Cavity/Broken Molar led to infection/abscess. Just looking for some insight

[Kris2484]

A few months ago, half of one of my upper premolars broke off after biting into a granola bar. I must have had a cavity on that tooth for a long time but never realized it. There was no discomfort when the tooth broke and since I don't have dental insurance, I put off having i looked at. Fast forward to 2 nights ago I noticed a dull throbbing ache not on the tooth itself but on the gum all the way up near where the inner cheek meets the gumline. I had experienced pain with this tooth in recent past (sensitivity to hot and cold) but this pain was in a completely different location. Yesterday morning my cheek was swollen. The pain was still there too so I went to an urgent care clinic just to have a doctor look at it and prescribe me with antibiotics until I was able to get to a dentist. The doctor told me it was most likely an abscess and wrote me a prescription for 250 mg of Amoxicillin (3x a day) and told me to get to a dentist the next day because she assumed they were going to want to lance/drain the infection.

I was able to see a dentist today and after an x-ray he determined extraction would be the best option for me since the decay extends under the bone. I asked if he was going to lance/drain my infection and he said no because the infection will drain out when the tooth is removed.

In the meantime I'm wondering how long I can let this go? I'm going back on Saturday to talk about payment options (as well as seeing the other dentist in their practice because she thinks a root canal *may* be possible) but I don't think the extraction will happen any sooner than next week. Is that too long to leave this infection? Although I'm on amoxicillin, I can't ignore all of the horrible stories I've read about infections spreading to the heart/brain/lungs and since they didn't drain my gums/cheek the infection is still there and I'm still swollen. Even after expressing my concerns about the infection, the dentist didn't seem to think it was such a big deal.

[Jerome Tsang, DDS]

I would guess its probably from the mouth wash routine you're following.  I would cut back on the hydrogen peroxide a bit and probably reduce the salt in your salt rinses.  The listerine is okay if you're using it once a day.  

An allergic reaction is different usually.  I usually look for anything else unusual like rashes, itching, etc.

[Kris2484]

(I wish there was a way to edit posts!)

I forgot to mention I have been alternating between gargling/swishing with warm salt water (high concentration of salt..about 1 tbsp of salt in a coffee mug full of water) , listerine and diluted hydrogen peroxide a few times a day. I'm sure doing any of the above enough time would give me an odd feeling in my mouth but I wasn't sure if it could also be an early sign of an allergic reaction to the amoxicillin

[Kris2484]

Thank you so much for your prompt response! My swelling has gone down a great deal and there is slightly less pain.

Something I've been noticing however is an odd sensation in my mouth/on my tongue. My tongue feels..I'm not sure I'd say numb or dry because it's not that exactly but there's a definite weird feeling inside my mouth. How would I be able to tell if I'm having an allergic reaction to the Amoxicillin?  Or maybe a better question is how long would a reaction to Amoxicillin take to appear?

This is the first time in 15 years I've been on *any* type of antibiotic so I'm not sure I'd even know if I was allergic to any. My mom did tell me I used to take amoxicillin when I was a kid and never had any reactions (although I did develop a skin reaction to a Sulpha drug in the past) Since Wednesday I've taken seven 250 mg doses. I'm due for another this evening but I'm a little worried to take it in case I'm developing a reaction..

[Jerome Tsang, DDS]

There's two approaches to an abscess.  One is to treat it right away and take care of the problem, such as extracting it, which would then allow the pus to drain out of the socket.  The other approach is to provide antibiotics to reduce the swelling and then treat the affected tooth.  Either way is fine and depends on the situation and judgement of the dentist.  If your dentist isn't too concerned, I would say it would be okay to wait.  If it worsens, they can drain it for you.  The antibiotics should help to keep it from spreading.  You may want to ask your dentist about increasing the dosage from 250mg to 500mg possibly.  Otherwise, you should be okay.  Just keep an eye on it and if it worsens, notify your dentist immediately.

[Kris2484]

I just wanted to add that I'm not in very much if any pain. My gum only hurts if I press that one spot but other than that there's no much pain (it actually feels like a coldsore when I smile or move my mouth a certain way)

Also just wanted to mention I've been gargling with hydrogen peroxide, listerine and warm salt water. I thought the salt water would bring out some type of boil so I could begin to push out some of the pus, but nothing will seem to come to a head.

Sorry for such a long question but I really hope you can offer me some insight or reassurance. Thanks so much for taking the time to read this!