Therapy of tooth root inflammation with antibiotics

If a tooth suffers from a root inflammation, it is treated with a root canal treatment.

Depending on the severity of the root inflammation, which is usually caused by bacteria, the dentist prescribes additionally an antibiotic for his therapy,

which should support the immune defense of the body.

With a tooth root inflammation, on closer inspection, an inflammatory process develops at the tip (apex) the root of the tooth, which is why it is also known as root tip inflammation (apical Periodontitis).

It is caused by the penetration of bacteria into the tooth tissue. These migrate over the inflamed root canals to the root tip and cause inflammation there.
In some patients, however, bacterial colonization of deep gum pockets is also a trigger for tooth root inflammation (apical periodontal disease).
These deep gum pockets are usually caused by long-term, untreated inflammation of the gums (gingivitis) or in the course of periodontal disease (the disease known as periodontal disease is actually called periodontitis).

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Note: Antibiotics only work against bacteria, not viruses or fungi.

Basically, it should be noted that the treatment of tooth root inflammation with an antibiotic only makes sense if a disease (in this case a Root inflammation) caused by bacteria.
Antibiotics have no effect against viruses or fungi.

However, since in about 99% of the cases of tooth root inflammation it can be assumed that tooth root inflammation (apical periodontal disease) is triggered by bacterial infestation, the administration of an antibiotic is in no way wrong.
Nevertheless, taking an antibiotic always inevitably leads to side effects. Many patients report diarrhea that can be traced back to the harmful effects of the antibiotic on the intestinal flora.

This means that the extremely important bacteria that occur in the intestine are also combated by the drug. Furthermore, allergies or fungal infections can occur in connection with antibiotic therapy.

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The attending dentist should therefore carefully weigh up whether the tooth root inflammation must be treated by taking an antibiotic orally or whether it might not be sufficient to inject an antibacterial drug into the tooth root.

However, in the course of a root tip resection or tooth extraction, the maxillary sinus can open. This often occurs in patients with very long roots of the molars in the upper jaw, as these tooth roots can extend into the maxillary sinus. If such a tooth is now pulled or its root tip removed, a connection is created between the maxillary and oral cavity. It is important to prevent bacteria that live inside the oral cavity from migrating into the maxillary sinus. For this reason, taking an antibiotic is inevitable in this case.

Which antibiotic should be used for tooth root inflammation?

Which antibiotic the dentist chooses depends on a number of factors. Play an important role here Allergies. There are people, for example, on the active ingredient penicillin allergic to Rash, shortness of breath or something similar.

If this is the case, it is essential that the attending physician find out about it, otherwise it can be life-threatening. There are then other active ingredients that can be used, e.g. Clindamycin. The spectrum of pathogens, i.e. the type of bacteria that reside in the body, is also important for the decision. There are specific antibiotics for each species that have a targeted effect. In the dental field, the active ingredient has become Amoxicillin proven. This works particularly well against inflammation inside the body. But also will continue Penicillin V or Erythromycin. used. As a rule, the attending physician informs himself about previous intake and intolerance before prescribing and will only then decide on the right remedy.

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What to do if the antibiotic doesn't work

When an antibiotic doesn't work, there can be several reasons. Either the drug does not work against the pathogen or the duration of use was simply too short. It is normal that the pain does not improve immediately after the first tablet within an hour, as is known from pain medication. Mostly it takes time up to three daysuntil you can feel the first successes.

However, if this time is exceeded or the swelling gets worse and worse, then the most important thing is to go back to the dentist immediately or to the emergency service at the weekend! The Otherwise, inflammation can spread rapidly and cause permanent damage. Under no circumstances should self-therapy be carried out. There are no healing home remedies that can still help in this case. The pain can be relieved a little to bridge the time until the dentist's visit. Short-term use of pain relievers, for example Ibuprofen or Paracetamol, help with this well.

Cooling the affected area also alleviates pain, but warming often causes the inflammation to spread even more. The bacteria can spread faster in the warm.

How long must the antibiotic be taken?

The antibiotic should definitely be taken for as long as the dentist prescribes it. Since the dentist only uses this remedy in severe cases, the drug is allowed under no circumstances should it be withdrawn independently! The duration of intake depends on both the drug itself and the degree of inflammation. For amoxicillin, the average intake time is between three and seven days. Even if the pain improves before the planned end of use, the antibiotic must still be taken completely. The likelihood that the inflammation will flare up again is just too great.

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When does the antibiotic start working?

You can only roughly say how quickly an antibiotic works, since every person has their own metabolism and every antibiotic has a different effect. The drug can only really break through when it has reached the site of action in a sufficiently high concentration. Only there can it achieve something. Usually put noticeable successes about two days after the first dose a.

Taking antibiotics during pregnancy

If possible, antibiotics should be avoided completely during pregnancy. In principle, however, it is also possible to take an antibiotic. Because without a healthy mother, no healthy child can be born. But there are some special features that must be observed. The dentist should check very carefully whether an antibiotic is really necessary in the present case or whether the inflammation will heal without it. All advantages and disadvantages must be strictly weighed against each other!

If absolutely necessary, it is necessary to resort to special drugs during pregnancy that do not harm the fetus. This group includes drugs such as: Ampicillin or Cephalosporin. If you are unsure, ask your doctor or pharmacist again about the prescription so that the unborn child is not harmed!

When does the pain improve after taking antibiotics?

The pain usually improves after a short time. However, as is common with painkillers, not immediately after taking it. It usually takes about 1.5-2 days for the number of bacteria to be reduced so much that the pain is less. However, complete freedom from pain can only be expected after the wound has healed.


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