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How is tooth pain treated ?

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General & Family Physician
Practicing since : 2005
Answered : 2573 Questions
have a throbbing tooth ache, taken amoxilin 3 times today for inflammed nerve given by dentist. Had been taking extra strength excedrin since yesterday - 4 times 2 capsules in 18hrs. Dentist then gave me Ibiprofen 600mg, did not help, was told to take ponstan 500. Took one tablet 5 hrs ago and another 1 hour ago and the pain is still killing me!! Can I now take paracetamol, excedrin, anything,? Please, have throbbing pain it's unbearable!! Am 37, no health issues, 68 kilos. Thank you!!!
Posted Wed, 11 Apr 2012 in Dental Health
Answered by Dr. Prasad 1 hour later

First let me thank you for posting your query here. Next apologies for the delay to answer it.

You have reported of a throbbing tooth ache which has not responded to multiple analgesics.

Often such terrible tooth ache may not respond well to oral medications. I would suggest injectable antiinflammatory medication at the ER for better pain management followed by a course of prescription NSAIDS.

I am also concerned if you have dental abscess, in which case drainage of the abscess effectively reduces the pain.

I would hence suggest you to visit the ER. Discuss with your dentist of a possible abscess formation which needs drainage.

Hope I have been some help to you. Should you have any more concerns, I am available for follow ups.

Above answer was peer-reviewed by
Follow-up: How is tooth pain treated ? 43 minutes later

Thank you for your reply!
However, I was at the dentist this morning, took an x-ray and she saw a very inflamated nerve. I was told it would hurt too much to treat it today, thus I was given the antibiotic and scheduled to return Monday.
Now firstly, should I believe that the dentist would have identified if there was abscess and treated it then? Or is it a given that the inflammation has abscess but she chose to use antibiotic?
Secondly, should I expect a large improvement by tomorrow due to the antibiotic?
Most importantly, what can I take to help ease the pain at this point given all the medication I have already taken?

Again, many thanks for your help!!
Answered by Dr. Prasad 1 hour later

Thanks again.

Yes, abscess can be identified by physical examination. Significantly large abscess usually presents with visibly large mass with severe throbbing pain and high grade fever. And such abscess are the ones that concerned me. I presume you did not have these symptoms then.

If abscess has been ruled out, amoxicillin is effective in most gram positive and few anaerobic bacteria which are the usual suspects associated with dental infections. It usually takes 2-3 days to produce effective control of infection. A change of antibiotic or addition of cloxacillin / clavunate / or similar antibiotic is entailed if you develop swelling, fever or worsening of pain.

Now with respect to pain, you have tried combination of over the counter antiinflammatory medications. Since they have not been very effective, stronger NSAIDs (prescription medication) can be tried as they are more efficient in relieving pain. I wish you could consult a general practitioner or the doctors at ER to obtain these useful drugs.

Hope this answer has been informative, useful and appreciable to you.

Wish you a speedy recovery.

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