How Long After Starting Antibiotics Will My Tooth Pain Go Away?

It may take a few days after starting antibiotics for tooth pain to go away. Pain relief is just one reason why your healthcare provider may prescribe antibiotics to treat a tooth infection, which occurs when bacteria lead to an abscess (pocket of pus) most often located in the soft, living tissue inside a tooth, called the pulp.

Serious infections require antibiotics because they can spread to the surrounding bones and become life-threatening. If the infection hasn't spread to nearby teeth, however, your dentist may decide not to prescribe antibiotics because of concerns about side effects or avoiding antibiotic resistance.

This article explains how a tooth infection is diagnosed and why antibiotics may be used in treating tooth infections. It offers information about prevention and common home remedies for a tooth infection.

When Are Antibiotics Used for a Tooth Infection?

Tooth infections don’t always require antibiotics. In many cases, they may clear up on their own. Rinsing with warm saltwater or taking over-the-counter medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs), may help to reduce tooth pain and swelling.

The American Dental Association (ADA) recommends that dentists avoid prescribing antibiotics for most tooth infections due to potential side effects. Dental treatments, such as drainage, deep cleaning, or a root canal (removing the infected pulp from the tooth), may sometimes be necessary.

However, your dentist may prescribe antibiotics if you are immunocompromised (have a weakened immune system) or if your tooth infection is spreading. Some of the signs that your tooth infection is getting worse may include:

• Fever
• Fatigue
• Malaise (a general “ill feeling”)
• Swelling in the jaw or neck
• Intense pain or swelling that does not go away

If left untreated, a tooth infection may spread to the surrounding bones and tissues. This can lead to serious health complications, including:

• Tooth loss
• Blood infection
• Pneumonia (lung infection)
• Brain infection
• Endocarditis (infection in the heart)

If you have a severe tooth infection, your dentist may prescribe a course of antibiotics to prevent it from spreading. Antibiotics may prevent tooth loss and other serious health complications.

What Kind of Antibiotics are Used For Tooth Infections?

The goals of taking antibiotics for a tooth infection are to prevent tooth loss and other serious health complications. Your dentist can determine the need for antibiotics after diagnosing a tooth infection through a physical examination, pain assessment, and imaging tests, such as dental X-rays. 

According to the ADA, the first-line antibiotics for a tooth infection include: 

• Oral amoxicillin
• Oral penicillin V potassium

Amoxicillin and penicillin V potassium are both in a class of antibiotics known as penicillin-type drugs. They work to fight infections by killing bacteria or stopping its growth. Penicillin-type drugs won’t work to treat viral infections. 

If you are allergic to penicillin-type drugs, your dentist may prescribe one of the following antibiotics instead:

• Oral azithromycin
• Oral clindamycin
• Oral cephalexin

Azithromycin, clindamycin, and cephalexin are all commonly used to treat bacterial infections.

Dosages depend on the type of antibiotic used. Oral azithromycin doses begin at 500 milligrams (mg) per day, while oral cephalexin doses typically are at 500 milligrams, four times per day. A full course runs from five to seven days, sometimes up to 14 days.

In some cases, your dentist may prescribe another type of antibiotic, such as:

• Augmentin (amoxicillin with clavulanate)
• Flagyl (metronidazole)

These drugs are typically prescribed if other antibiotics don’t work to treat your symptoms or if your tooth infection begins to spread.

It’s important to take antibiotics exactly as prescribed, even if you start feeling better quickly. If you stop taking antibiotics too early, your infection may linger. You could also raise your risk of developing a bacterial infection that is resistant to antibiotics.

Are There Side Effects of Antibiotics?

Some of the most common side effects of antibiotics may include:

• Nausea
• Headache
• Diarrhea
• Yeast infection
• Changes in taste 

Seek immediate medical help if you experience any serious side effects while taking antibiotics, such as:

• Rash
• Difficulty breathing
• Wheezing
• Hives
• Peeling skin or blisters
• Swelling (edema) in the face, eyes, or mouth 
• Stomach cramps
• Joint pain
• Worsening signs of a tooth infection
• Fever

Allergic reactions to penicillin drugs are common. If you have a history of allergy symptoms (such as hives, swelling, or low blood pressure) after taking penicillin-type drugs, let your dentist know. They may prescribe a macrolide antibiotic, such as clindamycin, to clear up your infection. 

How to Prevent Tooth Infections

A tooth abscess may sometimes be caused by a cracked or chipped tooth, an injury, or failed dental work. However, in most cases, tooth infections are caused by tooth decay. 

The best way to prevent a tooth infection is to practice good oral hygiene. Here are some ways to protect your teeth from cavities and gum disease: 

• Brush your teeth at least twice a day with fluoride toothpaste.
• Floss or use interdental brushes regularly to remove hard-to-reach plaque from between your teeth.
• Limit your sugar intake, especially between meals.
• Visit your dentist regularly for cleanings and check-ups.

Summary

A tooth infection is a pocket of pus that develops inside a tooth's pulp due to the multiplication of bacteria. Tooth infections are usually caused by tooth decay, failed dental work, broken or chipped teeth, or injury.

Not all tooth infections require treatment with antibiotics. However, a dentist may sometimes prescribe antibiotics to save the tooth and prevent the infection from spreading. The most common antibiotics used to treat tooth infections are penicillin-type drugs.

Possible side effects of antibiotics for tooth infections may include nausea, diarrhea, yeast infection, changes in taste, and headache. More serious side effects, such as rash, hives, swelling, joint pain, and fever, require immediate medical attention.