Saturday, May 15, 2010

Tooth Abscess, Need Advice Please?

I had extreme tooth pain and tried to set up an emergency appointment with my dentist. I was told they're full for over a week. I couldn't even get them to prescribe antibiotics, they told me to ask my regular doctor. Thankfully, I was able to get Penicillin VK (750mg total daily). In a few days, I finally had relief from the pain. The problem is, this morning my face began to swell, in front and above the bad tooth. I phoned a nurse at the hospital and after talking with her, she said I need to be seen by a dentist within 24 hours. Well, the two dentist I can see are both full. I decided to head to the er, since she insisted. The doctor said the infection is in the bone and there's nothing he could do. He said the tooth has to come out and I need to see a dentist as soon as possible. Well, I already tried. He said the antibiotics aren't doing their job since I'm swelling. I'm on 2000mg total daily now. I tried the dentists again and the soonest opening is five days away. Is this safe?

Tooth Abscess, Need Advice Please?
It is honestly against the law to not see an emergency patient within 24 hours. You can report the office to the dental board in your state or the ADA. Your tooth may not need to come out. The infection will literally eat away the bone above the tooth and you can either have a root canal to try and drain the infection or an apicoectomy (look it up :) ) that is where you go above the tooth and remove the infection. Your dental office will then place a filler in to try and re-generate the bone. That is the best option but when you call the dental office to schedule you NEED to tell them that you are aware that it is the policy to be seen for an emergency appt. within 24 hours. Also why can you only be seen in 2 offices?
Reply:My take on this is that you need a different antibiotic. Some bacteria don't respond to one, so you can be given another antibiotic--this is probably why your face continued to swell. I'm not doctor, and I know tooth infections should be dealt with ASAP, but if you can change antibiotics, you should be OK for a couple days. But do see about a different antibiotic.
Reply:If you can't get an appointment with your general dentist, try getting an appointment with an oral surgeon. (They tend to have more openings in their schedules to allow for emergency appointments.)





An endodontist (root canal specialist) can also help with this problem by opening the tooth and allowing the infection a path for drainage. You may also be able to keep the tooth once the infection has been removed and root canal therapy completed.





Also consider going to a hospital emergency room that has either a dental clinic associated with that hospital or that has a dentist on its staff.





In any case, an abscess that has gone into the surrounding bone is quite serious and needs to be treated a.s.a.p.
Reply:DIAMOND,





YOU DIDN'T KNOW, NEITHER DID THE M.D. WRITING THE PRESCRIPTION. IT'S OBVIOUS THE BACTERIA IN YOUR INFECTION IS PEN. RESISTANT SO NO MATTER HOW MUCH YOU TAKE IT WON'T WORK. THE MEDICINE YOU SHOULD BE ON IS AMOXICILLIN OR METRONIDAZOLE.


I NEVER PRESCRIBE PEN. FOR MY PATIENTS BECAUSE OF THE LARGE # OF PEN. RESISTANT BACTERIA. VISIT ANY ORAL SURGEON A.S.A.P.
Reply:Ahhh did i ever get scared too when my cheek swelled up from an abcess and it hurt so much to press onto it. The antibiotics worked for me but there was a period too where i ddint think they were working. The nurse might have said see a dentist right away but it isnt the tooth that is causing the swelling its the infection, so you need an antibiotic that works. Most doctors do not know much about teeth but they can prescribe a different antibiotic that may help and bye you enough time to see a dentist. Good luck
Reply:You need dental treatment immediately!


The infection you have must be resistant to


antibiotics, and can be dangerous





If a general dentist can't see you- TELL THEM its an EMERGENCY! I believe as a "doctor" they took


an oath to help people and and decent dentist has


time in their schedules for emergencies.





If you have no luck with a general dentist, seek


an oral surgeon.
Reply:Actually it is not against the law not to see you within twenty four hours if you are not a patient of record. However if you are a patient of record in one of these two offices than they should at least be able to get you in for an emergency. The problem is that many people (I am not saying that you are one of them) neglect their teeth for so long that when something starts hurting they are surprised. For example we have had many patients that have come in for an emergency exam, we saw them, explained that they had an abcessed tooth that either needed a root canal or extraction. The patient says okay, we give them an RX for antibiotics and pain, they leave, and we don't see them again for three months in which their tooth has become so painful and unbearable that they want us to stop everything and see them. Most dental professionals will tell you that this is the most frustrating part of our business. So many times if a patient has a history of being a no-show for appointments, has a history of emergency visits only and then not following up on treatment that the doctor diagnosed, or being constantly late than the staff may very well make them wait for a few days until they have an opening in their schedule. It is like the little boy that cried wolf too many times. As I said I am not implying that this is the type of patient that you are, but I am trying to explain why many offices may make you wait. I am happy to say that if our patients of record have a true emergency (such as pain etc) then we will get you in on the same day. We understand that not only can tooth aches be painful, but in the case such as yours, it can be very dangerous. Good luck.


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