A Toothache That Is Worse After an Antibiotic

According to the American Academy of Family Physicians (AAFP), dental emergencies are extremely common and cause missed time at work and school 1. Most emergencies are the result of a severe toothache. Analgesics and antibiotics are frequently prescribed to relieve the pain. A toothache that is worse after an antibiotic has been prescribed may be distressing, but it is a definite possibility.

Time

Oral medications, such as antibiotics, must have time to reach sufficient levels in the bloodstream to be effective. Those prescribed for dental infections, such as penicillin and amoxicillin, will take 24 to 48 hours before the benefits are noticed. During this time, it is possible for the toothache to worsen. In these cases, stronger analgesics may need to be prescribed and the antibiotic given more time to work.

Resistance

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Antibiotics are some of the most commonly prescribed drugs by physicians and dentists. The unnecessary use of these medications can result in some bacteria becoming resistant to antibiotics that were effective in the past, according to the American Heart Association. Penicillin was highly effective in treating dental infection for many years. Because of its frequent use and misuse more and more abscessed teeth are not responding as they should. When this occurs, a stronger antibiotic, such as clindamycin, may be required.

Cyst

A long-standing dental infection can cause a periapical cyst to form in the bone surrounding a tooth’s root. These cysts will usually resolve after root canal treatment and antibiotic administration. However, some will not respond to this conservative treatment. According to New York-Presbyterian Hospital, these cysts will require surgical removal so that the bone will heal. It is only after this surgical procedure that some toothache pain will be alleviated completely.

Fracture

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A fractured root is an exasperating dental condition. It is extremely difficult for a dentist to diagnose with complete certainty because they are not visible even with dental X-rays. A fractured root leads to a toothache and subsequent root canal treatment. Regrettably, the tooth will not heal even when antibiotics are employed. The American Association of Endodontists (AAE) concedes that these teeth cannot be saved with endodontic therapy and must be extracted 3. A toothache caused by a fractured root may continue to worsen until it is removed.

Inflammation

Antibiotics are only effective in the presence of bacterial infections. Although some toothaches are caused by an infected dental pulp and the surrounding tissues, others are caused by inflammation. An inflamed dental pulp, known as pulpitis, can cause a severe toothache that will not respond to antibiotics, according to the National Institutes of Health (NIH) 4. Pain will be alleviated only after removal of the inflamed pulp and the administration of anti-inflammatory medications.

Prevention/Solution

A toothache that is worse after an antibiotic has been taken should be reported immediately to the dentist who is treating you. Immediate attention to the persisting problem usually results in quicker healing and pain relief.