From the Guidelines
For a dental abscess, the recommended dose of amoxicillin is 500 mg taken three times daily for 5 days, as adjunctive treatment to surgical drainage, incision, or root canal therapy. The treatment of dental abscesses primarily involves surgical intervention, such as root canal therapy or extraction of the tooth, with antibiotics playing a secondary role in managing the infection 1. According to the Medecins sans frontieres guidelines, for acute dentoalveolar abscesses, incision and drainage should be followed by amoxicillin for 5 days 1.
Key points to consider when prescribing amoxicillin for a dental abscess include:
- The dose and duration of amoxicillin may vary depending on the severity of the infection and the patient's medical history.
- Antibiotic treatment alone is insufficient for dental abscesses, and definitive treatment requires dental intervention to drain the abscess and address the underlying cause.
- Amoxicillin works by inhibiting bacterial cell wall synthesis, effectively treating many oral bacteria, but some infections may be resistant and require alternative antibiotics like clindamycin 1.
- Patients with penicillin allergies should not take amoxicillin and should inform their healthcare provider to receive an appropriate alternative.
- It is essential to complete the full course of antibiotics even if symptoms improve to prevent antibiotic resistance 1.
In general, the European Society of Endodontology and the Canadian Collaboration on Clinical Practice Guidelines in Dentistry recommend against the use of antibiotics in patients with acute apical periodontitis and acute apical abscesses, except in specific cases where there is systemic involvement or progressive infection 1. However, for dental abscesses, the use of amoxicillin as an adjunctive treatment to surgical drainage is supported by the guidelines 1.
From the Research
Antibiotic Treatment for Abscess Tooth
The use of antibiotics for the treatment of abscess tooth is a common practice, but the choice of antibiotic and duration of treatment can vary.
- Amoxicillin is a commonly used antibiotic for the treatment of abscess tooth, but the ideal dose and duration of treatment are not well established 2, 3.
- A study published in 2016 compared the efficacy of amoxicillin plus metronidazole with cefixime in the treatment of chronic periodontitis, and found that both treatments were effective in improving clinical parameters, but cefixime was more effective in reducing gingival index 4.
- The American Dental Association recommends against using antibiotics in most clinical scenarios for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling, except in cases with systemic involvement or high risk of progression to systemic involvement 5.
- A review published in 2009 highlighted the need for evidence-based guidelines for antibiotic prescribing in dental practice, and recommended suitable antibiotic prescribing for adult patients suffering from acute dentoalveolar infections based on evidence 3.
- Another study published in 2021 found that narrow-spectrum agents, such as amoxicillin, appear to be as effective as broad-spectrum antibiotics in the treatment of acute dentoalveolar infections in otherwise healthy individuals 2.
- A study published in 2022 emphasized the importance of definitive surgical management in the treatment of acute odontogenic infections, and highlighted the role of antibiotics as an adjunct to surgical treatment 6.
Dosage and Duration of Amoxicillin Treatment
The dosage and duration of amoxicillin treatment for abscess tooth can vary depending on the severity of the infection and the patient's overall health.
- A common dosage of amoxicillin for adults is 500-875 mg every 8-12 hours, but the ideal dosage and duration of treatment are not well established 2, 3.
- The American Dental Association recommends that antibiotics be used for the shortest duration possible to minimize the risk of adverse effects and antibiotic resistance 5.
- A study published in 2016 found that a 7-day course of amoxicillin plus metronidazole was effective in improving clinical parameters in patients with chronic periodontitis 4.