Dr. Silberman often gets asked the question: “Do I apply heat or cold to a toothache?” Watch our one-minute video to discover the answer:
Should you apply heat or cold to a toothache?
ALMOST NEVER APPLY HEAT to your face when experiencing a toothache. If you have an infection the heat may draw that infection out causing more swelling. Apply COLD! If you are experiencing a severe toothache the best thing is ice water in the mouth. You may have gasses trapped in your tooth. If you keep ice cold water in your mouth, the gasses will contract and pain either lessens or ceases.
“Inflammation is the body’s natural response to any infection. Heat increases inflammation. Ice helps to relieve inflammation.” —Dr. Paul Silberman, Dentist in Waldorf
What to do if you have tooth pain
- Get to your dentist as soon as possible.
- Putting it off will make it worse.
- Even if the pain eases, the underlying cause for the pain is still present and you will wind up experiencing pain again.
There are many reasons you may have a toothache. It can occur even if you have seen a dentist regularly. If you have a toothache and have not seen a dentist for a long time, do not be intimidated. Just go to a dentist as soon as possible if experiencing pain. Never worry about telling a dentist that you have not seen anyone for dental treatment for a long time. Your dental office must be a judgment-free zone. What is important is how you can start to achieve dental health now, not what you did or did not do in the past.
Are you experiencing tooth pain right now?
Call The Silberman Dental Group
Editor’s note: This post was originally published in July 2014 and has been revamped for comprehensiveness and timeliness.
I recently had two root canals. #’s 18 And 19. Both of which were broken and chipped. A week later I went in for temporary crowns. After one week the pain along my lower jaw from one side to the other was, on a scale of 1-10, at a ten! I recently went back to the dentist to have my bite adjusted. After 5 days, I still experienced pain, at a 10! I was not prescribed antibiotics or pain reliever. I called the dentist yesterday and insisted they give me antibiotics Incase there was bacteria within the teeth that went infected. Should the dentist, during my initial visit prescribed an antibiotic? I could have avoided all this pain!
Sylvia, I am sorry for this terrible dental experience you went through. You asked, “Should the dentist have, during my initial visit, prescribed an antibiotic?” This is very controversial.
I always prescribe antibiotics at the time I diagnose the need for root canal therapy and the patients never have post-operative pain. That is not what is taught in dental schools today. The treatment you received is considered the standard of care today, and unfortunately, the result you received occurs in one out of five patients. From my point of view, if the ratio was 1:5,000 or even 1:500, I might consider that approach. But because I know that one out of five is going to suffer, I pre-medicate with antibiotics. The downside is that some will have an allergic reaction to the antibiotic. I always tell the patient that if a rash or difficulty breathing develops, stop the medication and call me.
There is also concern about over-prescribing antibiotics and patients developing resistant strains of bacteria. While a valid concern, I still weigh that against what you had to go through. It’s not like I am suggesting antibiotics for the treatment of the common cold. If a tooth requires root canal therapy, bacteria are present. I want to reduce the number of bacteria before treatment. I want to “take the bees out of the hive before I stick my hand in it.” But I am in the minority. I hope that answers your question.
Hi i was seen today at the er for a tooth abscess that it causing tooth and ear pain. They gave me an antibiotic as well as 800 mg ibuprofen. However the ibuprofen seems to wear off after 5 hours and its killing me to wait 3 more hours for another dose. Can ai take tylenol too??
Hello Nichole, It is often helpful to alternate Tylenol and Ibuprofen every 4 hours. In other words, take 800 mg Ibuproven every 8 hours. Four hours later take two extra strength Tylenol (2 x 500mg) and take the Tylenol every 8 hours. Do not take either one more frequently. So every 4 hours you will be alternating 800 mg Ibuprofen with 1,000 mg of Tylenol. That should help with the pain. Tests show that is as effective as Codeine and not nearly as addictive. The antibiotics will take 48 to 72 hours to fully kick in. Once it does, the need for pain medication will decrease. I hope that helps. Dr. Silberman
I have been on amoxicillin for 36 hours but it seams like it is getting worse not better
Amoxicillin is not my drug of choice for tooth infection. Unless you have a history of GI issues, the drug of choice is Clindamycin. See if you can have your dentist switch you to this medication. Good luck. Doc
I had a tooth infection last year and went to three different dentist and they wouldn’t give me antibiotics even though my tooth was infected⅘
Hi Sylvia (or is it Kevin), My response to your comment regarding treatment of tooth infection via antibiotics is that not all dentists are convinced it will help. Or if they think it will help, they don’t want the patient exposed to a medication that could cause an allergic reaction. My position is that is nonsense. If you have an allergic reaction, stop the medication. If you have difficulty breathing or a rash develops, stop the medication. Take some Benedryl and if the reaction is severe, go to an emergency room for care. The odds of that are so extremely low, it doesn’t make sense not to go with an antibiotic. The post-treatment discomfort after root canal therapy is almost zero when the patient is premedicated with antibiotics. This is one dentist’s personal experience from 40 years of practice. But I am in the minority in this regard. I suggest finding a dentist who will premedicate you prior to treatment. Good luck. Doc
Call your dentist and tell them that it is an emergency. Stress that you are in pain and cannot take it. Normally, they will fit you in regardless if there is a wait list. If that doesn’t work ask your dentist for a pain reliever –they may be able to prescribe something that is stronger than you are taking. Furthermore, if the tooth is impacted (which yours sounds like) they give you meds to relieve the swelling in order that they will be able to facilitate the extraction. If worst comes to worst perhaps call a different dentist. Normally, the ER cannot do anything for you.
Hello GoToothache! Thanks for the helpful tips. We agree that if you are in pain, you should call your dentist. They will either be able to fit you in for an appointment or offer advice on easing the pain.
My face is so swollen because of my toothache..I never in my life had this..not even when I’ve had some of my teeth.pulled..I’m 61 diabetic and can’t stand this pain…
If you can’t get in to see a dentist, go to an emergency room or Urgent Care Center. You need to be put on antibiotics to control the swelling. As a diabetic you know that the healing response is always more difficult. It is very important that you do not apply heat to your face as this will dramatically increase the swelling. It is OK to apply cold compresses. You can take Tylenol 500 mg (2 extra strength) along with Motrin (two 200 mg) every 8 hours. Or when you get your antibiotic prescription you might be able to get a stronger pain medication prescribed too.
I took advil or tynenol with cold water. My orthodontist suggested try rinsng your mouth with salt water. It will get better as your teeth align.
My sister pregnant her wisdom tooth have a cavity nothing is working we tried everything the dentist won’t pull it because they have to put her to sleep the tooth pain wake her up at night she can’t sleep or think
There should be a way to get this tooth numb without putting your sister to sleep. I suggest going for a second opinion. Also, the dentist could numb the tooth and remove the part that’s causing the pain. After delivery, she can go back to fix the tooth. Good luck and I hope she has a happy and healthy baby. Doc
Rinse with warm salt water, Infection in your mouth can spread quickly. Do not use alcohol as this causes inflammation to your gums making it worse.
Hi Deborah! Thanks for sharing. Warm salt water rinses are an easy and effective way of preventing the spread of infections
If your old its all good, if not then be sure to lay of acid drinks and candy. And don’t brush your teeth right after eating these, wait at least an hour
Why does it hurt so much worse when I quit using cold water. Will it eventually stop hurting like that or will I have no choice but to try to withstand the pain when stopping the use of cold water. It hurts so bad when I stop using cold water I can barely talk. It like no pain I’ve ever had
There is an infection in your tooth. The bacteria (germs) in the infection give of a byproduct of gas. The gas can’t escape and is trapped inside the tooth. Applying cold to gas makes it contract and takes pressure off the nerve which stops the pain. A dentist can numb the tooth and open it to allow the gas to escape which will stop 80% of the pain. You can save the tooth with root canal therapy or have it extracted. I hope that answer helps.
I can’t afford to go to a dentist someone told me to go to the local feed store and buy fishbiotics cephalexin is this a suitable substitute till I can get into the dentist
Hello Worried, That’s an appropriate name for how you should feel if you are considering taking fish antibiotics. While it is true that the antibiotics used to treat fish are the same as humans and other animals, it is the only pharmaceutical group that is unregulated. You have no idea if the strength per dose is accurate, or what the purity of the product is. The cost of the fish antibiotics would probably be around $30. For a little more, you could see a dentist and get a proper diagnosis with treatment options. Call some dental offices and ask if they could see you to have an evaluation at minimal cost. If you need an antibiotic, an appropriate one can be prescribed. An alternative is to go to an emergency room or urgent care, and they should be able to prescribe for you too. Your best bet is seeing a real dentist. Call some dentists and explain your predicament. See if one will take you to diagnose the problem and take an x-ray for a set fee. Good luck. Doc
I’m 21 and I have tooth on my left bottom side (two teeth away from my wisdom teeth that are also coming in) an it’s hurting so bad its causing me an extreme earache as well, I tried Coconut oil pulling but it hasn’t really helped and my 500mg Ibuprofen isn’t helping either. It’s to the point I can’t even sleep I just toss and turn at night. I don’t know what to do!
Sorry that you are going through this Annabelle. It sounds like you might have an infection in your tooth and you should see a dentist who would be able to diagnose the problem. It may need an antibiotic to help stop the infection and the pain. If you can’t see a dentist, go to an Urgent Care or Emergency Room. Though they don’t have the diagnostic skills of a dentist, they would be able to put you on an antibiotic to quiet the situation until such time that you can get to see a dentist. If the tooth is infected, it might need to be extracted. Or it might be saved with root canal therapy. So get to your dentist or ER as soon as possible and stop the pain. The treatment of choice is easier to select when you aren’t hurting. Good Luck, Dr. Silberman
Hello Robert! Thank you for commenting. We believe everyone, regardless of age, should be aware of sugary and acidic drinks or foods.
And great tip on waiting to brush! It is proven that you should wait to brush after having acid in your mouth or else it can further damage your enamel.
Hello my lower broken tooth is causing me a severe pain to the point i hit my head and wish for death,i went to the dentist today and he gave me some antibiotics to heal the abscess before removing my tooth i went home and took the meds it stopped for only 2hours and started hurting like crazy again and it wont stop at all i dont know what to do :’) helpp
Hopefully your situation has been resolved. For pain management, we recommend alternating Tylenol (2 x 500mg tablets) with Motrin (Ibuprofen, Advil, 2 x 200mg tablets) every four hours. Do not take more than 6 Tylenol or 6 Motrin in a 24 hour period. If the tooth isn’t cold sensitive, holding ice water in your mouth can quiet the pain. I hope you are doing better now. Best, Dr. Silberman
I have a visable abscess in my mouth and the pain is killing me. I have antibiotics, but is there anything I can do to alleviate the pain a little until I can get to the dentist Wednesday
Sorry you are going through this. The abscess tells me that there is no “feeling” in at least one root of the tooth. The pain is coming from the infection outside the tooth or from one of the other roots that still have feeling. A quick remedy is to hold Ice Water in your mouth in the area of the affected tooth. It should take away the pain for a while and can be continually reapplied as needed. Once the antibiotic kicks in, the frequency of the need for ice water should decrease. Hopefully, the other teeth are not sensitive to cold or this becomes a trade-off.
The reason ice water helps is because the bacteria inside the tooth give off a bi-product of gas. The gas is trapped and has no way to escape. When gas is heated it expands. Your body heat may be enough to cause it to expand and put pressure on the nerves causing the pain. The ice water gets the gas to contract and remove the pressure from the nerves. You may have to keep ice water on the night stand next to the bed if the pain wakes you. Take a swig and hold it around the tooth, then swallow and go back to sleep.
Where are you located?
I hope this helps. Good luck!
My molar tooth cracked and my tooth nerve was alive so the dentist put a crown on it without a root canal(DEC). He did mention that I may need one down the road. Anyways, I finally got the new crown on (end of Feb) and this month I have an abscessed next to my gum. It does not hurt unless something very hot or very cold is put on it. I am on antibiotics and have to wait a month to finish my root canal( the dentist started it) with an endodontist. Not understanding how I could have no pain but an abscessed on my tooth. It can get irritated with food, especially salty food; on the other side I have a temporary crown on a canine so I can’t eat on that side. Lastly, when the dentist went into the fake tooth a smell came out. Awful smell- is that from the bacteria? Never smelled it before. So happy he did not smell it. OMG. Does the abscess go away after my root canal is finished? Or how does it go away?
TY
Hi Maryanne, Sorry that you are going though this. Your dentist has provided you with excellent care. I agree that in your situation, I would have placed a crown on the damaged tooth in hopes that it would heal and not require root canal therapy. Each tooth has it’s only blood and nerve supply and the tooth shelters this from the bacteria that are in your mouth. But if a tooth cracks or decays, sometimes the bacteria can get into the tooth circulation. This may or not cause discomfort or temperature sensitivity. The bacteria take over inside the tooth and the blood and nerve gradually disappear. The abscess forms as the bacteria increase in number. That can result in swelling or pain or both, or sometimes a pimple forms to create a relief valve. Instead of pressure building up in the tooth and the abscess, the pimple (fistula) allows for drainage and relieves the pressure, and there is usually no pain. The root canal treatment cleans out the bacteria from the hollow spaces of the root while leaving the actual roots intact. Sometimes it smells really bad, like in the case of your tooth. Once cleaned out, rinsed and dried, the space in the roots are filled with a plastic type material that flows into position. That process eliminates the bacteria from the tooth, and the antibiotics kills the bacteria outside the tooth in the jawbone and gum. The infection goes away and everything heals within a few weeks, if all goes according to plan. I hope that answers your questions. Best, Dr. Silberman
I will tell you I am on antibiotics now for 4 days !! and I have been taking ibuprofen 800 milligrams and alternating and IT DON’T WORK! I have also took a tramidol 100 milligrams! and IT didnt work the pain was so bad that I turned my head upside down to stop the pain for just a bit of relief!!! anyone who has pain get ambensol!!! the gel kind it is magic!!!!!!!stops the pain instantly!!!
Hello Sara, If Ambesol worked, the problem is likely more gum related than tooth related. Tooth pain would be unaffected by a topical anesthetic like Ambesol. Having said that, the antibiotic of choice for gum problems is one in the “cillin” class, like Amoxicillin. You should be taking that every 8 hours (500mg). If it is a tooth problem, Clindamycin is the drug of choice, either 150 mg or 300 mg every 6 hours. The correct antibiotic should become effective after 48 hours. For gum problems, warm salt water holds in the mouth would be helpful. A teaspoon of salt in an 8 ounce glass of warm water held for a minute or two every few hours will help. I hope that helps.
Hello Dr so recently the nerve in my tooth died and it was also infected around my gums and was spreading but my dentist put me on antibiotics and I alternated between two pain medications it’s been 4 days and the swelling and infection is going away and there’s no more pain now I just have to get a root canal I was just wondering if I could take a hot shower because I know if u apply heat to an infection Thats not good and I don’t want the infection coming out so is it okay if I take a hot shower?
Hello Russell, I wouldn’t allow the heat to be in contact with the area for very long. I have seen where a sauna caused an abscessed tooth to swell the face considerably. Take your hot shower but don’t let the hot water run on that side of your face, and don’t stay in for too long. Have a cold compress ready to apply to your face when you exit the shower, just to be on the safe side. Good luck. Doc
I’m going through some hella pain with an abscessed tooth right now. It just started yesterday. My whole tooth is gone and all that remains is the root under the gums. The pain is unbearable. But I was always told that cold water was bad to use as it holds the infection in where warm water extracts it out, but ice cold water is the only thing that works for me. Glad to see a professional recommending it. Even though it only lasts a few seconds at most. I was also told not to swallow the water because then I’m just swallowing the infection and that can cause me to be sick. Is that true?
Hello Stacey, So sorry to hear that you are going through this. Yes, the cold water held in the mouth will stop severe pain in some cases, but just for a short while, as you stated. It is OK to swallow the water. That is not going to pass your tooth infection to the digestive tract. Hopefully you are going to a dentist ASAP to have that root removed today. Or at least be put on antibiotics which will stop the pain in 48 to 72 hours until such time that the root can be removed. As for the controversy between heat versus cold, the rule of thumb is to never apply heat externally to the face to soothe a tooth infection. That will draw the swelling to the outside of your face. If there is gum related swelling or following an extraction, warm salt water holds inside the mouth will help the unhealthy gum tissue to heal. Cold can be applied externally, but I’m not sure how much that will help. When cold is held in the mouth to stop the pain, the reason is because there are gasses trapped in the root with no place to escape. The gasses are formed from bacteria in the infection. Cold water causes the gas to contract and take away the pain. by removing pressure on the nerve. I hope you feel better soon. Best, Dr. Silberman
Hi Dr 🙂
I realized last Sunday (5 days ago) something was not very well with one of my wisdom tooth (already grown). I saw a dentist on Tuesday and she confirmed that the tooth is going through an infection and needs to be pulled out. Therefore since 3 days I am getting Amoxicillin 1000 mg 3xday, and I must wait at least one week for the imflammation to disappear and have my tooth pulled out.
I don’t have an extreme pain, but the whole area (including my ear) is swollen; I find it almost impossible to open my mouth (only eating baby food). My question is: is the antibiotics my dentist prescribed enough? Or I have to take something else as well?
Info+.: we are having very hot temperatures where I live now (40 degrees) can it also have an impact ?
Thank you a lot!
Hello Patty. Sorry for the delay in getting back to you. Hopefully the problem has been resolved by now. But for anyone else reading this and having a similar problem, it does take time for the antibiotics to kick in and reduce the swelling. I would suggest warm salt water rinsing to help bring down the swelling. Also, apply cold compresses (never hot) to the outside of your face. Any external heat will increase the swelling and pain. That would include weather related, or sauna, or hot tub, or any other source of heat. Keep it cool. I hope that helps. Good Luck, Dr. Silberman
Hi Doc! How long does it take reversible pulpitis to reverse?
Hi Dana, I usually tell my patients that antibiotics will quiet a tooth within 48 hours, but it won’t fix the problem. It lessens the pain by 80%. The fix is an extraction or root canal therapy and either will stop the pain completely. I hope that helps. Doc
I am having a tooth pulled tomorrow that has had a root canal in the past. My face is super swollen and draining out of my nose. I am on antibiotics. Can I apply a warm wet wash cloth to help the abscess drain?
Do not apply heat to your face. It will draw the infection to the surface and create severe swelling. It is OK to apply cold compresses. You should not have tooth infection drainage from the nose. There should not be communication between the sinus and oral cavities. Be sure you tell the surgeon at the time of the extraction that this has been your experience. It may be necessary to apply a membrane that will separate the extraction site from the sinus to create proper healing.
I had a tooth pulled a year ago. This week I have developed an incredible throbbing pain on the gum in the tooth extraction site. What could this be?
There are a few possibilities. If part of the extracted tooth was left behind, it is possible that your body is still healing and pushing the fractured piece to the surface. Essentially, you are “teething” as the fragment pushes out through the gum. Another possibility is that a neighboring tooth is acting up and it’s very difficult to determine exactly where the pain is coming from. If you are having any sensitivity to cold, hot or pressure, the problem is likely another tooth. In any event, you should see a dentist to have the site x-rayed and evaluated. I hope that helps.
I have severe toothache, been to the dentist and nothing is visible on the xrays. The pain is unbearable, if I sip on cold water the pain subsides but only for a minute. I’m on antibiotics and painkillers but nothing is making is easier, it gets worse every day. Not even able to fall asleep, the pain is just horrific.
What should I do?
You have a tooth that is infected. It is in the early stages of infection so it does not show up on the x-ray, but that doesn’t mean the pain is any less. The bacteria causing the infection have a by-product of gas. There is no escape route for the gas to get out of the tooth so it gets trapped in the root where the nerve is located. The pressure from the gas builds up and causes the pain by pressing on the nerve. When you sip something cold, the gas in the tooth contracts and takes the pressure off the nerve, and the pain stops. But it is very temporary. It confirms the diagnosis. Also, if you take your finger and tap on that tooth, it will feel different from the other teeth. Sometimes the difference is very mild and sometimes severe. It just depends on how advanced the infection is. Bottom line is that tooth needs a root canal treatment to be saved. The alternative is to have the tooth extracted. Good luck. Doc
Thanks for the tip Dr. Silberman. It is indeed interesting to note that heat can actually cause inflammation in your tooth, since warm saline water is considered a useful home remedy to tackle infections. Rather it is the hot spicy foods which can cause gum inflammation.
Warm saline rinses are a good home remedy for minor gum swelling. An abscessed tooth is a different story. It is best not to apply heat externally as it will draw the infection to the outer surface and potentially cause severe swelling. If the abscess is draining in the mouth next to the tooth, it is again OK to use warm saline to help with the draining process. No External Heat.
dear dr silberman, my front center top tooth is very loose and there is some pain. dental appointment is in a few days time. how may I reduce the swelling or kill the bacteria that is causing the inflammation please? thank you
Until the tooth is removed, hold warm salt water in your mouth around the tooth to help bring out some of the swelling. Once the swelling is reduced, it will feel more comfortable. Once the tooth is out, it will feel even better. I hope that helps. Best, Dr. Silberman
I recently got a crown put on a tooth that had gotten a root canal about 7 years ago. I never had any pain in the tooth for all these years. After the crown was put on(About a month ago), it was fine as well.
Up until about 4 days ago. I had felt like there was something stuck between by teeth. I flossed, and there was a bit of blood. The next morning I woke up with pain at about a 5, from 1-10. Every day it has gotten worse, to now it being at a 10.
I went to a dentist yesterday(The only one with openings on a Friday). They did xrays, and said that , my root canal “Didn’t work”. I’ve had years of xrays and have NEVER been told that. They said I would need to have it redone, set me up an appointment for 10 days from now. And here I am today. In the worst pain of my life. Waiting for 10 days from today.
Does this sound normal? There is no swelling. Just a little redness around the gum that touches the crown. My tongue cannot even lightly touch the tooth without terrible pain.
Hi Paige. Sorry to hear you are going through this. Without an x-ray to diagnose, it is very difficult to determine the problem. It is possible that the root canal needs to be retreated. It is also possible that there is a crack in the root of the tooth just below the newly placed crown and a retreatment won’t work. The tooth may need to be extracted. In either case, you need to be put on antibiotics to get the infection under control. Warm salt water holds in the mouth around the tooth might help bring out some of the redness and prevent swelling to help quiet things. Also, a combination of 400mg Motrin (Advil, Ibuprofin) plus 1,000 grams of Tylenol (2 extra strength) should help you with the pain. These are over the counter non prescription medications that are very helpful when used together. I hope that helps and I hope you can get in to see the dentist sooner. Call them and explain the situation and let them know you can come in at any time on short notice. Good Luck. Dr. Silberman
Hello doctor,
I have recently had a root canal on my lower left side which has been successful. After 1 week i started to get a root canal on my lower right side (tooth no 7). I have never experienced pain on that tooth despite always eating on that side all my life. After the first appointment my dentist cleaned the tooth and put temporary filling. But now my tooth is throbbing with pain. I went to him and got the filling removed and he says its because of trapped gas. Im currently using Metrolag, klavox and cataflam. But i just can not bear the pain. I cant do anything and only feel like weeping.
Hello Paige. If the Metrolag and Klavox antibiotics have not been successful, I recommend Clindamycin 150mg four times a day for 10 days. I find it to be more effective than the other antibiotics in the treatment of tooth infection. You cannot take this medication if you have gastrointestinal problems like Crohn’s Disease or Irritable Bowel Syndrome. Also, check to see that, when you bite together, do your upper teeth contact this tooth. If so, ask the dentist to reduce the height of the tooth to eliminate contact with the opposing teeth. That will help to stop the tenderness. The tooth reduction will be necessary in the future to accommodate a crown so don’t worry about adjusting the tooth height. In addition to the Cataflam, you should add 2 extra strength Tylenol every 8 hours to help control the pain. I hope that helps. Good Luck, Dr. Silberman
I cant get in to my dentist till tomorrow I am hurting I have taken ibuprofen, used cold pack nothing is working. Even did the salt water still nothing, I cant use ice water as this only increases the pain
Hi Wendy. You can take two extra strength Tylenol every 8 hours and 2 Ibuprofen every four hours. Don’t apply heat to the outside of your face because it could create and draw out swelling. If the pain remains as intense, you might need to go to an emergency room for care. I hope that will tide you over until you can see your dentist. Good Luck. Dr. Silberman
Im getting my tooth pulled in 6 dAys I believe an infection is beginning to abscess its a weekend, should i go to the emergency room to get antibiotics or can i wait until Monday to ask my dentist?
Hi Jessica, I would recommend that you go to the emergency room for an antibiotic. Or call your dentist that is going to be doing the extraction. If there is an emergency number for the dentist, he / she could call in a prescription for the antibiotic and you could save the emergency room visit cost. I am assuming that you have already seen this dentist and an x-ray of this tooth has already be taken. If you cannot reach the dentist, you should go to the emergency room. The antibiotic will take 48 to 72 hours to become fully effective so be patient. For pain, you can take 2 extra strength Tylenol every 8 hours, and 2 over the counter Advil (Motrin, Ibuprofin) every 4 hours. And remember to avoid applying heat to your face. Stay in air conditioning. The heat will draw out the swelling to your face and become very uncomfortable and unsightly. Applying ice is OK. I hope that helps. Good Luck, Dr. Silberman
I was told by a dentist that they couldn’t pull my wisdom tooth because i have another wisdom tooth growing under another so now im stuck wondering how im gonna get my wisdom teeth out can you help me?
Hello Rodneica, I am not sure exactly what your condition is. It is unusual to have a second wisdom tooth below another one. It happens, and in that circumstance, it is possible that the deeper one would be left in place and x-rayed every 3 to 5 years to make sure that there is no cyst formation around it. Consider getting a second opinion from an oral surgeon. Good Luck. Dr. Silberman
I’m having the absolute worst pain in my jaw , I’m visiting my family in ny and have an appointment with my dentist when I get home to California. Went to the Er twice first time I got antibiotics and a pain blocker shot , nothing changed for the better 4 days later my face was really swollen and the pain was 100 times worse went back this time I got a cortisone shot and some pain pills nothing Is helping I feel like I want to cut the inside of my mouth the drain the infection is there a safe way to do this at home
I’ve had a toothache on my right side a a few days and went to a dentist and was prescribed antibiotics and tylenol 3 with codeine. The pain med did not do anything. I had to end up getting whiskey and putting it on my tooth. About half way through my antibiotics the other side starts to hurt. I finish the antibiotics and still hurts on the left now should I call and see if I could get another round of antibiotics?
Hello Thomas, I would call the dentist and explain what you are going through. It’s possible that a different type of antibiotic would be more effective. Also, I am having just as much, if not more success, avoiding opiods like Tylenol with Codeine. Try alternating two extra strength Tylenol with 2 200mg Motrin (Ibuprofen, Advil) every four hours. In other words, take two Tylenol, then four hours later take two Motrin. Continue to alternate as needed. If you are not having cold sensitivity, it is possible that there are gases building up in your tooth that are causing your pain. Take a glass of ice water and hold the water in your mouth until the pain subsides. If trapped gas in the tooth is the problem, it will be relieved by the cold water. It is a temporary fix, but it works great. The treatment of choice would be extraction or root canal therapy. Good Luck, Doc
I had a deep cavity on one of my top molars. My dentist did a filling 4 days ago. Everything was fine until the anesthesia wore off and I got home. I have been in SEVERE pain and I am very uncomfortable. The only thing that subsided the pain is when I fill my mouth up with water and let it just sit in my mouth. Strange but it works… also I am pregnant so I’m only able to take Tylenol for pain. I have tried orajel, clove oil, etc nothing is working. I really just want this pain to stop. I think my dentist may have drilled a little too much and possible irritated my nerve. First time I went to that dentist other than a cleaning. Please help.
Sounds like this was a cavity that was so deep, it caused an infection that your body was tolerating. The tooth was like a hornets nest of bacteria instead of bees. The dentist’s work stirred up the hive and you are feeling the result. The reason that the cold water helps is because there is gas that is trapped inside the tooth. The bacteria give off a by-product of gas and there is no escape. The cold water causes the gasses to contract and take the pressure off of the nerve endings. The treatment is to get the tooth numb and have the dentist open the chewing surface to allow the gas to escape. Once the gas is out, the pain will not come back after the numbness wears off. The next step would be to fill that space where the bacteria were, and that process is called root canal therapy. The alternative is extraction, but if you can save the tooth, try to do so. Good luck and I hope you have a happy and healthy baby. Doc.
Had a root canal yesterday and the doc said I would still feel the unbearable pain I was in before for a day or two afterwards. My question is why does the ice water trick still work after it was done?
If all of the canals of the root were filled, there should be no space left in which gasses can collect, so the ice water trick should not work. There are some possibilities. If the dentist did a partial root canal treatment and did not fill the roots, there could be gas build up and the cold water would work. Or if the canals were filled and one canal was overlooked, same holds true. Also, it is hard to tell if the pain is coming from the tooth that was worked on. It is possible that the tooth next to this one also needs root canal treatment, or one that is in the opposing jaw. Sometimes the brain gets confused and can’t tell if the pain is upper or lower jaw. I hope that helps.
Doc
Several months back, I broke a tooth pretty bad. About three months ago I developed an abscess with puss coming out of it and I was prescribed an antibiotic, it seemed to work. I made a huge mistake and didn’t have it extracted at that time. So about a month ago the abscess came to visit again. My dentist prescribed Amoxicilin and scheduled an appointment for a surgical extraction. Well, my appointment wasn’t until this up coming Friday. About 9 days ago, the abscess was there again and the pain was beyond horrific. So, my dentist called in a Rx for Clindamycin 150 mg HCL to take tid for 7 days. I called my dentist yesterday because I had already completed the antibiotic, but there is still puss coming out and the pain is so horrific. I haven’t slept, but about a total of 5 hours in the past 3 days. I feel exhausted, but this pain will not subside for me to sleep at all. So, here I am at 3:50 in the morning and my dentist is squeezing me in at 3 PM to do the surgical extraction. I am counting down the hours hoping that it will come quick. My concern is, since there is still infection and Clindamycin did not work, what happens now? Will the extraction just clear up the infection? Can I take another antibiotic at this point if no other antibiotic has helped? I know very little about teeth, but I do work in a hospital and have a fear that I will get c-diff.
Once the tooth is extracted, the infection will clear without the need for additional antibiotics. The infection will have “an exit route” though the extraction site. I hope that helps.
Doc
Thanks so much. My tooth has now been surgically removed and the clot has formed well thus far, but the amount of pain I am in is horrific. I previously had 3 wisdom teeth removed and had less pain than what I am experiencing after this removal. My dentist said that OTC Motrin should work, but it doesn’t even ease the pain. What now? Do I just wait it out? Am I supposed to have this much pain?
Without seeing the xray, it’s difficult to answer your question. Most simple extractions that require no removal of bone have minimal post op pain and are treated with Motrin or Tylenol, or a combination of the two. I usually recommend alternating them every four hours. If you start with 400mg of Motrin (Advil, Ibuprofen), then take 1,000 mg of Tylenol in four hours. Then four hours later go back to 400mg of Motrin and continue alternating every four hours until you don’t need it anymore. If there was bone removed at the time of the extraction, some narcotic medication may be necessary until initial healing has set in. An intermediate medication that is a prescription but not as strong as some medications is Tramadol. You could suggest that to your dentist. Good luck. Dr. Silberman
so i had half a root canal done back in february and that tooth hurt for like 4 hours one night and then i woke up and my cheek was swollen. my tooth hasn’t hurt but it’s been swollen for 3 days now and i went to the dentist yesterday. he gave me antibiotics and nothing will take the swelling down. i’ve applied ice packs and done everything. idk what to do
Having half a root canal done is like delivering half the baby. Not good for you or your baby, or in this case, tooth. The roots of your tooth are like straws with a thick outer shell and a thin opening that runs down the center. These canals can be treated by being cleaned out and filled to prevent bacteria from growing in them. That is a root canal treatment. If you empty the canals and don’t fill them, there is no circulation or nerve in the tooth, so it will feel OK for a while. But without circulation, there is no way for your body to clean out the bacteria that will inevitably form in that dark, warm moist space in the canals. The bacteria build up in number and pass into the bone at the tip of the roots, causing pain and swelling. So here you are. If oral antibiotics are not working, you may need to be hospitalized for intravenous (IV) antibiotics. If the swelling is not too severe, you might be able to increase the antibiotic dosage orally. Consult with your dentist. Most importantly, do not apply heat to the swelling. It will dramatically make it worse. Good luck. I hope that helps. Dr. Silberman
I have been on antibiotics for about 5 days now, clindamycin and flagyll, due to a cracked tooth that is due to have a root canal in a few days. It has been extremely swollen and painful…it’s subsiding some, but I cannot open my mouth more than about a fingers wdith without major pain, and have been pretty much “eating” soups and stuf i don’t really need to open my mouth much to consume. I do have swelling in the jaw, and do cold packs off and on all day. Is there anything I can do to help with the pain and inability to open my mouth? If I can’t open my mouth wide enough how the heck can they do a root canal? I’m worried and don’t know what to do.
You are correct that a root canal won’t be possible if you can’t open very wide. Sometimes the antibiotic takes a while to be effective, especially on a lower tooth where the circulation is poor. It might be necessary if the swelling persists to go to the ER for IV antibiotics. You will need to work closely with your dentist to make that determination. This level of swelling happens very infrequently. It is usually associated with someone applying heat to the outside of the face in an attempt to get some relief. Heat is what brings out the swelling. It is possible to get the swelling without the heat though . . . . . it happens. The antibiotics you are taking are the same as what I would have prescribed. Hopefully your swelling has subsided, but if not, consider the ER. Good luck.
My dentist did a freeze test on #11 after a filling a year prior…now it hurts like mad now. Does that mean I will have to get a root canal or will it calm down?
I have jaw/teeth pain on lower and part of my upper teeth we did xrays and found my wisdom tooth is on that main nerve and the tooth is trying to erupt.
Hi Amber, I’m not sure what you mean by a freeze test. If a filling is large, the tooth may eventually become sensitive to cold or hot or pressure, even though there are no symptoms immediately after placement. In your description, it has been a year since the filling was placed. To test the tooth we take an x-ray to see if there is visible infection at the tip of the root. We do a tapping test and compare it to other teeth to see if it feels different. And we do a cold test where we apply a cold stick to the tooth in question and compare it to the teeth around it or the mirror image tooth on the other side of the mouth. This could be what you mean by a freeze test. These tests help to determine if the tooth needs root canal treatment. Based on your description, it sounds like the tooth need root canal treatment. I usually put my patients on a round of antibiotics to calm the situation, and then to the root canal treatment. It’s best to remove as many bacteria as possible before doing the treatment. Take the bees out of the hive before you stick your hand in it. I hope that helps. Best, Dr. Silberman
I went to the dentist yesterday as I was in agony. She said my wisdom tooth is coming through and that’s what is causing the pain. There is some swelling and I have been given a 3 day course of antibiotics. I’ve been taking Ibuprofen and paracetamol regularly but the only thing that is helping is holding cold water over the tooth but as soon as the water is gone it starts hurting again
Hi Erin, Sorry to hear you are going through this. The source of your pain is coming from gasses that are trapped inside the decayed / infected tooth caused by bacteria. The antibiotic will decrease the bacteria present and the gas production will slow as a consequence. Your body heat is often enough to expand the gas and put pressure on the nerve causing the pain. Be sure to avoid heat (coffee, tea, saunas, direct sun, hot showers, etc) The cold water reduces the pain because it causes the gas to contract and takes the pressure off the nerve. Getting the tooth extracted will give you the relief you are looking for. The antibiotic helps gradually to relieve the frequency that you’ll need the cold water. But getting the tooth out will solve the problem. I hope that helps. Best, Dr. Silberman