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Not Treating a Tooth Infection Can Kill You

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Woman holding her cheek needing a tooth extraction.

I get a lot of questions about tooth infections and ways to avoid getting treatment from a dentist. There are questions like “How long can I wait to get an infected tooth treated?” or “Is there a way I can treat this at home?” or “Can I just get an antibiotic from my doctor?”

Here is the problem with all of those. The only way to treat a tooth infection is by having the infected pulp physically removed. You need a dentist to do that. There are two procedures that can do that. He or she will use one of two treatments: a root canal treatment or a tooth extraction.

So, why won’t an antibiotic work? Because when a tooth is infected, the pulp will die which eliminates any blood flow. This will prevent the antibiotics from getting to the infection. It is going to continue to spread. Your brain and and heart are both near your jaw. You do not want it to spread there.

In the U.S., we average about 5 to 10 deaths from untreated tooth infections every year. Recently, there was a tragic story about a truck driver who had a toothache. He’d planned on taking care of it after he finished his long haul route. Before he could get to his destination, he started feeling too poorly to drive. He called his brother who agreed to meet him in the state he was currently in. But, his tooth infection spread rapidly. His condition was so bad that he ended up needing to be medflighted to a hospital.

He died a short time later.

These deaths are so preventable. He thought he had time to put it off. But these are dental emergencies. When you have a tooth infection, it needs to be treated. You do not want to become a statistic.

This blog is brought to you by a compassionate dentist in Kalamazoo Dr. Susan Dennis.

Periodontist Wants Me To Extract All My Teeth

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I haven’t been a fan of the dentist for most of my life. But, I recently decided I needed to go regardless of how I feel about it. I went to see a dentist who was very nice and said she did see some gum disease. We’d been working on that with some improvement but with some extra care we can get my oral health back in order. She suggested I also see a periodontist, who can help me with my gums faster. That, however, was a completely different experience. This dentist essentially berated me for being negligent and said that there was no point in trying to save these teeth. Instead, I should extract them all and get dentures. I’m 34. I don’t want to look like a grandmother while my children are still in elementary school. Do I have any options?

Ally

Dear Ally,

Woman asleep in a dental chair from a sedation dentist

I am very glad you wrote. These are two very different diagnoses of your condition. I find it hard to believe that none of your teeth are saveable given what the first dentist said. I also don’t like the way you were treated. Even if the state of your teeth was your fault (and I’m not saying that it is), I’ve found the worst thing you can do to a patient who suffers from dental anxiety is to make them feel guilty. What they need is compassion and a solution that allows them to get the dental care they so desperately need.

Additionally, if your gum disease were so advanced that your teeth couldn’t be saved, then you’d be losing them already. In fact, they might even just start falling out of your jaw. Your original dentist would have warned you about that.

First, let’s talk about a solution for the dental anxiety that you have been suffering from for most of your life. I recommend that you see a sedation dentist. They can give you a medication that will allow you to have all your dental work done in an anxiety free as well as pain free way.

Given that you need a lot of work and that you’ve had so many bad experiences, I’m going to recommend that you have oral conscious sedation. This is administered by a pill, but it is quite strong. So strong that you will need to have someone drive you to and from your appointment as well as stay with you for a bit after your appointment until you are lucid and steady on your feet.

If your dentist who was so kind to you is a sedation dentist, I would go back to her. Explain your experience and ask for them to do all your oral health care, including the gum disease. Using dental sedation will allow you to get more work done at each appointment was well, which will catch you up sooner.

If that dentist does not offer oral conscious sedation, ask for a recommendation of a periodontist who does AND who is compassionate. It will not hurt for you to check out their reviews as well, in order to make sure patients have the same opinion your dentist does. Save as many teeth as possible. If any of your teeth need to be extracted, you’ll want to replace them. My recommendation would be a dental implant once your gum disease is under control.

This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.

Dentist Can’t Figure Out Why My Tooth Hurts

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I’ve had a horrible toothache for several days and was able to get an appointment with my dentist. I’d just had some radiographs done three months ago, so he used those. He told me he didn’t see any crack in the filling where I am having the pain. He did prescribe me some antibiotics and told me if the pain goes away that I do not have to worry about it. However, this has me very worried because everything I’ve read said that if a tooth is infected, antibiotics will only be a temporary solution until the meds are done. Maybe I’m wrong.

LeeAnn

Dear LeeAnn,

A woman in pain holding her jaw, needing an emergency dentist.

The very first thing I am going to say is that you need a new dentist. There is so much wrong with both his diagnostic skills as well as his treatment plan. Let’s start with the diagnostics. He went from a three month old radiograph. Three months old. You didn’t have a toothache three months ago, did you? If not, then those imagings are useless. Something has changed in the last three months.

Second, there are other tests to do in addition to the one he did. For instance: tapping the tooth to evaluate pain, hot/cold tests, even electrical tests to determine if the pulp is alive. He did none of these. He just looked at three month old imaging. That is insane.

Even worse, however, is his treatment plan.If your antibiotics do help, that is a sign of a tooth infection. As you indicated, antibiotics do not cure tooth infections. You have a better understanding of this than your dentist.

There are two ways to adequately treat a tooth infection. The first is with a root canal treatment. The second is by extracting the tooth. If the antibiotics do cause the pain to get better, then I want you to see a dentist, a different dentist, to get this tooth treated. If you don’t, you’ll end up with a dental emergency that can turn life threatening.

This blog is brought to you by Portage Dentist Dr. Susan Dennis.
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Tooth Replacement for Hockey Players

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My son is a hockey player. He’s damaged teeth before but never lost one… until now. We’ve always heard not to use dental implants because of the danger of ripping out bone if it happens again. I totally get that, but he’s planning on being a hockey player for a while. I am aware that the longer he is without an implant, the more of his bone that he’ll lose. Is there any way to preserve his bone? If so, what type of replacement do you recommend?

Susie

Dear Susie,

Illustration of dental implants

I am very glad you wrote. You have so many good things in your questions. Whenever you have to extract a tooth it is very stressful. Yes, he will lose bone if there is not a dental implant there. Yes, there is a danger of bone being ripped out. HOWEVER, that danger is only there if there is something anchored to the implant, like a crown.

Here is my recommendation. First, get the dental implant placed. This will protect his bone. But, do not place the dental crown on it. As I mentioned above, that is where the danger lies. Instead, get a temporary, removable tooth replacement, such as a dental flipper. This way if he gets knocked in the mouth with another puck or a hockey stick, the flipper will fly out but his dental implant will remain secure in his jaw.

You do want to make certain that the dentist who does his procedure has post doctoral training in dental implants. This is a very advanced procedure with countless horror stories about things which went wrong from dentists who didn’t have adequate training. Dental school is not enough. In addition to their post doctoral training, ask them what their success rate is. You want at least a 95% success rate.

This blog is brought to you by Portage Dentist Dr. Susan Dennis.

Do You Have to Get Implants If You’re Only Losing One Tooth?

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I understand why dental implants are important if you are losing all of your teeth. But what if you’re just having one tooth extracted? Is there the same risk of facial collapse? I do need to have a tooth extracted. At the moment I cannot afford a dental implant so I’m hoping there is an alternative for me.

Bella

Dear Bella,

Removable partial denture

While you won’t be in danger of complete facial collapse the way you would be if you had all of your teeth extracted, the area where you do extract a tooth will lose bone bone structure in that spot.

If you can’t afford a dental implant in that spot right away, you could get a removable partial denture or even a dental flipper as a temporary replacement.

You will still lose bone in that area, but only in that area. Plus, it will at least hold the space open for a dental implant while you save up for one. If it takes a long time for you to save up, you may have to also save up for some bone grafting. This is a procedure that builds up the bone in that area in order to support the implant.

Depending on the condition of the teeth on either side of the extraction site, a dental bridge may be a good option as well. With this procedure, you would suspend a false tooth between two dental crowns. If either of those teeth are already in need of a crown, a dental bridge would make more sense because you would be taking care of two issues at once.

As an esthetic consideration, if your extracted tooth is visible when you smile, you want to consider the color you will want in the long run. Once the replacement is made, you cannot change its color. So, if you are wanting a whiter smile any time in the near future, you will want to have teeth whitening done before having the replacement made so it can be made to match the color you want.

If the tooth isn’t visible when you smile, then I wouldn’t worry about that at all.

This blog is brought to you by Portage, MI Cosmetic Dentist Dr. Susan Dennis.

Misdiagnosis Caused Pain and Dental Emergency

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I need advice on what to do. I went to my dentist telling him that my first molar (#19 according to an online chart) was bothering me. He felt like it was actually because of an impacted wisdom tooth. He suggested I get a filling, which I did, but it didn’t help. Then, he suggested I pull the tooth, which I did, but it didn’t help. A few weeks later, my cheek became swollen. I went to the hospital and they told me that I had a tooth infection and needed to see a dentist. The abscessed tooth is on the first molar, like I originally said. I’m not sure I trust my dentist. Should I see a specialist?

Ashley

Dear Ashley,

A woman in pain holding her jaw, needing an emergency dentist.

I’m sorry this happened to you. I’m not sure why your dentist thought a filling would fix an impacted wisdom tooth or why he didn’t check out the tooth you told him was hurting. You didn’t mention anything about him doing x-rays, but that doesn’t mean he didn’t do them. Either way, I wouldn’t trust this dentist either.

When you have an abscessed tooth it is serious. The fact that yours has spread to your cheek makes it more serious. I would consider it a dental emergency at this point. You don’t have to see your current dentist. I understand why you are having trouble trusting him. However, you do need to see a dentist soon. It doesn’t necessarily need to be a specialist, just someone able to treat you.

Most dentists leave room in their schedule for dental emergencies. Just explain to them what is going on and someone will get you in quickly. Hopefully, all you will need is a root canal treatment. That will save your tooth, but you will still likely need a dental crown on it.

If the tooth is too far gone to save, then the tooth will have to be extracted. Don’t just leave the open space once the tooth is gone. It will be important for you to replace the tooth. The ideal replacement will be a dental implant, but there are other options as well. Your first order of business is to get this tooth infection treated.

This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.

Are Tooth Infections Really Dangerous?

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I had a molar break a couple of weeks ago. Now the tooth hurts a lot and my cheek has stared to swell. I’ve been taking some antibiotics I had laying around. It helped at first, but hasn’t done much recently. Now I feel pain going up to my temple. Could this be a sinus thing or is it the tooth? Someone told me this is dangerous, but I don’t have a ton of money right now. How serious are we talking?

Luke

Dear Luke,

Man holding his cheek in need of an emergency dentist

I am very glad you wrote. This is a tooth infection, and yes, it is dangerous. If this remains untreated, it could spread to your brain and become life threatening. The situation you are in would be considered a dental emergency. Antibiotics alone will not deal with the infection. The best it can do is hold it at bay temporarily. But, it sounds like you have gotten everything you will be able to out of your antibiotics.

The only way to cure this is for a dentist to get in there and physically remove the infected pulp. This can be handled in one of two ways. First, you can have a root canal treatment. This is ideal because it means the tooth can still be saved. If that is no longer possible, then you will need to have the tooth extracted. I would not mess around with this.

Sometimes patients avoid the dentist because of anxiety. If that is your case, then I would look for a sedation dentist. They can provide you with an anxiety-free appointment.

If you end up extracting the tooth, then you will need to replace it or the adjacent teeth will then shift or tip into the open space. This will throw off your bite leading to jaw pain, headaches, or even TMJ Disorder.

The best tooth replacement is a dental implant. However, those are expensive. For now, you could always get a dental flipper, which is much less expensive and will hold the space open, giving you time to save up for the implant.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Space Maintainers for Pediatric Teeth

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My six-year-old daughter has decayed back teeth that have led to one of the molars breaking and getting infected. Her dentist said that the tooth needs to be extracted. Is there no way to save her tooth? When I have a severely infected tooth, my dentist does a root canal treatment. Do we really have to extract the tooth?

Cam

Dear Cam,

A boy smiling and holding a toothbrush proudly.

While there is a child’s version of a root canal treatment, called a pulpotomy, in many cases it doesn’t work. Plus, it sounds like your daughter’s tooth is quite far gone. Those back teeth have lots of pits and grooves where bacteria can become trapped. It helps if your daughter gets those back teeth sealed, but that doesn’t eliminate the possibility of decay.

If the tooth is infected and is as far gone as it sounds, your daughter is much safer getting it extracted. If not, then the infection can spread. Not only can that affect her bone and the development of her permanent teeth, but it can even spread outside of her bone and become a life-threatening infection. I would consider your daughter’s situation a dental emergency and not delay treatment.

You did not mention anything about a space maintainer. I hope your pediatric dentist was planning on that. Often, baby teeth are fine coming out early. However, the back teeth are an exception. These need to stay in until your daughter is around twelve-years-old, otherwise the adjacent teeth will shift into that space during that time period and will crowd out the adult teeth.

Sometimes, however, like in a situation such as what your daughter is in now, the tooth has to be removed. Using a space maintainer will protect that space until her adult molars are ready to come in.

I hope this helps.
This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Options for an Infected Tooth

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I had two partial fillings done. They’d been hurting on and off for almost three months, which is since I got them. The dentist told me that is pretty normal. They’re my first ever fillings so I just dealt with it and hoped I didn’t get any more decay. I can tell you I’ve been brushing my teeth quite a bit extra! The pain became a bit worrisome to me so I went in to see another dentist and asked him to do an x-ray just for my own peace of mine. He said that the teeth should be extracted because they have an infection. I just wanted to make sure this is my only option before I extracted two teeth. I feel like I’m in a bit of a nightmare. If I do have to lose two teeth, how do I replace them?

Alison

Dear Alison,

A woman in pain holding her jaw, needing an emergency dentist.

I am sorry for what you are going through. There are a couple of things bothering me about this. As much as you probably don’t want to, I think you need to get a THIRD opinion. It’s possible you have either two incompetent dentists or else one of them is a bit dishonest. First, I’m wondering, if these teeth are infected, which I suspect they are, how that happened. Were the fillings placed incorrectly? The purpose of the filling was to prevent a tooth infection.

However, the second dentist does not sound much better. You definitely do have other options. Not only that, but dentists are under an ethical obligation to tell them all to you. It sounds like that didn’t happen for you. When a tooth is infected, when at all possible, you will want to save the tooth. This is done by getting a root canal treatment. An extraction is only for when a tooth cannot be saved. In that case, you will want to extract it and replace it. The best tooth replacement is a dental implant. However, there are other options as well. The first step is finding out if that is actually necessary.

Though I am sure you are frustrated, I would not put this off. Dental infections spread. Once it leaves the tooth it can reach your brain, throat, and heart. Any one of these can turn a dental emergency into a life threatening one.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

High Resistance to Novocain

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I have a very high resistance to Novocain which has made my dental care a nightmare. It got so bad I stopped going. I need to get control of this. Is there anything I can do to make this easier, like a different numbing medicine? I need to have three teeth extracted by the look (and feel) of things. I’m terrified about going in but know I need to. I also want to find a way to go on a more regular basis.

Terry

Dear Terry,

Woman sleeping in a dental chair from dental sedation, wearing a blue cloth cover

I know exactly how to help you. When someone has a high resistance to Novocain, it usually means there is some dental anxiety going on. That would also make perfect sense with the trauma you’ve experienced with your past appointments. The anxiety you’re experiencing is what causes the Novocain to wear off so quickly.

The way to solve this problem is to take a medication that relaxes you before your procedure. This will put you in a calm state and allow your numbing medicine to work to its full potency. This is done using a dentist who offers sedation options and works with anxious patients.

Options in Dental Sedations

There are two common forms of dental sedation. The first is nitrous oxide. This is the mildest form but may be all you need. This is simply a matter of you breathing the gas through a nosepiece. Its biggest advantage is once you’re done, your dentist switches the gas from nitrous to oxygen. In just a few moments you are completely good to go and ready to get on with your day.

The next level is oral conscious sedation. This is a pill you’ll take before your appointment. It is very strong. It’s so strong you will need someone to drive you to and from your appointment. They’ll also need to stay with you until you are lucid and steady on your feet after your appointment, which could take several hours.

This is so strong, you will be completely relaxed. Most patients sleep through their appointment.
You’ll also find you’ll be better able to catch up with your dental work because you can get more done at each appointment.

I know you’re needing to extract some teeth. Talk to your dentist about the possibility of getting dental implants to replace those teeth. This is the top choice and will be like having healthy, natural teeth in your mouth again.

This blog is brought to you by Kalamazoo Sedation Dentist Dr. Susan Dennis.