Edited and Reviewed By Dr. Zankhana Shah, BDS
Sudden onset of sharp, shooting pain in one of your teeth during the night that prevents you from falling asleep. Thinking of taking an antibiotic to relieve your pain?
Stop before considering over-the-counter (OTC) antibiotics for every dental pain. Let’s learn why and what ADA and other studies say about the use of antibiotics for dental problems.
Toothache can occur due to multiple factors including a cavity, sensitivity from hot and cold food items, a fractured tooth, eruptive forces of an adjacent tooth, or pulp (the inner most layer of tooth) exposure.
However, it may not always be associated with a bacterial infection for which you need antibiotics.
Antibiotics may help relieve the following symptoms associated with the dental pain:
Pus drainage
Fever
Inflammation
Intra or extraoral swelling
Gum swellings
Immunocompromised patients (in such cases antibiotics are given as a prophylactic measure)
However, the use of antibiotics should be considered after consulting a dental professional. The dentist can prescribe the best suitable antibiotic according to your dental problem after clinical and radiographic examination.
Some of the dental problems that require treatment by a dentist and antibiotics may not be of much use include:
a tooth having a cavity
a fractured tooth
a cracked tooth
The antibiotics may help relieve symptoms associated with these conditions such as swelling following a crack or fracture in a tooth, but a cracked or fractured tooth can not be fixed by medications, including antibiotics.
A 2024 study by ADA 1 suggests evidence-based clinical guidelines for the use of antibiotics for dental pain. According to the study, there is no benefit in prescribing antibiotics to healthy patients, but they may cause significant harm if prescribed without following the appropriate guidelines.
Prescribing antibiotics may be beneficial when there is systemic involvement due to a dental condition (swelling, infection, fever). A cross-sectional study has revealed that dentists were prescribing antibiotics for some cases where they were not required.
So, when the dentists were educated through an RCT (randomised controlled trial), antibiotic prescriptions were reduced significantly. Educating the dentists on appropriate use of antibiotics through a randomised controlled trial (RCT), had helped reduce antibiotic prescriptions significantly.
Are antibiotics necessary for relieving every case of toothache?
MedBound Times connected with Dr. Charvi Kundu BDS, MDS (Periodontologist), a senior lecturer at the Department of Periodontology at Manav Rachna Dental College for her expertise on antibiotics use for toothache.
Not every toothache needs antibiotics. If the toothache is due to a cavity, a damaged tooth, or nerve problem, antibiotics won’t stop the pain. Antibiotics are needed if you have infection, pus, fever, or difficulty in opening your mouth.
Dr. Charvi Kundu BDS, MDS (Periodontologist), Senior Lecturer, Department of Periodontology, Manav Rachna Dental College
How to treat tooth pain without antibiotics at home?
Warm saline rinses, cold compresses, clove oil, and OTC pain relievers such as ibuprofen can manage pain until you see a dentist.
Do all teeth infections require antibiotics?
No. In cases such as root canal treatment (RCT) and extractions, treatment is the permanent solution to cure the pain. Antibiotics may help provide relief for a while, the pain may start again once the drug’s action fades away.
What is the best over-the-counter pain relief for a toothache?
Ibuprofen is generally considered the most effective OTC option for dental pain, though it should be used as directed.
1. Lockhart, P., Tampi, M., Abt, E., et al. (2019). Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling. The Journal of the American Dental Association, 150, 906–921.e12.
2. Murphy, A.M., Patel, U.C., Wilson, G.M., Suda, K.J. (2024). Prevalence of unnecessary antibiotic prescriptions among dental visits, 2019. Infection Control & Hospital Epidemiology, 45(7), 890–899. https://doi.org/10.1017/ice.2024.13
3. Seager, J., Howell-Jones, R., Dunstan, F., et al. (2006). A randomised controlled trial of clinical outreach education to rationalise antibiotic prescribing for acute dental pain in the primary care setting. British Dental Journal, 201, 217–222. https://doi.org/10.1038/sj.bdj.4813879
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