An infected tooth is an emergency, and treatment for the infection should not be delayed.
Not only can the pain be severe, especially while eating or drinking, but a dental infection can soon lead to an abscessed tooth and other complications.
Fortunately, tooth infections can usually be treated by a course of antibiotics before they develop into abscesses.
One common treatment is clindamycin, an antibiotic that is used by enough patients worldwide to be on the World Health Organization Model List of Essential Medicines.
Clindamycin is particularly valuable for the millions of people who are allergic to or intolerant of penicillin or penicillin-based antibiotics like amoxicillin.
In this article I’ll explain how to know when a toothache is actually an infection, and when you see a doctor.
I’ll discuss when clindamycin may be appropriate for tooth infection.
I’ll also help you determine whether or not clindamycin is the right antibiotic to help with your infection, and talk about who is best suited for a prescription of this antibiotic—and who should avoid it.
Tooth Infection Symptoms and When to Seek Treatment
While not always the case, dental infections are generally caused by poor dental hygiene, an injury like a chipped or cracked tooth, or poor dental care.
Symptoms can range from mild to severe depending on the location and extent of the infection, but generally speaking, the longer a person waits for treatment, the worse it gets. A person with a tooth infection might experience one or more of the following symptoms:
- Lump or bulge around the infected tooth
- Throbbing or persistent pain around the infected tooth
- Throbbing or constant pain that radiates to the jaw, neck, ear, or face
- Red, swollen, or bleeding gums
- A swollen mouth or face
- Sensitivity to hot or cold temperatures
- Tenderness or sensitivity to touch around the infected tooth
- A discolored or loose tooth
- Bad breath or a foul taste
- Difficulty opening the mouth
If you feel any combination of these symptoms, see a doctor right away to catch the infection before it worsens.
If you find a bump on your gums that is tender to the touch or leaks liquid (pus) when you press on it, you may already have a tooth abscess that requires urgent medical attention.
In rare instances, this untreated abscess can develop into a serious skin infection called cellulitis, or a potentially fatal blood infection known as sepsis. Symptoms of a tooth infection that is spreading throughout your body and becoming very serious include:
- High fever and chills
- Red, warm, or swollen skin
- Confusion, dizziness, or lightheadedness
- High heart rate
- Nausea or vomiting
- Feeling generally ill or unwell (malaise)
Benefits of Taking Clindamycin For a Tooth Infection
Even though it’s generally available to be taken orally, clindamycin can also be applied as an injection or even a cream to treat different kinds of infections.
That’s because clindamycin is active against a variety of different bacteria and can treat multiple types of infections, which can be crucial for curing tooth infections that commonly involve several different strains of bacteria.
Additionally, those who haven’t had success with penicillin may have a better response to clindamycin.
Dosage Information: How Much Clindamycin Should you Take for a Tooth Infection?
The dosage of clindamycin for a tooth infection varies. Patients should take this medication exactly as directed by their doctor.
Adults can anticipate taking 150-300 mg orally every six hours, or with a more severe infection, 300-450 mg every six hours.
Treatment should last 7-10 days depending on the prescription and severity of infection. Clindamycin dosage for children is based on body weight and is determined by a healthcare provider, and is also generally taken 3-4 times per day.
How Long for Clindamycin To Work On a Tooth Infection?
While dependent on dosage and severity of the infection, patients can expect their symptoms to improve within 48 hours of taking their first dose of clindamycin.
If symptoms don’t improve or get worse after that, contact your doctor.
What are the Potential Side Effects of Clindamycin?
Patients who have used the drug have described a bitter taste when taken orally, so a full glass of water with each pill is recommended.
While rare, check with your doctor immediately if any of the following side effects occur:
- Cracks in the skin
- Chills or loss of heat from the body
- Red, swollen, or scaly skin
Other potential side effects include nausea and vomiting, diarrhea, and if injected, pain at the site of injection.
Signs of Allergic Reaction
Allergic reactions to clindamycin are rare.
The most common symptoms of such a reaction include skin rashes, itches, and difficulty breathing.
In extreme cases, an allergic reaction can lead to life-threatening anaphylaxis and will require urgent medical attention. If you take clindamycin and begin to experience any of the following, call your doctor immediately or go to the ER:
Is Clindamycin Safe?
Clindamycin is safe for most people, particularly those allergic to other kinds of antibiotics.
Studies have not shown issues specific to pediatric, geriatric, or breastfeeding patients.
If a breastfeeding mother uses clindamycin, it is recommended to check the infant for symptoms including diarrhea, diaper rash, or, rarely, blood in the stool indicating possible colitis.
It’s always important to talk to your healthcare provider about known allergies and medical conditions before starting a new antibiotic.
Using clindamycin simultaneously with either the active cholera vaccine or an antibiotic called erythromycin is not usually recommended, while taking it with any of the following medications may cause an increased risk of side effects:
Other medical problems may affect the use of clindamycin.
Avoid taking other medications while using clindamycin unless they have been discussed with your doctor, including over-the-counter (OTC) medications, and herbal or vitamin supplements.
Patients with meningitis should not take this antibiotic, and make sure to tell your doctor if you have other medical problems before starting a course of clindamycin, particularly:
- Atopic syndrome
- Liver disease
- History of stomach or bowel problems
Other Treatment Options for Tooth Infection
Clindamycin is not the only antibiotic that can be used to treat a tooth infection.
The common first choice for dental infections is penicillin, which can treat everything from urinary tract infections to skin infections to chest infections, or amoxicillin, another penicillin-based antibiotic.
Both of these drugs can be good options if you have a tooth infection, but not if you’re one of the estimated 10% of the population who has a penicillin allergy or intolerance (though research has shown penicillin allergies might be over reported and likely fade over time).
Anyone who has demonstrated an intolerance to penicillin, including rashes, hives, fever, swelling, shortness of breath, or anaphylaxis, should look to solve their tooth infection with clindamycin or another non-penicillin-based antibiotic instead.
Another potential antibiotic to help cure a tooth infection is cephalexin, also among the most commonly-used antibiotics in the world. It is generally effective against infections, particularly on the skin and in the urinary tract, but also carries the same risks for patients with an intolerance of penicillin.
It’s important to remember that antibiotics, while helpful at preventing worsening of a tooth infection, are rarely the definitive treatment.
Anyone who has a dental infection needs to be evaluated by a dentist as soon as possible to determine whether a procedure such as pulling the tooth, filling the tooth, or draining an abscess is necessary.
Antibiotics should not be taken for a prolonged period of time, and anyone with a dental infection should try to see a dentist within 24-48 hours for further care.
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WHO Model Lists of Essential Medicines. 2019. https://www.who.int/publications/i/item/WHOMVPEMPIAU2019.06
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Clindamycin and taste disorders. 2007. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2048568/
Clindamycin. 2021 https://www.ncbi.nlm.nih.gov/books/NBK501208/
Penicillin allergy. 2019. https://www.mayoclinic.org/diseases-conditions/penicillin-allergy/symptoms-causes/syc-20376222
Rinsing with Saline Promotes Human Gingival Fibroblast Wound Healing. 2016. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159843