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Is That Safe Periodontal Abses Which Morphed ?

Posted on Mon, 30 Dec 2024

Question: I have been diagnosed with a periodontal absess which morphed into a bad infection under the gum - pain, swelling. My dentist gave me an R/X for Clindamycin 150mg to take for one week 3 times a day. I'm into around the third day and it does not seem to be working plus is killing my stomach. (I have no allergies to penicillin). At the same time, he gave me an R/X for amoxicillin 500 saying if the first antib. didn't work so good, go to the amoxicillin. My question is this - is that safe to do? If so, should I wait a few days in between or just immediately drop the Clindamycin and begin the amoxicillin? Also, for a periodontal absess, what would be the antibiotic of first choice? Thank u.

Answered by Dr. Honey Arora (7 hours later)

Brief Answer:
You can switch to Amoxicillin

Detailed Answer:
Hi.
Thanks for the query.

Yes, you can switch to Amoxicillin, no issues with that.
For stomach issues that are occurring due to antibiotics you can take Pantoprazole after consulting your doctor.
Take more of probiotics like Yogurt.
Drink plenty of water and avoid spicy and heavy foods.

Also start doing warm saline gargles and antiseptic mouthwash gargles.

Hope this helps..

Thanks

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Honey Arora (18 minutes later)

Just to clarify - it's safe to drop this first one and immediately start taking the second? Also, what is the best antibiotic for a gum infection like this? Dentist said there are different properties to each.

Answered by Dr. Honey Arora (1 hour later)

Brief Answer:
Yes, it is possible

Detailed Answer:
Hi.
Yes you can drop Clindamycin and take Amoxicillin.
Well, there are a number of antibiotics that can be taken like Metronidazole, Erythromycin, Doxycycline etc.
And yes, all have different properties so tge Doctor will advise you as per your signs and symptoms.
So you can take Amoxicillin.

Thanks

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Honey Arora (5 hours later)

Doctor, thank u for your answer. Your patients are very fortunate to have you. One last question. In a front tooth root canal, when the dentist opened it up to go to fill it, he found blood in the canal. It hadn't had any work on it for some time. He's baffled as to how or why the blood is there. Few days later, I was diagnosed with a severe periodontal absess with an infection above that same tooth. There was no pus, only blood and the scan showed no infection in the tooth, only up above in the gum. Could that be the source of the blood getting into canal?

Answered by Dr. Honey Arora (25 hours later)

Brief Answer:
Need an x ray to rule out

Detailed Answer:
Hi.
Well many a times going too deep apically crossing the root tip opening can cause bleeding.
Sometimes if there is infection in the canal or if the canal is not properly cleaned of the tissue then there can be bleeding.
Please send me the x ray of the tooth so that I can advise you better.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Honey Arora (5 hours later)

I wish I could send an x-ray but not possible. One last question since had trouble with that front tooth again today (#9). It was checked by a specialist (endo) who took a full scan and said that the apex looked fine and infection that went into gum was probably caused by an unfilled canal. Today, he partially filled it with some calcium hydroxide only (which has hardened) but leaving it concave and not filled completely. My question is this - does temporary (or permenant) filling typically now be put over this med to complete it or does med need to be removed first?

Answered by Dr. Honey Arora (2 days later)

Brief Answer:
First the canal will be re filled

Detailed Answer:
Hi.
Well, first the canal will be filled completely and then permanent filling will be done and not now.

Thanks

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Honey Arora (3 days later)

One last question, doctor. It was found that I have an infection past the apex on that front tooth (#9) that even extends over a bit into the lateral next to it. Doctor wants to do an implant vs an apico due to poor prognosis of the tooth (it's loose, blood in the canal, etc). My question is this - when tooth is extracted, can all infection in that entire area be well cleaned out prior to placement of implant?

Answered by Dr. Honey Arora (7 hours later)

Brief Answer:
Yes, infection will be cleared first.

Detailed Answer:
Hi.
Yes, the infection will be cleared.
The tooth will be extracted followed by a course of antibiotics.
And once infection clears further treatment will be done.

Thanks

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Above answer was peer-reviewed by : Dr. Raju A.T