Sonia Chopra, DDS, is a healer and tooth saver. She’s a board-certified endodontist, TEDx speaker, Forbes contributor, author, endodontic instructor, and founder of Ballantyne Endodontics in Charlotte, North Carolina.
On top of running her thriving practice, Dr. Chopra provides groundbreaking digital education and community support to general dentists and endodontists who want to uplevel their technical skills, patient experience, and practice efficiency. Through her thoughtfully-designed courses and in-person programs, such as her award-winning E-School, she is revolutionizing endodontic continuing education through the simple, tangible lessons rooted in her own diverse experience.
So often, people think a tooth infection can just go away by taking antibiotics, but sadly, this just isn’t true. Antibiotics are often overprescribed in dentistry. Many times they just aren’t necessary. I always say that treatment trumps drugs when it comes to antibiotics.
Antibiotics have a tendency to mask symptoms and the source of the problem, making it hard to find the correct diagnosis. I always ask my patients not to start any antibiotics prior to seeing me for the first time and not to take any pain meds on the day of that appointment. I want to be able to see everything in order to make a diagnosis quickly. If I can’t find the pain, I can’t treat it, and it will delay solving the problem. In fact, I prefer to see my patients on a bad day. This way, I see what is truly ailing them, I can use my expertise to figure out exactly how I can help them, and we can just “git ’er done.”
When someone takes a leftover antibiotic from a previous surgery or a prescription from their dentist or doctor, oftentimes, the symptoms go away, but the problem doesn’t. It’s important to note that these symptoms only go away temporarily. If you don’t have pain, it does not mean that you don’t have a problem. In fact, sometimes, by taking antibiotics, what you’re doing is just delaying treatment of the real issue. And the longer an infection is left untreated, the less likely the treatment is to succeed. If you have an infected tooth that becomes painful, and you use an antibiotic to buy some time, just know that the next time it flares up on you, it will likely be worse than the first time.
I always urge my dental colleagues to be mindful when they prescribe antibiotics, and I urge my patients to do the same thing when they request antibiotics. You can always ask to see if they’re necessary, but many times you won’t need them. Trust that your provider will give them to you as needed, but don’t strong-arm them into giving you medicine. Anything that you take has the possibility of causing an adverse reaction. An antibiotic can cause an allergic reaction, or it can have a negative impact on your gut and create dysbiosis (an imbalance among your microbes). That’s because antibiotics are systemic and impact your whole body; they can’t just target one area. In my opinion, less is more.
There are also times when antibiotics alone just aren’t effective at resolving an infection in your tooth. In most cases, when your tooth is infected, it has already lost its blood supply. And if your tooth has lost its blood supply within the canals, then your body cannot get the antibiotic into the canals where the bacteria reside anyway! The antibiotic could help reduce the flareup of the infection and can help address an abscess, but it will not completely eradicate it. And in fact, in the earlier stages of the pulpal inflammation and infection, taking an antibiotic will have no effect on your symptoms, and it certainly won’t make you feel better in the long run.
This is why I never suggest taking an antibiotic simply for pain management. If you’re in pain, the solution isn’t antibiotics alone or to overuse antibiotics. Instead, a better idea is treatment and pain medication. An antibiotic can be used when the infection has gotten way out of hand, but we cannot depend on antibiotic treatment alone as a cure. Simply put, antibiotics treat infections, and pain medications treat pain.
The point of this is it’s important for your dentist to correctly diagnose and treat the problem instead of just medicating it. I always say, “Treatment trumps drugs.” This will give you the best prognosis.