Yes, even when there's visible swelling, going ahead and extracting the infected tooth right away is still the preferred plan. In some cases, to safely extract a tooth, the patient will need to take antibiotics beforehand. This will eliminate the infection to the point where extraction is safe. However, the infection can often be treated manually if it hasn't progressed too far.
If an abscess has occurred under the tooth, the dentist can make an incision and drain it, then wash the space with saline solution to clean out any remaining infected material. As long as the bacteria is on its way to the nerve in the tooth, the abscess or infection will continue. This is true EVEN IF you don't have pain, swelling, or think you don't have an infection. Antibiotics DO NOT eliminate the infection in this case.
They cannot prevent bacteria from entering the pulp chamber. You should do a root canal or remove the tooth to eliminate the infection. If you have a root canal, the infected tissue is removed, the area cleaned, and then sealed so that no more bacteria can enter. By extracting the tooth, the tooth is removed from the presence of oral bacteria.
In either case, the immune system can then clear up any remaining infections. Right now, most patients believe antibiotics are necessary, however, their endodontist knows otherwise. Due to the anatomy of the tooth, bacteria are trapped in the roots. Without proper cleaning, such as through endodontic therapy, the infection will remain and could spread to the jaw or even the brain.
Draining, cleaning, or possibly even a tooth extraction are needed to completely eliminate a bacterial infection in the teeth. Once a tooth has been extracted, bacteria will still live in the mouth, especially in people who have poor oral hygiene. Infections are very common after extractions. Depending on how bad the tooth that the dentist extracted is, he may prescribe some antibiotics that will greatly reduce the risk of getting an infection.
However, in some cases, even antibiotics can't prevent infection. Dentists will treat a tooth abscess by draining it and eliminating the infection. They may be able to save your tooth with endodontic treatment. However, in some cases, the tooth may need to be removed.
Leaving a tooth abscess untreated can lead to serious and even fatal complications. If you have a very severe abscess, you'll need to use antibiotics to treat the infection before the dentist extracts the tooth. Sometimes, dentists choose to use intravenous sedation or laughing gas, in case local numbness doesn't help. And especially when it comes to an infection with swelling, the treating dentist must weigh the patient's ability to combat and contain that process and adjust their treatment plan accordingly.
While infections can cause a lot of pain and should be treated right away, you may not have to take antibiotics once your dentist has extracted your tooth. Your dentist just needs to find a way to numb the corresponding nerves at a time before they enter the affected tissues. The level of swelling due to an infected tooth may make it difficult or even impossible for the dentist to have the access or visibility they think they should have to remove it. It's important to note that using antibiotics alone won't reliably prevent dental infections from getting worse.
Although it's usually not serious, you should call your dentist and schedule an appointment to have you seen. Dental professionals also look for physical findings, called signs, that indicate the presence of an infection. If you go to the dentist before the extraction, you had swelling of your face, swelling of the gums, pain in your teeth when applying light pressure, or bleeding around the extraction site, then you may already have an infection. Therefore, a dentist or endodontist may prescribe an antibiotic when the infection is severe, has spread to the jaw, or if the patient has a weakened immune system.
If you have a fever and swelling on your face and can't go to the dentist, go to an emergency room. Just because tooth extraction, even in the presence of swelling, is the preferred plan for infected teeth doesn't mean that there aren't issues your dentist should consider on a case-by-case basis before offering to perform your procedure. In general, in routine cases involving healthy people, the belief that removing an infected tooth will cause the spread of infection is not a major concern and, therefore, does not constitute a reason not to proceed to immediately extract the patient's infected tooth. Symptoms of a dental infection include pain, swelling, a visual abscess inside the mouth, tooth sensitivity, bitter taste or bad breath that won't go away, and fever.
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