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Pediatric Dentistry/Significant Tooth Damage - Toddler

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Question
My 2 yr old son fell 6 mon. ago damaging his 2 front top teeth.  He intruded top right tooth (back up into his gum...can't see it anymore)& twisted & chipped the left.  Seen by ped dentist who refered to oral surgeon.  Decision was made that if there were no problems (swelling, fever) that they would eventually need to pull the teeth but, not until he was closer to 5.  In January we took him for his routine dental check up & dentist saw an infection around top left tooth so it needed to come out (likely along with the intruded top tooth).  We went back to the oral surgeon who agreed (he was put a course of an antibiotic for 10 days) and we scheduled (earliest appointment 6 weeks later).  This past week we noted the abcess around the damaged tooth getting bigger and going from purple to whiter in color.  No fever, no pain to touch (if I press gently on his gum).  He is scheduled for surgery in 5 days.  I called the dentist's office who told me to call the oral surgeon and that if they didn't prescribe him an antibiotic to call them back and they would.  I called oral surgeon's office and they said if he didn't have fever or pain they would like to let it be and not prescribe an antibotic at this time since he is having the tooth removed in 5 days.  Now I'm a confused and worried mom...should he or shouldn't he recieve an antibiotic...neither saw him in person...this was over the phone with office staff going back and forth to the dentist/surgeon).  I am continuing to monitor him daily (checking for fever and pain) but, the worry is creaping up on me and I wonder if I should call the dentist back for the antibotic??

Answer
Dear Jen;

Their are different philosophies regarding antibiotic therapy prior to a tooth extraction with an abscess. What is being done is one way of handling the situation. In my office we would prescribe an antibiotic prior to the extractions. I feel that the antibiotic will prevent the abscess from possibly enlarging in size and causing pain. Also, it will help with the potency of the local anesthetic, a minor issue in your son's case.

Maybe you can see if they have a cancellation and get the procedure done sooner!


Hope this helps,

Dr. Glen

Pediatric Dentistry

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Glen Ehrenman D.D.S.

Expertise

I can answer any question in the field of pediatric dentistry which may include questions regarding interceptive orthodontics.

Experience

I have been in private practice for 26 years in Westbury, NY. My practice treats patients from infancy through their late adolescence.

Organizations
American Academy of Pediatric Dentistry Nassau County Dental Society American Dental Association New York State Dental Association

Education/Credentials
SUNY at Stony Brook, School of Dental Medicine 1981-1985 Eastman Dental Center, Rochester, NY, Pediatric Dentistry 1985-1987

Awards and Honors
Diplomate of the American Board of Pediatric Dentistry Clinical Asst. Professor-SUNY at Stony Brook, School of Dental Medicine-Dept of Children's Dentistry Attending DDS-SUNY Stony Brook University Hospital Attending DDS-North Shore University Hospital at Syosset Attending DDS-Winthrop University Hospital

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