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The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by tooth decay, broken teeth or extensive periodontal disease (or combinations of these factors). A failed root canal treatment may also create a similar abscess.
Dental antibiotic prophylaxis is the administration of antibiotics to a dental patient for prevention of harmful consequences of bacteremia, that may be caused by invasion of the oral flora into an injured gingival or peri-apical vessel during dental treatment.
If this does not work, incision and drainage is required, as described in Dental abscess Treatment. Antibiotics are of secondary importance to drainage, which if satisfactory renders antibiotics unnecessary. Antibiotics are generally reserved for severe infections, in which there is facial swelling, systemic upset and elevated temperature. [20]
Although mouth infections can present in many different ways, they are managed according to the same guiding principles - protect the airway, drain the abscess, and treat with antibiotics if necessary. Securing a patient's airway is the most important part of initial treatment because loss of airway is emergently life-threatening.
Doxycycline is also used as a prophylactic treatment for infection by Bacillus anthracis and is effective against Yersinia pestis, the infectious agent of bubonic plague. It is also used for malaria treatment and prophylaxis, as well as treating elephantitis filariasis . [ 10 ]
Muscle relaxants may be prescribed in order to reduce the patient's stress levels and/or to help the patient discontinue grinding their teeth. It can also be used to treat TMJ disorders. Antifungal medication may be used to treat oral thrush, which is common in infants. The goal of treatment is stop the spreading of the Candida fungal infection.
If the abscess does not heal only with incision and drainage, or if the abscess is in a place that is difficult to drain such as the face, hands, or genitals, then antibiotics may be indicated. [ 1 ] In those cases of abscess which do require antibiotic treatment, Staphylococcus aureus bacteria is a common cause and an anti-staphylococcus ...
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