Q. I have pus in the gums of decayed wisdom tooth. Will antibiotic help in clearing infection?

Answered by
Dr. Sandeep Menon
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 21, 2020 and last reviewed on: Feb 25, 2020

Hello doctor,

My wisdom teeth came a few years ago. The top ones are straight but too close to the molars next to them, so they broke the molars. Those top molars next to the wisdom teeth, as well as those top wisdom teeth are broken, decayed, and sometimes painful. My bottom wisdom teeth have not damaged the molars next to them, but they are not fully erupted out of the gums. One is impacted but does not cause trouble. The other is straight, but in pain, it is also infected.

There is green pus that comes out from between the gum and that tooth as well as from the tooth in front of it. There is also a cracked second molar which the gum is partially detached from and it also has some pus coming from it. Now here is the dilemma, I have been taking Amoxicillin 250 mg three times a day for a month now, and just yesterday I switched to 500 mg three times a day to try to clear up that infection. Yesterday there is no pus, but today there is.

I do not have an appointment with the oral surgeon until a few weeks. I am afraid that this infection will not clear up with the 500 mg Amoxicillin. And the big problem is that I am on Medicaid and they only give us 1000 dollars a year which resets every July. I only have about half of that left which means I cannot go to any more appointments until after this oral surgeon. I can only have three to four of the six bad teeth out. So do I have to extract the bottom infected wisdom and cracked tooth or the semi painful broken decayed top teeth? And to make it even better, I have high blood pressure and severe anxiety and happen to be on Propranolol for the blood pressure and heart rate. I know that Propranolol interacts with local anesthetics that have vasoconstrictor in it, but local anesthetics without vasoconstrictor do not last as long and I am severely afraid of death from dental work (or from infection). So I do not know which teeth to do, what to do about the anesthetic, and I am afraid of the infection spreading. Please help.



Welcome to icliniq.com.

Put your mind at ease. There is a high chance of food getting stuck between the wisdom tooth and the molar because of the position of the molar. This gets unnoticed during brushing and over time gives rise to the decayed tooth. Plain Amoxicillin will not help in decreasing the infection. You need Amoxicillin and Clavulanic acid combination (675 mg) two times a day for three days. This with Metronidazole 400 mg three times a day for three days. Before having these, it is mandatory that your blood pressure is within the normal range. Local anesthesia with vasoconstrictor can be used for hypertensive patients with proper guidelines being followed. Do not worry. Please visit the dentist first, take the revised set of medicines, bring your BP under control as well. Let the infection subside and then remove the infected tooth.

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