What to know about antibiotics and dental infections

A dental infection, or a tooth abscess, usually occurs as a result of tooth decay and poor oral hygiene. However, it can also develop due to previous dental work or traumatic injuries.

When an infection occurs, it causes a pocket of pus to form in the mouth as a result of an overgrowth of bacteria. This infection often causes swelling, pain, and tenderness in the area. Without treatment, the infection can spread to other areas of the jaw or even the brain.

Dental cavities are very common. As noted in an article, up to 91% of adults ages 20-64 have cavities. Also, about 27% of people in the same age group have untreated tooth decay. Early treatment of tooth decay is important to prevent complications such as tooth infections.

Anyone experiencing a dental infection should see the dentist immediately to prevent the infection from spreading. One of the first things a dentist will likely recommend is an antibiotic to kill the infection. Some antibiotics work better than others for dental infections, and there may also be some over-the-counter (OTC) pain relievers to help with symptoms.

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When to use antibiotics for a dental infection

Dentists will generally only recommend antibiotics in dentistry for dental infections. However, not all infected teeth require antibiotics. In some cases, a dentist may simply drain the infected area, remove the infected tooth, or perform a root canal to fix the problem.

They tend to avoid recommending antibiotics unless they are absolutely necessary, such as when the infection is severe or spreading, or if a person has a weakened immune system.

List of antibiotics and doses

Although antibiotics can help clear a dental infection, it is important to use the right antibiotic in each situation. The type of antibiotic that a dentist recommends will vary depending on the bacteria causing the infection. This is because different antibiotics work in different ways to kill different strains of bacteria.

As a study in the Journal of Dentistry points out, there are more than 150 different strains of bacteria that occur in the mouth. Many of these bacteria have the potential to grow and cause an infection. Treatment can change depending on the bacteria causing the infection, although most of the time dentists recommend an antibiotic that works against many types.

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Penicillin-type medications are common forms of antibiotics for dental infections. This includes penicillin and amoxicillin. Some dentists may also recommend amoxicillin with clavulanic acid, as the combination can help kill more stubborn bacteria. Typical doses of amoxicillin for a dental infection are 500 milligrams (mg) every 8 hours or 1,000 mg every 12 hours.

Typical doses of amoxicillin with clavulanic acid are around 500–2,000 mg every 8 hours or 2,000 mg every 12 hours, depending on the lowest effective dose. However, some bacteria can resist these drugs, making them less effective. In fact, many doctors now choose other antibiotics as their first line of treatment.

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Also, some people are allergic to these drugs. Anyone who has had an allergic reaction to similar medications should inform their dentist before receiving their recommendation for treatment.


Clindamycin is effective against a wide range of infectious bacteria. As a study in the International Dental Journal notes, some researchers recommend clindamycin as the drug of choice for treating dental infections, as bacteria may be less likely to resist this drug than drugs in the penicillin class. A typical dose of clindamycin is 300 mg or 600 mg every 8 hours, depending on the dose can be effective.


Azithromycin works against a wide variety of bacteria and works to stop their growth. It can be effective in treating some dental infections, although dentists only recommend it to people who are allergic to or unresponsive to penicillin class drugs or other drugs such as clindamycin. The typical dose of azithromycin is 500 mg every 24 hours for 3 consecutive days.

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