Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Tooth Infection and No Money

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I need some advice. I’ve already had a few teeth in the back of my mouth sort of come out on their own. Now I have one that is infected. It’s gotten pretty bad and my right cheek is swollen. I look a bit like that guy from the Godfather. I do have some antibiotics that my ex-wife left here. She never took them because she went through a phase where she didn’t believe in “western” medicine. It’s a z-pack. Will that work for my tooth?

Bradley

Dear Bradley,

An adult male grimacing in pain as he holds his cheek

I’m sorry you are going through so many difficulties at once. That is hard. Be aware that while a z-pack can temporarily hold your infection at bay, it will NOT take care of it. In fact, unless you get the proper treatment in a timely manner, you can actually end up in a worse situation than you were in before.

In order to properly treat an infected tooth a dentist has to physically remove the infected pulp. There are two ways to properly do this. The first is with a root canal treatment. This is the ideal because it will save your tooth. The second is by extracting the tooth.

Because your cheek is swollen, I would consider this a dental emergency. It has spread out of your tooth. You don’t want it to reach your brain or heart because then it will become a life-threatening situation.

This blog is brought to you by a compassionate dentist in Tulsa, Dr. Ryan Noah.

Are There Options for Infected Teeth?

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I have two back teeth with fillings that have been hurting me for a while. When the pain got to the point of distraction, I broke down and went to the dentist. He said the teeth are infected and will need to be extracted. I’m really feeling awkward about missing teeth. I know they are in the back, but I feel sort of like I’ll turn into a hillbilly or something. Are there consequences to this? Do I have any other options?

Merrill

Dear Merrill,

blonde woman holding the side of her jaw in need of an emergency dentist

I am glad you wrote. Your dentist is under a legal obligation to give you all of your treatment options. I am surprised that he only gave you the possibility of extraction. Is it possible you are on government insurance? That could be an explanation. On government-funded insurance, you aren’t really given an option. They tell you what treatment you can have, unless you want to pay out of pocket.

Options for a Tooth Infection

Your best option in this case, is to get a root canal treatment. This will remove the infected pulp, while still saving your tooth. It is always better to have natural tooth structure. Without that, you have to replace the teeth. If you don’t replace them, the adjacent teeth will begin to shift into the empty spots. This will throw off your bite, but it could also lead to painful TMJ Disorder.

Any tooth replacement will keep the teeth in place. However, you will begin losing some bone structure where those teeth were if you do not have prosthetic roots placed there with dental implants. However, those are very expensive.

The first priority is to try and save the teeth, if possible, with a root canal. The faster you deal with a tooth infection the better. This will also save you the money of getting tooth replacements.

This blog is brought to you by Glenpool Dentist Dr. Ryan Noah.

Antibiotic and Tooth Infections

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My tooth was infected. I went to see my dentist and he did an x-ray where he found an infected tooth. He provided me with an antibiotic. I took it faithfully. The swelling started to go down and I was even feeling better. Then, it started to get worse again. I guess what I need to know is if I need to get more of the same antibiotic or if I need to get a different one. I want to know what to ask for when I call the dentist again.

Lucy

Dear Lucy,

A woman holding her jaw in pain

I hope there has been a miscommunication between you and your dentist and not that he does not understand how dental infections work. While an antibiotic is useful for holding back a dental infection, it does not cure it. The only way to get rid of a dental infection is for the dentist to physically get in there and remove the infected pulp. There are two ways to do that.

The first is with a root canal treatment. This is the ideal solution because it will save your tooth. If the tooth is no longer salvageable, the next option is to have your tooth extracted. That is the last resort option because it is always better to keep your natural tooth structure.

The fact that your infection started to get better and then got worse again is a particularly bad sign. I think you need to schedule an emergency dental appointment. He may write you another antibiotic but this time make absolutely certain that a follow up appointment is scheduled for before the antibiotics will run out.

If the worst case scenario happens and the tooth cannot be saved you will want to replace it. If you don’t, the other teeth will either shift or tip into the open space. This not only will make your bite look off, but it can also lead to painful TMJ Disorder. There are a variety of tooth replacement options, some removable, like a partial denture, others permanent, like a dental implant.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Can’t Afford to Treat My Infected Wisdom Tooth

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I have a massively infected wisdom tooth. I’m furloughed during the quarantine and my unemployment hasn’t kicked in yet. I don’t have the money to get this treated yet. Is it possible to just take antibiotics until the money kicks in or should I just go to the ER to have this treated?

Kelly

Dear Kelly,

A man holding the side of his jaw like he needs an emergency dentist

Antibiotics won’t solve a tooth infection

Tooth infections aren’t something to mess with. In fact, they are considered dental emergencies. Unlike other infections which can be solved by antibiotics, a tooth infection has to be physically removed by a dentist, either by a root canal treatment or a tooth extraction. Without that, it will continue to spread. The most an antibiotic will do is hold it at bay for a short time. Then, when the antibiotics run out, it will begin to spread again. If you think about how close your jaw is to your lungs, heart, and brain, you realize how people still die from tooth infections.

I’ve found most dentists to be compassionate. That will be especially true during this time of the COVID-19 pandemic. I would simply call around to dentists in your area and explain your situation. I’m positive you will be able to find one who will work with you financially until your unemployment payments kick in.

Start by looking for a dentist who advertises as an “affordable dentist“. They pretty much offer payment plans even when there isn’t a world wide health emergency. I’m positive they will in your situation now. You can just get the wisdom tooth extracted and you’ll be back to normal in no time.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Sinus Infection after Extraction

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I had a dental emergency a couple of weeks ago and the tooth is beyond repair. The dentist did an extraction. In the process my sinus was perforated. I’ve done some research and this seems to be something that can happen without it being the dentist’s fault. He told me about it after the extraction, cleaned the area, closed it up and then gave me a prescription for antibiotics. I was feeling better and had finished my antibiotics. Today there is drainage and pressure in my sinuses. Could I have developed an infection at the extraction site?

Miranda

Dear Miranda,

blonde woman holding the side of her jaw in need of an emergency dentist

I’m glad you know that a sinus perforation doesn’t necessarily mean your dentist made a mistake. Some roots of teeth are so close to your sinus cavities the only thing separating them is a thin membrane, which will be perforated during an extraction when they’re that close.

It sounds like your dentist followed correct protocol when that happened as well. You’ve got a responsible caregiver and that is something to be grateful for. I can think of three possibilities going on here.

The first is that you just needed to be on your prescribed antibiotic a little longer than you were. Some infections need a little extra oomph to help your body fight it. This may be the case with yours.

A second possibility is you need to be on a different antibiotic. You didn’t mention which antibiotic your dentist prescribed. A good one for this type of situation is clindamycin.

A third possibility is there is some bone in the sinus cavity. This will blow up into an infection and can cause another dental emergency, plus a host of other problems.

I want you to call your dentist and schedule an appointment to be seen again. He’ll likely put you on more of the antibiotic or a different one. He may do an x-ray to see if there is some bone trapped there. If he doesn’t don’t panic. Try the antibiotics. If they don’t work, then it will be time to see an ENT and have this investigated further.

You are doing a good job staying on top of this. I don’t know if you and your dentist have started talking about what you will replace the extracted tooth with, but once you have this infection settled, I’d like you to discuss getting a dental implant with him.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.