Pain in and around the teeth, a common problem, occurs in many people with poor oral hygiene, according to the Merck Manuals. Toothache accounts for 1 to 5 percent of emergency department visits in the United States, according to an article by Dr. Shari Welch on Emergency Medical News. Bacteria can cause a number of infections that produce dental pain. These infections and the resulting dental pain usually respond to antibiotics.
Dental Abscess
According to the British Society for Antimicrobial Chemotherapy, dental abscesses produce dull, constant facial or dental pain, made worse by tapping the tooth. The three types of abscesses include gingival, or in the gum; periodontal, or within the pockets and supportng structures around a tooth; and periapical, or infection of the central part of the tooth. The latter is due to mouth bacteria entering the tooth from a cavity. A periapical abscess can cause cellulitis, or infection of the surrounding tissues.
Treatment includes amoxicillin plus metronidazole, co-amoxicillin clavulanate, or clindamycin. An abscess in the tooth or gum may require drainage, root canal or tooth extraction.
Cellulitis
An untreated cavity may result in a periapical tooth abscess; eventually, this may result in cellulitis, or infection of the surrounding tissues. Treatment of patients with cellulitis includes oral antibiotics such as penicillin, at a dose of 500 mg three times daily. Substitute erythromycin or clindamycin if the patient is allergic to penicillin.
Pericoronitis
According to the Merck Manuals, pericoronitis, or inflammation and infection between the tooth and gums, occurs most commonly in an erupting lower wisdom tooth. Treatment of pericoronitis includes penicillin or, alternatively, clindamycin.
Cracked Tooth
A tooth can crack vertically or horizontally by biting a hard candy or piece of bone. This allows bacteria to enter the tooth pulp, where infection can spread, causing dental pain. Treatment consists of root canal. An antibiotic like minocycline kills or suppresses most mouth bacteria until the root canal procedure can be performed.
