle thing also explains why it is a bad idea to drink alcohol while on antibiotics: the liver will process the alcohol first, effectively breaking the antibiotic processing cycle.

I've been there several times. Sometimes the root canal procedure was done right away, sometimes antibiotics were prescribed first. A very virulent infection can indeed make local anesthetic delivery a tremendously painful experience, which might explain why antibiotics are prescribed in those cases. If in doubt, I'd go for root canal surgery ALWAYS. I learned the lesson after finding myself in a remote tropical island with a badly-treated tooth abscess and an associated swollen lymph node on the back of my neck. "You'll be fine - we'll finish the treatment once you come back" has said before the trip he-who-is-not-longer-my-dentist.
posted by magullo at 5:36 AM on September 6, 2007

Oncology RN here who works with many antibiotics: Terribly sorry about your extreme discomfort.

Late to the thread but just wanted to restate please do NOT alter your antibiotic regime in any way. The doctor and pharmacist have probably calculated the doses specifically for you to receive the maximum benefit from the antibiotics at the prescribed dose. Altering it decreases this benefit.

Increasing it runs very serious risks to your liver, especially if you're taking ibuprofen - also very very hard on the liver. Liver toxicity for ibuprofen is generally 4 grams in a 24 hour period. Look at the milligram or gram dose - not the number of pills. You should not be any where near that at any time, especially if you're taking antibiotics. Do not risk your liver. Antibiotic regimes are strict and should be followed completely and to the end. To not do so makes stronger bugs and sicker people. Ask your doc if you have any further questions.

One question you should ask him/her is how to treat your pain. Your pain issues should be addressed as seriously as the infection.

Hope you feel better soon.
posted by dog food sugar at 2:54 PM on September 8, 2007