When seeing 40 patients on a daily basis, as a dentist, I have the opportunity to meet a lot of different folks and see many different dental circumstances. I wanted to post about this recent case so readers can understand the need for concern when you have a toothache. Toothaches are common and usually simple to treat.

Our patient, “Jaine Doe” came to us in pain, reporting she had swelling of the lower jaw and recent history of pain that awoke her from sleep. She had been to see a dentist 10 days prior and they gave her antibiotics (more on this later as I don’t agree with this practice…). Since then the tooth pain got worse and so did the swelling.

Upon my exam, I found that her swelling of the lower right jaw extended below the jaw, into the neck, and under the chin area. She was experiencing a dental infection that was spreading into different facial planes. Had she not seen us, it could have spread and closed her airway. Without being able to breathe she could have died.

This is an example of an infection that we can not treat in the dental office. I sent the patient to the emergency room at John Peter Smith Hospital. There she had a CT scan done, was taken to the Operating Room for extraoral incision and drainage along with the removal of the tooth. She was kept overnight for observation.

That sounds like a lot that an abscessed tooth can do to a person, -YES. Sounds expensive- CT, a trip to OR, and 10 doctor’s bills- YES. This would have been cheaper and easier to have the tooth pulled days ago. So readers don’t put off dental pain…. get it checked out. Even better see a dentist regularly.

Are antibiotics able to properly treat an abscessed tooth or a hurting tooth? – No. This case is a perfect example of how antibiotics fail to adequately treat a dental infection. The textbook answer is always to pull the offending tooth (the one causing the pain). This is how I treat our patient here, yes antibiotics can relieve the infection so that it can be easier to numb – however with correct knowledge of dental nerve anatomy and skill we can get you numb to get out a tooth even in the face of an infection. If this may be difficult, we can start an IV and sedate you for the procedure so you won’t have any recollection of the event.

We don’t always have to pull the tooth if it is causing an infection, a root canal can also be done. This allows you to keep the tooth. If you are experiencing tooth pain or an abscessed tooth, don’t put it off contact us today for an exam and X-ray. We usually are able to fit in emergencies for same-day extractions.

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