A Dentist's Guide to Different Tooth Abscess Antibiotics

If you have a tooth abscess, antibiotics are pretty much an essential part of treatment. Antibiotics for tooth infection are very effective, and the most common antibiotic for tooth infection is probably amoxicillin, a type of penicillin.

The discovery of penicillin by Alexander Fleming created a revolution. As Woody Allen said, "I wouldn't want to have lived in any time period before the invention of antibiotics".

When you think about it, he's right! Before antibiotics became available, many people died from simple infections that would be treated very easily today.

Although amoxicillin is probably one of the most widely used tooth abscess antibiotics in dentistry, there are a couple of others that are also used;

Alexander Fleming

  • Penicillin V. This is an earlier form of penicillin, and it is still very effective. It works against a relatively small number of bacteria types, the ones most commonly involved in dental infections. Because of this, it is less likely to cause "antibiotic resistance".

    One negative point about penicillin V is that it must be taken in four doses spread out over the day. A lot of people miss one of the doses because they forget or are busy. This means the antibiotic doesn't always work quite as well as it should.

  • Amoxicillin is good at being absorbed when taken in tablet form by mouth, and better if you have something to eat when you take the tablet. It's effective against many bacteria, and is called "broad spectrum". A plus point is that you only need to take three doses a day, so it's easier to keep track and take the course correctly.

    The recommended dose seems to vary from country to country. In some, the dose is 250mg taken FOUR times a day. In other countries, the recommended dose is 500mg, taken THREE times a day!

    So the DAILY dose seems to be between 1000mg and 1,500mg. This is divided over 3 to 4 intakes per day.


  • Clamoxyl

  • Clamoxyl is a mixture of amoxicillin and clavulanic acid, which makes it resistant to breakdown by certain bacteria, and so even more effective than straight amoxicillin. It's a pretty heavy hammer, and is effective against a wide range of bacteria, but can knock out some of the "good guys" too.

  • Metronidazole. This is marketed under the name Flagyl in most countries. It is very effective against certain types of bacteria that cause gum infectons. It is important to avoid alcohol while taking metronidazole, as it may cause serious stomach upsets.

    It is particularly effective on infections under the gum around the neck of the tooth or a dental implant infection. It is effective against bacteria that do not need oxygen.

    For more stubborn infections, metronidazole can be taken at the same time as amoxicillin. Taken together, the two antibiotics have a synergy which is greater than would be expected from just adding the two together! Tooth infections don't stand a chance against this powerful combination!

  • Erythromycin. An older antibiotic, but still in use, and effective where you might be allergic to the penicillins. However, it may cause various types of stomach upset, and so is usually kept "in reserve".

  • Clindamycin

  • Clindamycin is the 500lb. gorilla of tooth abscess antibiotics used in dentistry, It penetrates bone extremely well, and for this reason is normally given in much lower doses than other antibiotics.

    The usual dose is 150mg, taken FOUR times a day. This makes it very good for infections within the bone, such as a tooth extraction infection. However, it does have a very small risk of causing a potentially serious stomach condition.

    For this reason, it is usually kept in reserve as an "antibiotic of last resort". Having said that, it is becoming increasingly more widely used.

    Clindamycin is also an alternative antibiotic if you are allergic to penicillin.

    Tooth abscess antibiotics are also used in other areas of general medicine. They just happen to be particularly effective against the bacteria that commonly cause dental infections.

    An antibiotic works in one of 2 ways; either it kills the bacteria outright, or else it stops the bacteria multiplying and so gives your own immune system a chance to work.

    The ones that kill bacteria are called "bacteriocidal"' and the ones that stop bacteria multiplying are called "bacteriostatic". You might think that the best antibiotics are the bacteriocidal ones, but this isn't always true. Clindamycin, for example, is bacteriostatic, but extremely effective!

    To get the best results, you must always take your antibiotics exactly as directed by your health care professional.