How do I manage an infection near an impacted wisdom tooth?

Question

Hello doctor,

I have had an impacted wisdom tooth and get infections quite often, but this time is different. I have had pain since last weekend. I went to my dentist five days ago, who gave me a three-day course of antibiotics. I returned after three days, as the pain was worse. He cleaned the area and gave me more antibiotics.

I returned to my dentist and then went to the hospital yesterday. I have been placed on a short waiting list to have the tooth removed. However, the hospital found that my dentist had heavily overprescribed antibiotics. I was taking double the proper dose, and the infection still has not cleared.

I was on one set of antibiotics for three days. I also have been on new antibiotics after that and was taking too high a dose as advised by my original dentist. Yesterday, I was prescribed additional antibiotics to take along with Amoxicillin, but I have now been told the correct dose. The dentist also advised me to go to the emergency department if the infection does not improve soon.

How long would you recommend I wait to see if the infection improves? I have been on antibiotics, and I am taking painkillers, 30/500 mg Co-codamol, which are not working at all. I am also using Corsodyl mouthwash and Orajel, but nothing is helping, and the pain seems to be getting worse.

I cannot take anti-inflammatory medications due to stomach problems. My inner cheek and gum are still swollen around the impacted wisdom tooth, and the area under my jaw is very tender.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Based on the information you provided, it seems you have a severe pericoronitis, causing inflammation and infection of the gum flap around the wisdom tooth due to food lodgement. It commonly improves with antibiotics.

However, if it is not improving and the gum flap is partially covering the wisdom tooth, the best way to get relief is to have the gum flap removed. This procedure is known as operculectomy and is performed by an oral surgeon.

For now, along with taking antibiotics, you can do warm saline gargles, use Chlorhexidine mouthwash, and apply cool compresses over the cheek. You should also try to keep the area clean and avoid food accumulation in that region.

Also, if you notice increasing swelling, difficulty in opening your mouth, fever, or pain spreading towards the ear or neck, do not wait and seek urgent care. Continue your medications as prescribed and stay well hydrated. Soft foods may help reduce discomfort while chewing. This condition can be quite painful, but with proper care and timely treatment, it usually settles well.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.