The Cosmetic Dentistry Blog

I am a 25 year old female. I had a terrible toothache with slight swelling of the gums roughly 4 weeks ago. I went to the dentist who said I had an infection in my upper wisdom tooth and that it should be refered to a specialist and be removed. He gave me antibiotics and anti-imflamatory pain pills. The pain pills didnt work and I got stronger ones from the pharmacist. I went to the specialist just after the antibiotics had finished and the pain had gone away. He said to make an appoinment to have all my Wisdom teeth out. I have made the appointment but the earliest date I could get is the 10th of November. Over the last 3-4 days there has been a dull ache in that tooth and the tooth in front of it. It is not exactly painful just sensitive if I bite on that side.

My questions are these. Do you think it is another infection? Will the dentist refuse to operate if there is an infection? Must I see the dentist before my operation to remove the teeth to maybe get more antibiotics? I really cant afford this but I will not be able to afford more time off work if he refuses to operate because there is an infection? Please help I am hopelessly lost and confused as what to do.
- Jennifer from South Africa

Dear Jennifer,
It’s not essential, but it’s a good idea for the infection to be under control when the tooth is extracted. Some dentists will want the infection to be under control before the extraction. But more important is that this infection could get really nasty if it’s allowed to come back. Yes, your infection is coming back and you need to get back on the antibiotics and take them from now until you’re done with the extractions.

You should be able to call your dentist that gave you the prescription and tell him that you ran out and you need more, and that you need enough to get you to the time of your appointment and four or five days past. And he should be able to just phone that in without your needing another office visit. But if he won’t do that, you should go to the specialist and get that done. And I would do that as soon as you can.

These infections in your back teeth can travel to your brain or down your neck, and can cause swelling that cuts off your breathing. I wouldn’t trifle with them. And antibiotics alone will only control them – they never eliminate an infection when it comes from a tooth - you have to eliminate the cause or you still have the infection, even if the symptoms aren’t active.
- Dr. Hall

Related links:
Read more about tooth infection
Read more about wisdom teeth removal
More information about dental implants

I had all 4 of my wisdom teeth removed last year with only one issue on my back left tooth # 17? i believe, where there was a little “pocket” where my bone should have been. this has led to a complication that my orthodontist pointed out as when she poked the gum where my wisdom tooth was, green puss started oozing out (small amount, but had a very foul smell) my breath has been mildly bad because of this bacteria or infection of some sort, and it almost seems as if the bacteria seems to want to move to other areas of my mouth as my plaque smells of this bacteria. Do you know what kind of bacteria it is and how i can get rid of it? I have tried squeezing the bacteria out of the pocket, however it keeps reproducing itself. i regularly use listerine. Also, my dentist blew some air with a tool over that area, and they could see i suppose a small green area. help!!!
- Crandall in California

Crandall,
You need to get rid of this bacteria that are causing your tooth infection. And what you’re doing isn’t working. And I can’t help but think this is awfully putrid smelling.
Your on a little bit of the right track with the air. These bacteria that nestle in sockets like this are “anerobia” bacteria – oxygen is poisonous to them. The Listerine clearly doesn’t seem to be getting the job done.
I’ve deal with these infections many times, and I would recommend, in your case, a heavy-duty two-pronged attack. One, you attack them right in the socket. But you need a gentle rinse of hydrogen peroxide, like the kind that is used to help whiten teeth. Get a bottle of 3% hydrogen peroxide from the drug store, and mix it with a mild salt solution, half and half. Then you need your dentist to give you an irrigating needle so you can poke directly into the socket and gently pump in this hydrogen peroxide. Do it after every time you eat, because that’s when this hole fills up with gunk.
Then I’d attack them through the bloodstream with a prescription of Clindamycin, 150 mg four times per day for a good ten days.
I’m pretty confident the smell and infection will be gone by then. Then back off and irrigate the socket just once a day as it fills up with tissue.

You can read more about hydrogen peroxide and oral yeast infections.
Dr. Hall