Antibiotics for toothache: what, when and why?


When to take an antibiotic for teeth

Antibiotics are drugs that are used to treat bacterial infections.
It is important to note that we are talking specifically about bacterial diseases, not viral or fungal ones. Antibiotics are powerless against viruses or fungi. Therefore, if we are talking about a viral or fungal disease, then in such cases it is appropriate to use antiviral and antifungal drugs, respectively. Antibiotics are also used in dental practice when a tooth hurts. At the same time, it is important to understand in which cases the pain is of infectious (bacterial) origin, and in which – non-infectious.

A common type of toothache is due to pulpitis. It occurs when caries has already eroded the top layer of enamel. The resulting hole reaches the pulp of the tooth, which is why the latter begins to hurt when exposed to various irritants - thermal, chemical or mechanical. In this case, antibiotics are useless. In order to relieve pain due to pulpitis, anti-inflammatory drugs are used.

In cases where a dead tooth hurts, there is a high probability that the cause is bacteria. As you know, dead teeth (with filled canals) cannot hurt on their own. If such pain occurs, it means that bacteria have grown in the cracks or cavities of the tooth. Microorganisms multiply, infect the gums and lead to the accumulation of pus. The latter exerts pressure, which leads to pain. The above pathology is nothing more than a gumboil. The antibiotic for flux is selected by the doctor after diagnosis. After all, it is necessary to establish the type of pathogenic bacteria so that the antibiotic for flux will work for sure.

Antibiotics in dental practice are also used in the following situations:

  • After surgical operations . Tooth extraction and other surgical interventions are sometimes complicated by an infectious process. To avoid bacterial infection, surgical treatment is accompanied by antibiotic therapy.
  • Periodontal diseases . Advanced variants of periodontal pathologies are sometimes complicated by purulent periostitis (flux). To avoid such developments, treatment of periodontal diseases is sometimes accompanied by the use of antibiotics.

The above cases are not the only ones in which antibacterial drugs are used. These medications are prescribed by the doctor based on the clinical picture, as well as the individual characteristics of the patient. In some cases, antibiotics are also prescribed for preventive purposes - when there is a possibility of a bacterial infection. These risks are assessed by a doctor.

When you can't do without antimicrobials

Dentists prescribe antimicrobial agents if:

  • inflammation is caused by streptococcal or staphylococcal infection;
  • soft tissues in different parts of the oral cavity are infected;
  • purulent complications should be urgently prevented or eliminated;
  • inflammation progresses despite treatment;
  • The patient came to the dental clinic with advanced disease.

Since there is not always time to identify the causative agent of the disease, doctors usually select broad-spectrum antibacterial drugs. They quickly cope with negative symptoms.

Antibiotics for gumboil and toothache: types of drugs

Today in dental practice various antibiotics are used for gumboils and toothache. Let us remember that antibiotics are usually divided into classes. Let's look at the most popular types of antibiotics for purulent gum disease.

Nitroimidazoles

Nitroimidazoles are synthetic antibacterial drugs that exhibit high activity against anaerobic microorganisms (bacteria living in conditions without oxygen). The most popular drug in this group is metronidazole, which has been used since the 60s of the last century.

The mechanism of action of nitroimidazoles is associated with disruption of DNA replication and protein synthesis of microbial cells. Such violations are incompatible with the life of the bacterium.

Representatives of this group of antibiotics are active against most anaerobic bacteria (both gram-positive and gram-negative). Some types of protozoan microorganisms and the bacterium Helicobacter pylori are also sensitive to nitroimidazoles. The latter is the cause of the development of gastritis and gastric ulcers (as well as tumor lesions of the mucous organs of the gastrointestinal tract).

Fluoroquinolones

This is a group of drugs that exhibit antibacterial activity against a wide range of bacteria. It is noteworthy that fluoroquinolones are not considered antibiotics in the classical sense of the word. The fact is that antibiotics (even synthetic ones) always have analogues of natural origin. Fluoroquinolones have no natural analogue. The most popular representatives of fluoroquinolones include ciprofloxacin, ofloxacin, moxifloxacin, lomefloxacin, levofloxacin and others.

The mechanism of action of fluoroquinolones is reduced to inhibition of a number of important microbial enzymes. This leads to disruption of DNA synthesis and death of the bacterial cell.

Lincosamides

Lincosamides are a group of antibacterial drugs that includes antibiotics such as lincomycin and clindamycin. The mechanism of action of lincosamides is reduced to suppressing protein synthesis in bacterial walls.

Why you can’t self-medicate

Antimicrobial agents alone are not able to cure gumboil. Therefore, there is no point in carrying out antibacterial therapy at home and postponing a visit to the dental clinic. Drug treatment begins after cleansing and filling the roots, draining the inflammatory focus. Therefore, what precedes it:


  1. Opening the crown of a diseased tooth.
  2. Placement of a special composition into the carious cavity and installation of a temporary filling.
  3. Removing temporary filling material, cleaning and closing the canals.
  4. Fixation of a permanent filling.

At the same time, an incision is made in the gum in the area where the “bump” is located so that the pus comes out naturally.

Antibacterial agents are only one of the stages of complex therapy for inflammation of the periosteum of the jaw. It is often possible to do without them. To do this, you do not need to wait until the pain becomes unbearable and the gums become swollen. It is recommended to go to the dentist immediately - as soon as a purulent “bump” appears or a tooth begins to ache.

Antibiotics for tooth root inflammation

For toothache caused by inflammation of the tooth root, doctors also prescribe fluoroquinolones (as for gumboil). In addition, for inflammatory pathologies of the tooth root, antibiotics of the penicillin and tetracycline series are also used. Let's take a closer look at them.

Penicillins

These are the first antibiotics that were discovered by Alexander Fleming in 1928. The main mechanism of action of penicillins is bactericidal. These drugs disrupt the synthesis of peptidoglycan, a component of the bacterial cell wall. This leads to the death of the bacterium.

Currently, different types of penicillin antibiotics are used in dental practice. The most common are amoxicillin and ampicillin.

Tetracyclines

Another class of antibiotics that was discovered a long time ago - back in the 40s of the last century. Tetracyclines act against a wide range of bacteria, both gram-negative and gram-positive microorganisms. The mechanism of action of tetracyclines is inhibition of protein synthesis in bacterial cells. Microorganisms stop synthesizing vital proteins, which is why they die.

How long do antibiotics work for toothache?

The therapeutic effect of antibiotics occurs within the first three days. If relief does not occur during this time, then a decision is often made to prescribe another drug.

The minimum course of antibiotics is 5 days. In this case, an individual course of therapy is established for each patient depending on a number of factors.

Sometimes antibiotics do not work and the patient does not feel a therapeutic effect from taking them. Let's consider typical cases when antibacterial drugs do not work:

  • Insufficient dose of medication . When carrying out antibiotic therapy, strict adherence to the dosage is an important condition. If you take less than what your doctor prescribed, there will be no effect. In other words, there was not enough active substance to suppress pathogenic flora. Please note that the dosage of the antibiotic also depends on the age and weight of the patient. The heavier the patient, the more drug is required to achieve the required drug concentration in the blood.
  • Insufficient duration of therapy . Strictly adhere to the regimen and duration of taking the drug. Some patients, feeling relief, decide to interrupt the course, which makes a mistake. Premature interruption of the course of antibiotic therapy is fraught with the development of antibiotic resistance - resistance of pathogenic and opportunistic flora to antibacterial drugs.
  • Some concomitant diseases . Before prescribing medications, the doctor must have comprehensive information regarding the patient’s health. It is important to inform your doctor about all chronic and recent acute diseases that may affect the effectiveness of antibiotic therapy.
  • Antibiotic intolerance . The patient may have individual intolerance to some types of antibiotics. Don't despair. If one antibiotic is not suitable, then there is always an alternative antibacterial drug. Sometimes a patient has problems taking an antibiotic orally (in the form of tablets, capsules or solutions). In such cases, a decision is made to inject antibiotics, bypassing the gastrointestinal tract.
  • Interaction with other active substances . The doctor must be informed about the medications the patient is taking. Some drugs cannot be taken together with antibiotics, as they neutralize the effect of the latter. In addition, drinking alcoholic beverages is prohibited during antibiotic therapy. Otherwise, the treatment will not bring the desired effect.

The use of antibiotic therapy during pregnancy and lactation

Most antimicrobial agents are prohibited for use by expectant mothers and during breastfeeding. When prescribing antibiotics to suppress the purulent-inflammatory process in the gums and periosteum, the doctor takes into account the benefits for the woman and the possible risk for the developing fetus.

With the active spread of infection, suppuration, development of sepsis, severe complications against the background of the pathological process, it is possible to take certain groups of antibacterial agents. The new generation of antibiotics is less toxic to the fetus.

Under strict medical supervision, in the minimum effective dose, the following is prescribed:

  • Ornidazole;
  • Metronidazole;
  • Josamycin;
  • Azithromycin;
  • Clarithromycin;
  • Clindamycin;
  • Cefepime;
  • Ceftaroline.

The list of approved drugs is indicated by the dentist. The best option is to additionally consult with a gynecologist managing the pregnancy.

Anti-tuberculosis antibiotics are allowed to be used by pregnant women in combination with other drugs according to a specific regimen for a long period.

What you need to know when taking antibiotics

Let's consider some facts about antibiotics that will help the patient avoid mistakes during antibiotic therapy:

  • Taking antibiotics should not be combined with alcohol . Doctors prohibit drinking alcohol because alcohol increases the likelihood of side effects. It has been established that drinking alcohol during antibiotic therapy increases the likelihood of headaches, abdominal pain, tachycardia, and increased blood pressure. In addition, alcohol is an additional burden on the liver, which is already having a hard time coping with medications. Thus, drinking alcoholic beverages increases recovery time.
  • Antibiotics, orange juice and milk . Few people know about this, but it is not advisable to take antibiotics with fruit juices (in particular, orange, grapefruit, apple or pineapple), as well as milk or dairy products. This is due to the fact that the above drinks impair the absorption of antibiotics. For this reason, the effectiveness of antibiotic treatment deteriorates. Therefore, after taking medications, refrain from drinking juices and milk for at least 3 hours.
  • Antibiotics with meals . Some types of antibiotics should be taken on an empty stomach. For others there are no strict restrictions, and they are allowed to be taken with food. Read the medication instructions carefully and consult your doctor regarding your medication regimen.
  • Medicines and antibiotics . The instructions for the antibiotic contain a list of drugs with which it is undesirable to combine it. Some combinations may weaken the effect of the antibiotic or increase the likelihood and intensity of side effects.
  • Proper distribution of the antibiotic dose . The frequency of antibiotic intake per day is directly related to its effective concentration in the blood. For example, if the instructions say that the drug should be taken once a day, this means that after administration it remains effective for 24 hours. Thus, you need to take the antibiotic a second time the next day, at about the same time. If the instructions say that you need to take the drug 2 times a day, then the interval between doses should be 12 hours; if 3 times a day, the interval should be 8 hours.

Contraindications to treatment of flux with antibiotics

It is prohibited to use antimicrobial agents that are contraindicated for the patient. Pregnant and lactating women are prescribed medications in this group only if the benefits expected for the mother outweigh the possible risks to the fetus. For young children with weakened immune systems, they always try to eliminate inflammation of the oral tissues without antibiotics.

Before starting antibacterial therapy, it is recommended that you carefully read the information provided in the instructions. Side effects, contraindications, and maximum daily dosages are indicated there. This data is very important. It is unacceptable to ignore them. If you have any questions regarding drug correction, you should consult your dentist.

Adverse reactions from antibiotics

Antibiotics, like other medications, have side effects. Let's look at the most common problems that patients encounter from taking these drugs:

  • Digestive problems . This is due to a disruption of the normal microflora. Antibiotics affect not only pathogenic and opportunistic flora, but also normal flora. A change in the balance of microflora leads to the development of gastrointestinal disorders. In particular, this is diarrhea, bloating, and sometimes constipation.
  • Allergic reactions . After taking antibiotics, some patients experience allergic reactions. These include skin rash, runny nose, sneezing, watery eyes and swelling. In severe cases, severe allergic reactions, including anaphylactic shock, are possible. It is noteworthy that disruptions in the functioning of the immune system (and associated allergic reactions) are often a consequence of intestinal disorders. Let us remember that a huge number of intestinal bacteria are directly involved in the functioning of the immune system.
  • Headache . This is a relatively common side effect of taking antibiotics. Some patients who have never previously complained of headaches experience this symptom while taking antibiotics.
  • Sensitivity to the sun . While taking antibiotics, it is not recommended to sunbathe or visit solariums. This is due to the fact that some antibacterial drugs act as photosensitizers - photosensitive components. This significantly increases the likelihood of getting a burn.
  • Fungal infections . Since antibiotics also suppress the normal flora of the mucous membranes, this increases the likelihood of developing fungal infections. For example, oral candidiasis (thrush) is often caused by taking antibiotics.
  • Teeth staining . Another problem caused by antibiotics is tooth pigmentation. Most often, this problem is encountered by patients taking tetracycline antibiotics. In some cases, such staining is irreversible, especially in childhood.
  • Other side effects . The range of adverse reactions from antibiotics is not limited to the above effects. While taking these medications, the patient may experience joint pain, double vision, problems with the liver and kidneys (due to intoxication), and even depressed mood and depression.

Symptoms

The main manifestations of gumboil disease are pain in the area of ​​the causative tooth and the appearance of swelling in the soft tissues of the face. If at the beginning of the disease the swelling is mild, then as the process progresses the swelling increases and can spread to the eye area, scalp or neck. As the symptoms of flux increase, pus from under the periosteum can spread through the fatty spaces closer to the skin - this is manifested by the fact that the skin turns red, becomes dense and hot to the touch. Further, the skin in the center of the flux softens, becomes thinner, and a fistula with purulent discharge may appear. In this case, pain may decrease somewhat, which is associated with a decrease in pressure in the flux cavity during the formation of a fistula tract.

In addition to pain, symptoms such as limited mouth opening or inability to open the mouth, and pain when swallowing may occur. If the flux is located deeply, facial swelling may be mild or not expressed at all, and the main manifestations will be limitations in mouth opening, pain in the flux area and pain when swallowing.

Other ways to treat dental and oral infections

The advisability of antibiotic therapy is determined solely by the doctor after diagnosis. In some cases, it is impossible to do without antibiotics, since it is not possible to get rid of the pathogenic infection in other ways.

In some cases, for inflammatory pathologies of the teeth and oral cavity, antiseptic drugs and anti-inflammatory drugs can be used. Folk remedies, for example, rinsing with herbal decoctions, have also proven themselves to be quite effective in the treatment and prevention of inflammatory diseases of the oral cavity. However, remember that traditional medicine cannot be used as the main type of treatment. They can be used as an additional measure to the main treatment.

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