I have had my share of tooth infections and this is what I have learned so far:
1) Once it’s abscessed nothing works but a root canal or extraction
2) early on, regular dosed antibiotics do nothing.
There are options – loading doses and topical
What can we do safely instead? – Can be learnt from treatment of Sexually transmitted diseases – loading doses -they safely give a big dose once for STD
Safe STD doses used as “loading doses” include:
Amoxicillin 3.0 gm ( yes six 500 mg caps)
Megran, D. W., et al. Single-dose oral cefixime versus amoxicillin plus probenecid for the treatment of uncomplicated gonorrhea in men.
Antimicrobial agents and chemotherapy 34.2 (1990): 355-357.
“amoxicillin (3.0 g) and probenecid (1.0 g) orally” – latter appears to be no longer made but can be compounded by pharmacy
azithromycin 1-2 gms (4-8 caps of 250 mg)
Handsfield, H. Hunter, et al.
Multicenter trial of single-dose azithromycin vs. ceftriaxone in the treatment of uncomplicated gonorrhea.
Sexually transmitted diseases (1994): 107-111.
“In summary, a single 2 g dose of azithromycin is highly effective in the treatment of
Cefixime 800 mg (two 400 mg tabs)
the pain will remit within hours and usual doses may be given subsequent along with a dentist referral to image for abscess.
Infection of tooth is very close to the skin and localized so topical treatment is possible. I use something called Pennsaid – it has Dimethyl sulfoxide (DMSO) in it. It is a horse linament that penetrates so well it can be tasted within minutes of skin application. It is combined with Voltaren (diclofenac) to be a topical anti-infammatory especially for knees
I use a teaspoon of Pennsaid with contents of an antibiotic capsule added to it – soaked on a wisp of cotton ball and applied to sore gum area until it goes numb (5-10+ minutes) – changing cotton wisp every 5 minutes – may need to treat each side of tooth so time adds up
Antibiotic I have used:
Clindamycin 300 mg (tastes gross) – open capsule into 5 mls = 1 teaspoon Pennsaid and stir in small cup or egg holder –
Neomycin – used to use for bacterial overgrowth syndrome and had some 500 mg capsules made up by a compounding pharmacy – put 500 mg in and again 1 teaspoon of Pennsaid
(you could get one capsule of 500 mg made up to show you what 500 mg looks like and have the rest as a powder sticking to same amount on a knife end dropped in to 5 mls Penssaid)
Suggestion – use only a cotton wisp and don’t apply too much liquid to it as it is vile dripping down your throat. Change every 5 minutes – it is not how much you apply, it is how long you apply (changing every 5 minutes)
Only problem being, after a successful treatment, is getting your dentist to believe it wasn’t just cracked… I had controlled infection within 5 days but unfortunately Xray show bone loss by roots so abscessed and schedule for pull as had prior root canal and too big for an apical :(