Tooth Abscess

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HealthWiki > Where There Is No Dentist > Chapter 7 Part 1: Problems You Will See Most Often > Tooth Abscess

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In this chapter:

 

In this chapter:

A cavity that is not treated grows bigger and deeper until it touches a nearby nerve. Germs travel inside the tooth’s root and start an infection called an abscess. Pus forms at the end of the root, inside the bone. As the pus increases, it causes great pressure. This is why an abscess causes severe pain.

Signs:

• Pain all the time, even when trying to sleep.
• Tooth often feels longer, and even a bit loose.
• Tooth hurts when it is tapped.
• A sore on the gums near where the root ends (gum bubble).
• Swelling of the gums around the tooth, or swelling of the face on the same side as the bad tooth.

Treatment:

If possible, first drain the abscess. To do this, open the abscess with a sharp sterile knife to release the pus. Or you can remove the pus with a sterile syringe and needle. Then cover the wound with a sterile dressing to keep it clean. If you are not able to drain the abscess, reduce the swelling with heat and show the person how to continue doing this at home. Until the swelling goes away, they should regularly (many times a day):

• soak a cloth in warm water and hold it against their face.
• hold warm water inside their mouth near the swelling. It is not necessary to use salt water.

After draining the abscess or reducing the swelling, treat with antibiotics. See below for the correct doses.

THE BEST CHOICE		SECOND CHOICE
		(for those allergic to penicillin)
Amoxicillin		Erythromycin
Give enough medicine for 7 to 10 days		Give enough medicine for 7 to 10 days
Take this dose for 5 days		Take this dose for 7 to 10 days
Adults and children 8 years or older	1 g (1000 mg), 2 times a day	Adults 500 mg, and children 13 years or older	500 mg, 4 times a day
Children 2 to 8 years	500 mg, 2 times a day	Children 11 to 13 years	500 mg, 3 times a day
Children 3 months to 2 years	250 mg, 2 times a day	Children 8 to 11 years	500 mg, 2 times a day
		Children 3 to 8 years	250 mg, 3 times a day
		Children 1 to 3 years	250 mg, 2 times a day
		Children 2 to 12 months	125 mg, 2 times a day
IMPORTANT:: if amoxicillin upsets your stomach, take it with meals.		IMPORTANT: to avoid upset stomach, take erythromycin with meals.

Note: If you do not have amoxicillin, you may be able to use ampicillin. To use ampicillin, see Where There Is No Doctor. People allergic to penicillin will also be allergic to amoxicillin and ampicillin.

Make sure the person knows they must take all of the antibiotic as directed, even if the abscess is drained, the tooth is removed, or their signs improve. If they do not take the full dose, the infection may come back stronger than before.

Also give the person medicine for pain. A 2-day supply should be enough, because draining the abscess or removing the tooth and giving antibiotics should reduce the pressure and that will reduce the pain. The best medicines for pain are aspirin, which usually comes in 300 mg tablets, paracetamol (acetaminophen), which usually comes in 500 mg tablets, and ibuprofen, which usually comes in 200 mg tablets. Aspirin is usually cheapest, but paracetamol (acetaminophen) does not cause stomach pain and is safer than aspirin for children. (To avoid stomach pain, take aspirin with food, milk, or water.)

EVERY 6 HOURS (4 times a day):			aspirin	or	paracetamol (acetominophen)	or	ibuprofen
	adults		600 mg		500 to 1000 mg		200 to 400 mg
	children	8 to 12 years	do not use		375 mg (¾ of 500 mg tablet)		250 mg (1one 200 mg tablet + ¼ of 200 mg tablet)
		3 to 7 years	do not use		250 mg (½ of 500 mg tablet)		150 mg (¾ of 200 mg tablet)
		1 to 2 years	do not use		125 mg (¼ of 500 mg tablet)		75 mg (¼ of 200 mg tablet + ⅛ of 200 mg tablet)

This page was updated:17 May 2024