About 30 years ago my husband and I became acquainted with a local dentist, an avid Russophile. He played the balalaika, a stringed Russian folk instrument, and formed a balalaika group, which my husband was interested in joining, but didn’t have the time for. His sister, however, played with the group for a few years and we attended their events.
When the Moscow Circus came to Reno in 1991, Dr. Ocean immediately made their acquaintance, and somehow we got introduced as well. I can’t remember how it all came about. The kindly dentist, whose knowledge of Russian was very rudimentary, also offered his services to the circus members, and as my work back then dealt with translating medical articles from Russian to English I was called in once or twice to facilitate the conversation.
You see, Russian dental care at that time was nothing short of barbaric. Anesthesia was unheard of. People just avoided going to the dentist at all costs due to the sheer terror of having to experience that kind of pain. Unfortunately, those days will return, especially as dental procedures can be safely performed without anesthesia. And that’s why the most common solution to dental problems prior to the 1950-1960s was just to remove the offending tooth.
Frequent brushing and daily flossing will prevent many dental issues. Unfortunately, not everyone will practice prevention, and some people are just born with teeth made of chalk. We have to be prepared to help.
Survival and Austere Medicine, 3rd Edition and Where There Is No Dentist provide more information on this topic than any of the other off-grid medicine references. Unfortunately, the two are at complete odds with each other, with the latter’s solution to be just removing the tooth. The former differentiates between the two types of abscesses and takes a more conservative approach with the hope of saving the tooth.
Abscesses are one of the most common causes of tooth pain. There are two kinds of abscesses and they are managed differently.
APICAL ABSCESS
This infection occurs at the very tip of the roots and has penetrated to the thin bone of the jaw. It involves the pulp and extends into the bone and gum. Both the gum and tooth base appear normal.
Signs and symptoms
- Fever[1]
- Pain all the time[2] [3]
- Abscess or pus pocket[4]
- Tooth often feels longer and even a bit loose[5]
- Swelling where the gum tissue joins the lip[6]
- Not sensitive to heat or cold[7]
- Painful to percussion[8]
- A sore on the gums near where the root ends[9]
Treatment
- Incision and drainage through the gum to the level of the bone[10]
- A small drain, such as a bit of rubber band or cotton wick will speed healing (remove when no longer draining) [11]
- Antibiotics, if required[12]
The tooth may need to be extracted if treatment doesn’t work.
GINGIVAL/PERIODONTAL ABSCESS
This infection occurs between the gum and the tooth, with the abscess usually forming on the cheek side.
Signs and symptoms
- Not sensitive to heat or cold[13]
- Sensitive to percussion[14]
- Swelling of the gums around the tooth, or swelling of the face on the same side as the bad tooth[15]
Treatment
For both kinds of abscesses, Where There Is No Dentist advises extracting the tooth. If there is no swelling, the tooth should be extracted immediately. If there is swelling, the swelling must be treated first with antibiotics. A warm compress held against the face, and repeated as often as possible, may help reduce the swelling. Holding warm water in the mouth may also be helpful.[18]
WHEN TO USE ANTIBIOTICS
“Dental abscesses are best treated by drainage of any collection present. Antibiotics should be used in patients who are systemically unwell—high temperatures, chills or shakes, nausea, vomiting, or gross local swelling.”[19]
- Penicillin, 500 mg, 4x per day[20]
- Erythromycin, 500 mg, 3x per day[21]
- Metronidazole, 400 mg, 3x per day or Tinidazole, 2 gm, once per day may be added for patients who are very unwell.[22]
- Augmentin is also a good choice for more serious infections.[23]
Herbal Options
Unfortunately, by the time an abscess has developed, it may be too late for herbal treatment. Teeth don’t magically restore themselves after cavities have eaten away at them. (Well, usually. More on that in another post.) However, some herbs have been effective in the treatment of dental issues. Juniper tincture can be used to make a mouth rinse as effective as chlorhexidine. Arrowleaf balsamroot[24], bee balm[25], echinacea, garlic[26], willow[27], and yarrow were historically used to treat a toothache. Whether they would be of any efficacy in relieving the pain and treating the infection of an abscessed tooth by modern standards is unknown. There are anecdotal reports on the efficacy of goldenseal extract in eliminating the infection due to an abscessed tooth. Finally, another option for reducing the pain and swelling of an abscessed tooth is to make a poultice from charcoal powder wrapped in a thin piece of sterile, tightly-woven cloth. Instruct the patient to hold it in place over the abscess until the swelling is relieved.
Links to related posts:
Survival and Austere Medicine, 3rd Edition
[1] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[2] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[3] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[4] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[5] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[6] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[7] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[8] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[9] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[10] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[11] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[12] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[13] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[14] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[15] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[16] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[17] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[18] Where There Is No Dentist, https://hesperian.org/wp-content/uploads/pdf/en_dent_2022/en_dent_2022_07.pdf (accessed 26 April 2022).
[19] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[20] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[21] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[22] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[23] Survival and Austere Medicine, 3rd Edition, 2017, 306.
[24] Steven Foster, et al., Western Medicinal Plants and Herbs, 2002, 147.
[25] Steven Foster, et al., Western Medicinal Plants and Herbs, 2002, 206.
[26] S K Banerjee, et al., Effect of garlic on cardiovascular disorders: a review, Nutrition Journal, 19 November 2002, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC139960/ (accessed 23 February 2022).
[27] Steven Foster, et al., Western Medicinal Plants and Herbs, 2002, 342.
