Most people know that it is better to avoid dental infections. Tooth infections are painful, they can cause serious health complications that extend far beyond the mouth and teeth, and antibiotics can ease the pain. Everyone has germs in their mouth. In fact, bacteria cover our teeth, tongue, and every other surface in our mouths. When cracks appear, through cavities, gum disease, or dental damage, bacteria can find their way in and start causing problems. Tooth infection can also affect the tooth itself or cause infection in the root of the tooth and adjacent gums. These infection cavities are called abscesses. Read on to find out what to do if your teeth are giving you trouble. Treatment of tooth infection Treatment for a tooth infection depends on your symptoms and how far the infection has progressed. Most people will need antibiotics and pain relievers. In some cases, people may need surgery to drain the abscess and remove dead tissue. More complicated or widespread infections may require antibiotic treatment for weeks or even months. ### Stages of tooth infection A tooth infection progresses through several stages until it becomes an abscess. Enamel decay. The sticky layer (plaque) that forms between brushing your teeth contains bacteria. Over time, these bacteria release acid that can damage the enamel, or outer layer, of the tooth. In dental caries, bacteria breaks through the outer surface of the tooth and infects the underlying layer. This is the softer layer of tooth enamel, which is also called dentin. The decay by this bacteria moves towards the center of the tooth called the pulp, which is even more vulnerable, and attacks the nerve. If left untreated, the tooth infection can continue to grow and spread outside the center of the tooth. This infection can lead to the formation of a pus-filled pocket called an abscess that gets stuck in the tooth, jawbone, or gum tissue. There are several antibiotics that kill common oral bacteria that cause tooth infections. The best antibiotics for tooth infection are: - Amoxicillin - Penicillin - Cephalexin - Clindamycin - Azithromycin The best antibiotics for tooth infections are known to fight the bacteria most commonly found in your mouth. When your dentist prescribes one of these antibiotics, the choice depends on whether you have a penicillin allergy or other problems. Amoxicillin is often the first choice because it is very effective and has the fewest gastrointestinal side effects. The Dental Association recommends: **Oral amoxicillin (if you are not allergic to penicillin):** 500 mg three times a day for 3 to 7 days. **Oral penicillin (as a second option):** 500 mg four times a day for 3 to 7 days. If you have a history of severe allergy (symptoms of hives, swelling, or hypotension) to penicillin, ampicillin, or amoxicillin, it is recommended to: **Oral azithromycin**: loading dose of 500 mg on day 1, followed by 250 mg for another 4 days. **Oral clindamycin**: 300 mg four times a day for 3 to 7 days. If you have a history of mild allergy to penicillin, ampicillin, or amoxicillin, it is recommended to: **Oral cephalexin**: 500 mg four times a day for 3 to 7 days. If first-line antibiotics are not effective, other antibiotics may be used. They include amoxicillin with clavulanate or metronidazole. ### antibiotic for dental abscess complication Deep neck infection is a dangerous complication of tooth infection when it spreads to the space between the neck muscles. An abscess develops inside the neck. The abscess may swell and block breathing or swallowing. Deep neck infections are treated in the hospital with intravenous (IV) antibiotics along with opening the neck space to drain the abscess. For this type of infection, the best antibiotic may be amoxicillin with clavulanate by injection. The oral antibiotic for a deep neck infection may be changed if a laboratory culture shows that the bacteria are more sensitive to another antibiotic (called culture sensitivity). #### Taking antibiotics If you need antibiotics to treat your tooth infection, taking the full course exactly as prescribed by your doctor will help eradicate the infection. Failure to do so can make recurrent infections more difficult to treat. Antibiotics may have side effects such as: - Rash (a sign of antibiotic sensitivity) - Nausea - Fungal infection - Diarrhea Severe diarrhea may be a sign of an infection in the intestines. This infection occurs when the normal bacteria in your gut are killed by antibiotics and the gut bacteria are controlled. This type of infection is a serious infection that requires immediate treatment. #### Antibiotic resistance Sometimes the antibiotics used to treat the infection do not work well. This may be due to antibiotic resistance, which occurs when the bacteria in your tooth infection are not killed by the antibiotic medication. Overuse of antibiotics in people over time can cause this to happen. In this case, you may have to ask your doctor for another antibiotic. Many dental infections can be treated with dental care alone. Using antibiotics only when needed reduces the risk of bacterial antibiotic resistance. If you only have pain without swelling, your dentist may be able to treat your tooth with a dental procedure without the use of antibiotics. This may involve removing the tissue inside your tooth (pulpectomy) or performing a nerve extraction. If you have symptoms such as pain, swelling, and fever, antibiotics may be part of your treatment along with a dental procedure. Prevention of tooth infection The best way to prevent tooth infection is to visit the dentist regularly and maintain oral hygiene by brushing and flossing. A dentist can help treat dental problems that can lead to infection or pain that may become more severe, such as: - A cracked tooth - Mouth or toothache with swelling or fever - Difficulty swallowing or breathing requires immediate medical attention.