Dental Health Dental Conditions Antibiotics for Tooth Infection: What You Should Know By Laura Dorwart Laura Dorwart Laura Dorwart is a health journalist with expertise in disability rights, mental health, and pregnancy-related conditions. She has written for publications like SELF, The New York Times, VICE, and The Guardian. Learn about our editorial process Published on March 23, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Edmund Khoo, DDS Medically reviewed by Edmund Khoo, DDS Edmund Khoo, DDS, is board-certified in orthodontics and is a Diplomate of the American Board of Orthodontics. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents When Used Taking Antibiotics Common Antibiotics Side Effects Prevention Frequently Asked Questions A tooth infection is a pocket of pus (abscess) caused by the proliferation of bacteria. Usually, an abscess appears in the pulp—the soft, living tissue inside a tooth. A periapical abscess develops from an infection in the pulp that forms an abscess at the root of a tooth, while a periodontal abscess develops between the tooth and the surrounding gum tissue. Symptoms of a tooth infection may include a severe toothache, sensitivity to heat and cold, swollen glands, swelling in the gums, foul-smelling breath, and pain while chewing. If the infection spreads to the surrounding bones, it may become life-threatening. Your dentist may prescribe antibiotics to clear up your tooth infection. Learn more about antibiotics for tooth infections, including why they are used and how fast they work. Athima Tongloom / Moment / Getty Images 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. When to See a Dentist It’s important to seek dental treatment right away if you suspect you might have a tooth infection. Make an appointment with your dentist if you have a toothache that doesn’t go away, if your gums are red and inflamed, or if you notice a pimple-like bubble along your gum line. Taking Antibiotics Your dentist can diagnose you with a tooth infection with a thorough physical examination. Your healthcare provider may tap your teeth or ask you to bite down to assess your level of pain. They may also perform imaging tests, such as dental X-rays. If your tooth infection is severe or persistent, your dentist may prescribe antibiotics. The goals of taking antibiotics for a tooth infection are to prevent tooth loss and other serious health complications. 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. Penicillin, Amoxicillin, and Cephalosporin Allergy: What to Know Dosage The current ADA recommendations for antibiotic dosage for tooth infections are as follows: Oral amoxicillin: 500 milligrams (mg), three times per dayOral penicillin V potassium: 500 milligrams, four times per dayOral azithromycin: 500 milligrams on the first day, followed by 250 milligrams for four daysOral clindamycin: 300 milligrams, four times per dayOral cephalexin: 500 milligrams, four times per day Duration These are the current ADA recommendations for the duration of a course of antibiotics for a tooth infection: Oral amoxicillin: Three to seven daysOral penicillin V potassium: Three to seven daysOral azithromycin: Five daysOral clindamycin: Three to seven daysOral cephalexin: Three to seven days Some of your tooth infection symptoms should begin to clear up after two to three days. However, it’s important to take the full course of antibiotics as your dentist prescribes. Taking Antibiotics 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. Common Antibiotics Used for a Tooth Infection Penicillin-type drugs, such as amoxicillin and penicillin V potassium, are typically the first-line antibiotics that dentists prescribe to treat a tooth infection. However, allergic reactions to penicillins 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. 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. Side Effects Some of the most common side effects of antibiotics may include: NauseaHeadacheDiarrheaYeast infectionChanges in taste Seek immediate medical help if you experience any serious side effects while taking antibiotics, such as: RashDifficulty breathingWheezingHivesPeeling skin or blistersSwelling in the face, eyes, or mouth Stomach crampsJoint painWorsening signs of a tooth infectionFever Should I Go to a Hospital or a Dentist for My Dental Emergency? Prevention 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 (such as amoxicillin and penicillin V potassium). Clindamycin, azithromycin, and cephalexin are options for people who have a history of allergies to penicillin. If first-line drugs don't work, metronidazole may be prescribed. 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. A Word From Verywell When tooth pain starts you may be tempted to delay calling a dentist. But a tooth infection can lead to serious health complications if left untreated. Talk to your dentist right away if you suspect that you have a tooth abscess. Frequently Asked Questions How long does it take for antibiotics to reduce swelling from tooth infection? In many cases, you’ll start feeling better about two to three days after you start taking antibiotics for a tooth infection. However, you should take the full round of prescribed antibiotics. Usually, your dentist will prescribe an antibiotic for three to seven days for a tooth infection. How can I tell if the antibiotics are working for tooth infection? If your antibiotics are working, the symptoms of your tooth infection will begin to subside. Your fever, fatigue, pain, and/or swelling will decrease. If your symptoms persist or get worse, contact your dentist right away. Are there any natural antibiotics for a tooth infection? The most popular natural treatment for a tooth infection is a warm saltwater rinse. Other home remedies for a tooth infection may include baking soda, garlic, hydrogen peroxide, aloe vera gel, herbal tea, or essential oils (such as oil of oregano or tea tree oil). However, if you have a tooth infection, you should still make an appointment with your dentist. Where can I buy antibiotics for a tooth infection? The most common antibiotics for a tooth infection include amoxicillin, penicillin, azithromycin, clindamycin, cephalexin, and metronidazole. Antibiotics have to be prescribed by a healthcare provider, such as a dentist. You may be able to get a prescription more quickly via a telehealth visit. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Dental Association. Abscess tooth. Scholes Family Dental. What is the difference between a periapical and periodontal abscess? MedlinePlus. Tooth abscess. American Dental Association. Antibiotics for dental pain and swelling guideline. 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