Hi alexcast,

I understand that you are very anxious about this and scared. Please try to calm down as you are going to be okay.

The tooth is infected and the infection has spread into the bone which is why the fistula has formed. This is a common occurrence when a tooth has been infected for a long time. The fistula is not a gum infection. It is actually a tract of infection that begins from the tooth and travels through the bone and out of the gum tissue. The fistula acts like a drain for the pus coming from the tooth when the bacteria inside the tooth becomes too much. This is why the fistula keeps recurring. The only way to deal with this infection is to have the source of the infection removed, which is the tooth. Antibiotics may temporarily reduce some of the inflammation and bacterial count but they are not going to cure the problem.

A very important note....... It is never wise to take antibiotics for only a few days for an infection because depending on the infection, it takes 24-48 hours for the antibiotic to get through to the infection. So if you stop taking them before it begins to reach the bad bacteria you can actually develop a secondary infection as the medication does not differentiate between good or bad bacteria. So it kills off all of the good bacteria that is in that area leaving you vulnerable to additional problems.

Infrequent use of hydrogen peroxide is okay. But over using it can cause the oral tissue to become irritated, sore and painful. So you are best off using warm salt water to rinse with 3-4 times a day as this will not irritate the already inflamed tissue and will keep the fistula open. Also it is not wise to use your finger to pop the fistula as bacteria can enter that opening and travel to the bone. If the fistula is soft enough to pop, then gently use a new clean q tip and discard. Then rinse in that area with salt water. But do not do this q tip popping too frequently

It is best to have this tooth out while you are on the antibiotics as the meds will help reduce the acidity of the infection making the local anesthetic more effective. So if you could get in to see an oral surgeon asap it would be best.

I would recommend an oral surgeon because they are more experienced at extracting teeth that are badly infected and that have developed an fistula. A thorough surgical scraping of the socket needs to be done after this tooth is removed to help prevent reinfection from any residual bacteria. Oral surgeons are more apt to do a more thorough scraping. It is always wise to tell the surgeon that you want that thorough scraping to be done.... to be sure that that step is in fact done.

Financially.... I understand this can be an issue. However, it does not behoove you to wait to have this tooth removed as the infection can spread further and that is always best to avoid. You can make payment arrangements with the surgeons office.

The stress of this is only going to make the situation that much worse. So it really is best to not wait, take the steps to have the tooth removed asap.

Please keep us informed of how you're doing.
Bryanna