How to deal with a tooth infection?

Question

Caries and other similar disease can be a painful threat. It even can be a danger to life if not threatened over several months.

An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.

From Tom Hanks Abscessed Tooth Gets Cast Away

If one is somewhere in the wild (in a survival situation over a long period of time) far away from medical help and gets an infection, how should he react? For example in the movie "Cast away" the stranded person (Robinson Crusoe like situation) uses a skid to pull his tooth out:

Note: Only watch the scene on Youtube if you've the stomach for it!

Is it even a good idea to remove an infected tooth?

If yes, what is the recommended way to do this? Would be awesome to use natural material only but common camping equipment is also okay. So, an ice skate as mentioned above isn't acceptable :)

If no, what else should one do (treatment with herbs etc.)?

Answer 1

From the WMA emergency medical protocol (WFR's and WEMT's):

Urgent evacuation to higher level care is required if fever, swelling, or severe pain is present. Although the pain of dental infection can be extreme, the more critical issues are related to the spread of infection. Patients with more serious infections will show facial swelling and fever.

In the field, temporary pain relief can be obtained with topical pain relievers like Orabase or oil of cloves, and with oral or injectable pain medication.

If immediate evacuation is not possible, high dose antibiotics and warm compresses should be initiated. In extreme circumstances, the tooth can be pulled, and it should be remembered that until quite recently in dental history pulling the tooth was the definitive treatment.

Regarding your specific questions:

I wonder if it's even a good idea to remove the tooth?!

As stated above, it can be, although I would advise that it can sometimes be difficult to know exactly which tooth is infected and it's entirely possible you'll pull the wrong one out.

If yes, what is the recommended way to do this? Would be awesome to use natural material only but common camping equipment is also okay. So, an ice skate as mentioned above isn't acceptable :)

You need a proper tool to do it, or the incredibly painful version where you use your fingers to work the tooth loose (not that using pliers would be pleasant).

If no, what else should one do (treatment with herbs etc.)?

You should get professional medical care to treat the issue. Death from dental infection is real, and if treatment is delayed you might skip death but getting treated for septic shock would be no fun.

When I'm the responsible medical authority for a wilderness group, I'll typically carry several days worth of antibiotics that I get from a physician who authorizes me to use it for specific protocols.

Most emergency wilderness medicine is about stabilizing the problem, stopping it from interfering with a critical system (brain function and perfusion), figuring out how much time you need to get the person out, and getting them out.