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Infected Tooth and No Money

I’m missing one back tooth and have another that has had some decay for a while. Now I am pretty sure that it is infected. My problem is that I do not have dental insurance but I do have health insurance. Is there a way I can use my health insurance to get an antibiotic for a dental problem? My jaw is becoming quite swollen.

Abraham


Dear Abraham,

Man holding his jaw in need of an emergency dentist

I am glad you wrote. What you don’t want to do is use antibiotics as a solution for this. Even if your medical insurance would cover a dental issue, which it will not, an antibiotic will only be a very temporary solution. Then, once the antibiotics are done, your infection will blow up even worse with no way to keep it under control.

The only way to really get rid of a tooth infection is by a dentist getting in there and physically removing the infected pulp of the tooth. Ideally, this would be done with a root canal treatment because it would save your tooth. If that is no longer possible, the other treatment option is to extract the tooth. The downside to the extraction option is that you will need to replace the tooth. Otherwise the adjacent teeth will shift or tip into the empty space. This will throw off your bite and could lead to headaches, jaw pain, and TMJ Disorder.

The best tooth replacement is a dental implant, but that is also the most expensive. There are several other options. If you do need an extraction your dentist is ethically obligated to give you all of them.

With the swelling you have in your jaw, that signals to me that your infection has spread. I would consider this a dental emergency and get in right away. I know you don’t have dental insurance, but if you call around and explain your situation, I feel like you should be able to find a dentist who would be willing to allow you to pay it out and get the treatment you need.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.

How Long Can I Put Off a Root Canal Treatment?

If I have a tooth that needs a root canal treatment, how long can I put it off before I have to get one? I’ve been swamped with work and I can’t afford to take any time off right now.

Everett


Dear Everett,

Man holding the side of his face, portraying dentist cannot find source of toothache

While I cannot give you definitive timelines, I can give you some general guidelines. Please bear in mind that I have not examined you or even seen any x-rays, so this is just based on general information. Everyone’s body is different. If you want definitive advice, then it is important you see a dentist and let them examine you.

If your tooth is hurting, even a little bit, then you need to have the root canal done. This mean that you have an active infection. Another red flag is if there is a pimple on your gums. This is known as an abscessed tooth.

Depending on how severe your pain is, I would not necessarily call it a dental emergency, but you do want to get this scheduled or it will turn into one. So, don’t put off having this attended to.

Believe it or not, multiple people still die from tooth infections every year. When left untreated, a tooth infection will continue to spread outside of your mouth. If it reaches your heart or brain, what could have simply dealt with becomes life threatening.

If you do not have an active infection, then you are probably safe to wait. I’ve known people who waited years to get their root canal treatment. However, they did say that when they finally got it done, they noticed that they felt much better in general than they had in years.

I want to make sure that you are aware that by waiting, you risk external resorption. This is a condition where the infection eats away at the root of your tooth. When this happens the tooth is no longer able to be saved. Then, you are stuck with an extraction and the need to replace the tooth.

If you don’t replace the tooth, then the adjacent teeth will shift or tip into the empty space. This will throw off your bite and can lead to painful TMJ disorder.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.

Using Antibiotics for a Tooth Infection

Almost two weeks ago I went to the dentist for an infected tooth. It was pretty bad and even my cheek was swelling. He gave me some antibiotics, which I took in full. The swelling was almost gone. A few days later it started back up again. Do I go back to the dentist or do I just need a refill on my antibiotics?

Peter


Dear Peter,

Man holding his jaw in need of an emergency dentist

I think there was a miscommunication with your dentist. The antibiotic should have been just to get your tooth infection under control and tide you over until the infection can be properly dealt with. It is not meant to, nor can it, heal your infected tooth. The only way to cure a tooth infection is for a dentist to physically remove the infected tooth pulp. There are two ways to properly do this. The first is by extracting the tooth completely. This should be a last resort because natural tooth structure is always best; plus tooth replacements, especially the good ones, are expensive. The second option is a root canal treatment.

Hopefully, it was just a matter of you not hearing your dentist say that you would need a follow up appointment to do the real treatment, though the front desk should have mentioned it when you were checking out. If your dentist did not plan on any follow up treatment, then you need a new dentist because this one does not understand tooth infections.

It is particularly concerning that this started to get better and has now blown up again. I would consider this a dental emergency. Call your dentist as soon as the office is open and tell them what is going on. If they don’t get you in that day, then call around to some other dentists and see who will given the situation.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.

Delayed Treatment for an Infected Wisdom Tooth

I had some minor pain in a back tooth and went to see my dentist. He told me a wisdom tooth is infected. He gave me some antibiotics and referred me to a specialist. The antibiotics were very helpful. When the specialist saw me, he recommended I remove all of my wisdom teeth but he cannot schedule me for about a month. Since then, the antibiotics have run out and I can feel the pain coming back. Will he be able to treat me if the infection is back?

MaryAnne

Dear MaryAnne,

Man grabbing his jaw in pain

While you cannot rely on antibiotics alone to solve a tooth infection, in your case, it will be okay to call the specialist and tell him you have run out and need enough to get you through until your procedure. Let him know that you can already tell the infection is returning. He should have no problem writing you a refill on your prescription.

Do not wait to get it refilled. These infections are serious. Generally, they require urgent dental care, but it is okay to keep the infection at bay in the short term with medication. As I mentioned before, it will not heal the infection. The only way to do that is to physically remove the infected pulp of the tooth. Without proper treatment, this can turn life threatening. Our jaws are quite close to our brains and throats. You don’t want the infection reaching either of those places.

To remove the infected pulp there are two treatments: a root canal treatment and a tooth exraction. Generally, a root canal treatment is preferred in order to save a tooth. It is unnecessary on a wisdom tooth, however. This is because you can remove a wisdom tooth without needing to replace it.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.

Antibiotics for Tooth Infections

I have a toothache that has me so distracted I am having a hard time getting any work done. I am in the middle of a huge merger and DO NOT have time to see a dentist. I do have a doctor that will write me a prescription for just about anything. I just need to tell him what type of meds I need. Can you help me with that?

B.W.

Dear B.W.,

Man grabbing his jaw in pain

First, I’m just going to say what your doctor is doing is not only against medical ethics but super dangerous. While I am sure that it is handy to have a doctor willing to do that, I do worry. That being said, an antibiotic will not solve your problem. Instead, it will just be a temporary reprieve. Once the antibiotics run out, your tooth infection will come back with a vengeance.

The only way that you can stop a tooth infection is by having a dentist physically go in and remove the infected pulp. This is because a tooth infection kills the tooth and there is no longer blood flow to the tooth, which means the antibiotic will have no effect on the root of the infection.

You have two choices in truly dealing with a tooth infection. The first is to have a root canal treatment where the dentist goes in and removes the infected pulp. From there you are generally given a dental crown. The good news is that this saves your tooth. It is always better to have as much natural tooth structure as possible.

The second option is if the tooth cannot be saved and the decay and infection have gotten too far. When that happens, the tooth has to be extracted and you will need to replace the tooth. If that happens, I recommend you get a dental implant to replace it. That is the closest to having a healthy natural tooth in your mouth again.

I know you are short on time, but if you let this spread, it can turn from a dental emergency to a medical one. Think about how close your jaw is to your brain and heart. People still die from tooth infections because they allow the infection to spread. I know you are busy, but I really do not want you to put this off. You could call the dentist and ask him to prescribe you an antibiotic, but it will only buy you a short period of time.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.