Antibiotics For Tooth Infection: Uses, Types & Side Effects

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Medical News TodaySubscribeWhat to know about antibiotics and tooth infections

Medically reviewed by Christine Frank, DDS — Written by Jon Johnson — Updated on February 28, 2024

Antibiotics and tooth infections
Types and dosage
Side effects
How long do they take to work?
Other treatments
Natural remedies
FAQ
Summary

A tooth infection often involves bacteria, and a dentist may prescribe antibiotics in some situations. Examples include amoxicillin, phenoxymethylpenicillin, metronidazole, and clindamycin.

A tooth infection, or an abscessed tooth, generally occurs due to tooth decay. However, it can also develop due to previous dental work or traumatic injury.

When an infection occurs, it causes a pocket of pus to form in the mouth as a result of an overgrowth of bacteria. This infection often causes swelling, pain, and sensitivity in the area.

While some over-the-counter (OTC) pain medications can help with the pain, antibiotics may be necessary to target the bacteria causing the infection.

This article outlines when antibiotics may be appropriate for a tooth infection and explains what antibiotics a doctor might prescribe.

When to use antibiotics for a tooth infection

a black and white photo of a man in bed with toothache — Catherine Falls Commercial/Getty Images

According to a 2023 overview of research, antibiotics are not the first-line treatment for tooth infections.

Instead of prescribing antibiotics, a dentist may be able to drain the infected area, remove the infected tooth, or perform a root canal to fix the issue.

However, dentists may prescribe antibiotics alongside other surgical treatment options if there are signs that the infection is spreading outside of the oral cavity. They may also prescribe antibiotics to those with a weakened immune system.

Due to growing antibiotic resistance, doctors tend only to recommend antibiotics if they are absolutely necessary.

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Antibiotic types and dosages

More than 700 different strains of bacteria are present in the mouth. Many of these bacteria have the potential to grow and cause an infection.

Although antibiotics can help clear a tooth infection in some cases, it is important to use the appropriate antibiotic in each situation.

Treatment may change depending on the bacteria causing the infection. However, dentists may initially recommend an antibiotic that works against many types.

A dentist may initially prescribe one or more of the following:

Antibiotic	Dose in milligrams (mg)	Notes
Amoxicillin	500 mg three times a day for 5 days	A dentist may double the dose for severe infections.
Phenoxymethylpenicillin	500 mg four times a day for 5 days	A dentist may double the dose for severe infections.
Metronidazole	400 mg three times a day for 5 days	A dentist may prescribe this if a person is allergic to penicillin.Alternatively, they may prescribe this antibiotic alongside amoxicillin or phenoxymethylpenicillin.
Clindamycin	150 mg four times a day for 5 days	Due to allergies or drug interactions, clindamycin may be the only alternative to penicillin-class antibiotics. This antibiotic has a higher chance of causing gastrointestinal side effects, so a dentist will consider these risks when prescribing it.

If a person does not respond to the above treatment, a dentist may prescribe:

Antibiotic	Dose
Co-amoxiclav	375 mg three times a day for 5 days
Clarithromycin	250 mg two times a day for 5 days

A dentist may also prescribe azithromycin. Azithromycin works against a wide variety of bacteria, halting their growth.

Dentists may only recommend it to people who are allergic to penicillin-class drugs or who do not respond to them or other drugs such as clindamycin.

According to an older article from 2014, doctors may prescribe 500 mg of azithromycin every 24 hours for 3 days.

Side effects of antibiotics

Although antibiotics can help clear up an infection or prevent an infection from developing after dental work, these drugs have some possible side effects.

Common side effects from antibiotics include:

nausea
diarrhea
rash
yeast infection

More serious side effects include Clostridium difficile infection, life threatening allergic reaction, and anaphylaxis.

However, these side effects can vary with each type of antibiotic. It is important to discuss any possible side effects of taking a drug with a doctor before moving forward with that particular treatment.

Learn more about the side effects of antibiotics.

How long do antibiotics take to work?

How long each antibiotic takes to work varies depending on many factors, such as the severity of the infection and how effectively the drug eliminates the infectious bacteria.

People need to complete a full round of antibiotics, taking all of the prescribed medication exactly as the dentist advises.

Although a person may notice their symptoms begin to go away after a couple of doses, completing the full round of antibiotics helps prevent the infection from returning or getting stronger.

However, a 2021 systematic review says that the infection should begin to clear 2–3 days after taking antibiotics.

Other tooth infection treatments

Antibiotics may help clear the active infection. However, the tooth may need work to keep the infection at bay. This typically means undergoing one or more procedures in the area, such as:

draining the abscess
filling in any cavities
performing a root canal
extracting the tooth

Antibiotic treatment for a tooth infection is just one part of the solution. Most tooth infections require work on the tooth itself to clear up completely.

Natural remedies to ease symptoms

There may be some helpful practices a person can try at home to ease symptoms, such as:

gently rinsing the mouth with warm saltwater
gently rinsing the mouth with baking soda in water
avoiding very hot or very cold foods to prevent sensitivity
chewing with the opposite side of the mouth to reduce additional injury to the area
brushing with a very soft toothbrush around the sensitive area
avoiding very sharp, hard-to-chew foods that may bump into the sensitive area or become stuck in the teeth

Adopting good oral hygiene practices, such as brushing and flossing daily and seeing a dentist for regular checkups, may help prevent tooth infections and their complications.

Tooth infections do not usually go away on its own. A person will require prompt dental treatment.

Frequently asked questions

The following are common questions about antibiotics for tooth pain.

What is the best antibiotic for a tooth infection?

There is no single antibiotic that is best for treating a tooth infection. The type of antibiotic a dentist recommends will vary depending on the bacteria causing the infection.

This is because different antibiotics work in different ways to eliminate different strains of bacteria. However, doctors will often choose amoxicillin as the first-line treatment.

How long does it take for a tooth infection to go away with antibiotics?

After a person begins to take antibiotics, it can take 2–3 days for the infection to begin to clear. A person can finish the entire course of the medication as their doctor prescribes, even if they start to feel better sooner.

Will antibiotics stop tooth pain?

Typically, antibiotics for a bacterial infection show some improvement in pain within a few days.

While taking antibiotics, a person can manage pain with OTC pain relievers such as ibuprofen (Advil) and acetaminophen (Tylenol).

Can a person get antibiotics for tooth infection over the counter?

It is not possible to get OTC antibiotics for a tooth infection. A person with a tooth infection can contact a dentist for appropriate treatment.

Summary

Although antibiotics may help clear up a tooth infection, they are only one part of the solution. Most tooth infections require a dental procedure, such as a root canal or tooth extraction, to completely clear up.

Prompt treatment is important to keep the infection from spreading. Some home remedies may help keep swelling down or ease the pain while taking antibiotics and preparing for the dental procedure.

Dentistry
Infectious Diseases / Bacteria / Viruses
Pharmacy / Pharmacist

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Antibiotic use questions and answers. (2021). https://www.cdc.gov/antibiotic-use/q-a.html
Deo PN, et al. (2019). Oral microbiome: Unveiling the fundamentals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503789/
Erazo D, et al. (2023). Dental infections. https://www.ncbi.nlm.nih.gov/books/NBK542165/
Haque M, et al. (2019). Dental infection and resistance—global health consequences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473604/
Jevon P, et al. (2020). Management of odontogenic infections and sepsis: An update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517749/
Lockhart PB, et al. (2019). Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling. https://jada.ada.org/article/S0002-8177(19)30617-8/fulltext?_ga=2.202287569.1706873426.1649708408-1614335321.1649708408
Oberoi SS, et al. (2014). Antibiotics in dental practice: How justified are we. https://onlinelibrary.wiley.com/doi/full/10.1111/idj.12146
Sanders JL, et al. (2023). Dental abscess. https://www.ncbi.nlm.nih.gov/books/NBK493149/
Teoh L, et al. (2021). Oral antibiotic for empirical management of acute dentoalveolar infections—a systematic review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997333/

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Medically reviewed by Christine Frank, DDS — Written by Jon Johnson — Updated on February 28, 2024

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