Where There Is No Dentist 2012 93
A cavity that is not filled grows bigger and deeper until it touches the nerve.
Germs travel inside the tooth’s root and start an infection called an abscess.
Pus forms at the end of the root, inside the bone. As the pus increases, it
causes great pressure. This is why an abscess causes severe pain.
• Pain all the time, even when trying
• Tooth often feels longer, and even
a bit loose.
• Tooth hurts when it is tapped.
• A sore on the gums near where
the root ends (gum bubble).
• Swelling of the gums around the
tooth, or swelling of the face on
the same side as the bad tooth.
If there is no swelling, take out the tooth immediately (unless you are able
to give root canal treatment). This allows the pus to escape and relieves the
pain. See Chapter 11.
If there is swelling, treat the swelling first. Take out the tooth only after
the swelling goes down. This is necessary because an anesthetic (see
Chapter 9) will not work if there is swelling.
To treat the swelling, give an antibiotic. Penicillin by mouth is best. Use an
injection only when the person is in immediate danger. For example, inject
penicillin when the person has a fever or if the swelling is pressing against
the throat. But remember you can treat most serious infections with simple
penicillin by mouth. For the doses for serious infections, look below the box
on the next page. If you still think an injection is necessary, look at the
section on procaine penicillin on page 210.
Adults and children over 25 kg (60 pounds) of weight should take the same
amount of oral penicillin. Children under 25 kg should take ½ as much. For
most infections, penicillin by mouth is taken 4 times a day for 5 to 7 days.
The first dose is double and then the regular dose is taken every 6 hours. The
person should take all of the penicillin, even if the pain or swelling goes
down. For the correct doses, see the next page.