Tooth asked
My husband has a very painful tooth infection and been given Amoxillian (twice daily) at the A and E (i.e. emergency department). The pain is still there after 4 capsules, despite taking acetaminophen and Tylenol/codeine at 4-6 hour intervals. I have some Co-dydramol (dihydrocodeine tartrate and acetaminophen) which was prescribed for me some time ago and wondered if it is okay to give him this and if so how many. He is taking aspirin, Ramipril, Bisoprolol and statins for his heart. Thanks you in advance.
Answer
No, I strongly recommend you do not give him any of your medication.
Pain Medication For An Infected Tooth
Tooth infections can be a special kind of awful, in that they're often stunningly painful and in a difficult to treat location. If he was treated for the infection with a root canal, debridement, or other procedure by a dentist, the pain and swelling will gradually subside. If he still has an active infection, the antibiotic is likely to take much longer. After I figured out that A and E means Accident and Emergency, this American realized he probably hasn't seen a dentist yet, unless you have dentists on staff at hospitals in the UK. Emergency physicians are great at what they do, but they have to do a little of everything, and may not be well-versed in infectious disease of the teeth, periodontal areas, and jawbone. It sounds like he was given an amoxicillin prescription and sent on his way.
He's only been taking the amoxicillin for 2 days now, which is not sufficient to clear a tooth infection. In fact, it may not resolve for a while, and might never completely resolve without dental attention. The amoxicillin itself will not relieve pain directly. I would strongly encourage him to see a dentist immediately, especially if the pain is to such a degree that paracetamol (acetaminophen) and co-codamol (codeine and acetaminophen) aren't putting a dent in it.
This is not something to try to tough out...keeping calm is fine, but carrying on is unlikely to lead to a happy outcome. Your medication contains dihydrocodeine, which is similar to codeine. This was prescribed for you for a specific reason, and with your medical history in mind. Your husband is on a number of medications that interact with a lot of other medications, and sharing your medication with him may put him in danger of overdose or other medical problems. Don't risk it.
So if giving him extra pain meds isn't a good option, what is?
Anatomy Of The Tooth
A quick anatomy lesson is a solid place to start. Each of your teeth has a number of roots, which literally root the tooth to your jawbone. Each root (the number varies by tooth) has a thin canal in the center where tiny blood vessels and nerves pass through. These help the tooth finish growing when it first comes in, and then help maintain the tooth and prevent it from becoming weak and brittle. The canals lead to a slightly more open hollow, called the pulp chamber, in the center of the tooth.
Since this area is filled with soft tissues like blood vessels and nerves, it can be susceptible to infection by bacteria if a breach in the protective enamel occurs, as happens with a cavity or cracked/fractured tooth. The result is inflammation called pulpitis, which may or may not be reversible. The limited space and abundance of nerves mean the tissue swells in the pulp chamber that can cause debilitating pain.
There are a couple ways this is treated, depending on the severity of the infection. A "root canal", or endodontic therapy, entails drilling out the center of the tooth, removing all the infected tissue, and disinfecting the tooth. The roots are sealed off, as is the chamber, with an inert material or dental cement. This relieves the pain, and prevents future infection of the tooth because the soft tissue is completely gone.
If the tooth has sustained such damage as to be not salvageable, the dentist may opt instead to extract the tooth and replace it with a dental implant, depending on the patient's wishes.
If ignored long enough, a tooth infection can start to spread from the root area down to the periosteum, the part of the jawbone where the tooth is anchored. Bone infections are quite serious, and even more difficult to treat. Your best bet to handle the pain is to see a dental professional as soon as possible.
