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Julian Chen
Julian Chen, Dentist
Category: Dental
Satisfied Customers: 568
Experience:  Practicing General Dentist since 2002
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Infected tooth

Customer Question

Greetings, it appears I have what I believe to be an infected tooth. This has been bothering me for about three days now and I do not have dental insurance until end of November. I need to obtain a fix for this until such time I can get in to see a dentist.

I went to see my primary care doctor and he gave me "Ampicillin TR 500 MG" tablets the insructions were take 2 tables three times a day for 10 days. With a Quanity of 60 pills and a RX for Naperizon (please excuse my spelling on that one) 500MG twice a day.

I have begain to use warm salt water which tastes BLAH and have been doing that 10 times a day or so.

How long does it take the RX to work and take the infection down and the pain down? The tooth is very tender on the top and when I touch the sides. My goal is to get it under control until I have insruance.

Submitted: 8 years ago.
Category: Dental
Expert:  Julian Chen replied 8 years ago.
Hi Ken,

In my opinion, 3000 mg of ampicillin/day is way too much. The usual dosage for dental infections is 500mg (1 tablet) 3x/day, and a 10 day regimen is fine. Over dosing will have other undesirable affects on your gastrointestional tract and other potential complications.

It usually takes 3-4 days before the antibiotics start to have some effect, but discomfort may not be fully relieved pending on how bad the infection is. November is a very, VERY long time to wait having an infected tooth around and not being properly treated. You'll most likely end up with a lot of bone-loss around the tooth, which could cause the tooth to become very loose, and make it unrestorable. When you lose too much bone around a tooth due to infection, the bone loss can be permanent and greatly jeopardize the prognosis of this tooth. It can get to a point where root canal treatment is not even recommended because the tooth will need to be extracted due to insufficient supporting bone.

If allowed to continue without proper treatment, the bone loss will spread and affect the adjacent teeth, jeopardizing the health of those teeth as well.

I understand finances may be tough, and sometimes, we need to make sacrifices. But I would highly encourage that you go and see your dentist, get the tooth examined and treated sooner rather than later.

Depending on the severity of the infection, you may need multiple rounds of antibiotics before you can suppress the infection enough to reduce the pain. However, prolonged antibiotic treatment can potentially lead to antibiotic-resistant strains, making the infection immune to the antibiotics.


Customer: replied 8 years ago.
So would you sugguest cutting the ampicillin down to 3 times a day and 500 MG per time? I don't want to do anything wrong. I agree with sacrifices sadly I just lost my job so my only chance is someone to treat for free which won't happen or try to stick it out until November maybe sooner.

Could I safely go up to 3 times in a day of the (Alieve) Naperizon 550mg Sodium just to help get the imfilation down and such.

I appreciate your advice.
Expert:  Julian Chen replied 8 years ago.
Yes, my recommendation is to reduce the dosage to 500mg, 3x/day (instead of your current 1000mg, 3x/day), and take it for 10 days.

Well, without knowing how severe the infection is, it's hard for me to make some kind treatment recommendation. I'm more concerned with the health/condition of the adjacent teeth and bone supporting those teeth. A chronic infection (which is what this is/will be if allowed to fester for 1/2 year) can lead to substantial bone loss for those adjacent teeth, causing permanent damage, leaving you with localized severe gum disease in the area. I don't know which is the lesser of two evils:
  • Allow the infection to continue untreated for 6 months and suffer the consequences of bone loss, or
  • Proceed with an extraction now so that we can spare the adjacent teeth/bone the damage from the chronic infection.
I tend to think that you can't really put a price on your health. And if there is an infection that goes untreated, then you are jeopardizing your health until it is treated and resolved. Many people live perfectly normal, healthy lives with a few missing teeth. While most people with a chronic infection, suffers some pain/discomfort, as well as overall fatigue and malaise. If I had to choose, I would recommend just getting the tooth pulled and dealing with that consequence later than to have an infection go untreated for 5 months. I mean during the next 5 months, you plan to continue dosing yourself with antibiotics and pain medication? That's a lot of pills to swallow.