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Q. What is the best course of action for infected wisdom tooth?

Answered by
Dr. Geeth Sadasivam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 16, 2017 and last reviewed on: May 27, 2019

Hi doctor,

I have a lower wisdom tooth that has been infected chronically for well over a year. I also have an upper molar that is broken decayed and has been like this for years. The wisdom tooth oozes green pus if you apply pressure with a cotton swab. The decayed tooth is mildly painful. I saw my dentist a few days ago, who did not seem overly concerned. She slightly cleaned the gums around the wisdom tooth and prescribed me Cephalexin and sent me on my way. I have been taking Cephalexin for a few days, and yet the tooth is still oozing. My throat is red and irritated, the gums inflamed and there is no swelling in the mouth. Also, my nostril on that side is tender and painful. I am severely worried about the infection spreading to either my heart or my brain. In fact, I read an article a few days ago about a 26 year old who died from a tooth infection spreading.

I do not have a fever. I have mild nausea. It is tender on that side of my jaw. The dentist had said the next thing she could give me was Clindamycin, but I have a fear of the side effects of that medicine. I already have heart problems and mild stomach issues. I have read that Clindamycin can cause severe gastrointestinal problems and arrhythmias. She also suggested Zithromax, but I have had heart palpitations while on that medication as well. I am having the teeth removed by an oral surgeon in two weeks, but am afraid of dying from infection before then. What are my options? What is the best course of action? Are there other antibiotics for this? Am I dying from the infection already? Any of your advice or help is appreciated. My other possibly relevant health history is as follows: I have high blood pressure, tachycardia, high cholesterol and mild PVC's. I had a MRSA infection in my arm 10 years ago. I have many strep throat infections every year and frequent sinus issues. Also, I would like to mention that when I took smoothed Cephalexin capsule with a sip of water, I got a random salty taste in my mouth.

#

Hi,

Welcome to icliniq.com.

I have read your complaint and the relevant details. Please do not panic relating this to death.

  • The good thing is you do not have chills or swelling. Huge swellings that cover the entire face, jaw or neck are only dangerous. These are called space infection that keeps spreading all over and becomes lethal.
  • In your case, it is the infection seeing through as pus, which means the tooth is only heavily affected along with the roots. The correct treatment is the removal of the wisdom tooth.
  • Personally, I do not prescribe antibiotics straight away without mere treatment because that is of very less use. Cephalexin and Clindamycin are all prescribed to you because you had MRSA (Methicillin-resistant Staphylococcus aureus).
  • According to me, antibiotics are just add-ons to the treatment. If you have pain, then take just painkillers. Once the extraction is done, then you can take antibiotics to reduce the post-operative complications.
  • You have mentioned that you are a cardiac patient. So, before the extraction, you will be prescribed with prophylactic antibiotic dose for safety issues.
  • Overall, I advise you not to panic a lot. Stay calm, and you will do with the surgery fine. Follow the surgeon's instructions after then. Thank you.

Preventive measures:

Maintain good oral hygiene for this two weeks.

Regarding follow up:

Revert after a week of extraction to a dentist online.---> https://www.icliniq.com/ask-a-doctor-online/dentist


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