Dental abscess

Description

A dental abscess is a pocket of pus caused by a bacterial infection. The abscess can occur at different areas near the tooth for different reasons. A periapical (per-e-AP-ih-kul) abscess occurs at the tip of the root. A periodontal (per-e-o-DON-tul) abscess occurs in the gums at the side of the root of the tooth. The information here is about the abscess periapical.

A periapical tooth abscess usually occurs as a result of treating the oral cavity, an injury or prior dental treatment. The result of infection, irritation and swelling (inflammation) can cause an abscess at the tip of the root.

Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with root canal treatment. But in some cases, the tooth may need to be removed. Leaving a tooth abscess untreated can lead to serious, even fatal, complications.

Symptoms

The signs and symptoms of a dental abscess include:

  • Severe, constant, throbbing toothache that can spread to your jaw, neck or ear
  • Pain or discomfort with hot and cold temperatures
  • Pain or discomfort with the pressure of chewing or biting
  • Fever
  • Swelling of the face, cheeks, or neck which may cause difficulty breathing or swallowing
  • Tender, swollen lymph glands under the jaw or in the neck
  • Bad smell in your mouth
  • Sudden rush of foul-smelling and bad-tasting, salty fluid in your mouth and pain relief, if the abscess breaks

When to see a doctor

See your dentist right away if you have signs or symptoms of a dental abscess.

If you have a fever and swelling in your face and you can't reach your dentist, go to an emergency room. Also go to the emergency room if you have difficulty breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw, throat, or neck, or even to other areas of your body.

Causes

A periapical tooth abscess occurs when bacteria invade the dental pulp. The pulp is the innermost part of the tooth that contains blood vessels, nerves and connective tissue.

The bacteria enter through a dental cavity or a chip or crack in the tooth and spread all the way up to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.

Risk factors

These factors can increase the risk of a dental abscess:

  • Good dental habits and care. Do not take proper care of your teeth and gums as not brushing your teeth twice a day and not flossing, can increase your risk of dental problems. The problems can include tooth decay, gum disease, dental abscess, and other dental and mouth complications.
  • A diet high in sugar. Often, drinking, and eating foods rich in sugar, such as sweets and soft drinks, can contribute to dental decay and turn into a tooth abscess.
  • Dry mouth. Having a dry mouth can increase the risk of tooth decay. Dry mouth is often due to the side effects of certain medications or problems related to aging.

Complications

A tooth abscess will not disappear without treatment. If the abscess ruptures, the pain may improve a lot, making you think that the problem has disappeared — but you still need to get a dental treatment.

If the abscess is not drained, the infection may spread to the jaw and other areas of the head and neck. If the tooth is located close to the maxillary sinus — two large spaces under the eyes and behind your cheeks — you may also develop a gap between the tooth abscess and sinus. This can cause an infection in the sinus cavity. You can even develop sepsis, a life-threatening infection that spreads throughout your body.

If you have a weakened immune system and leaving a tooth abscess is not treated, the risk of a spread of the infection increases even more.

Prevention

Prevent tooth decay is essential for the prevention of a dental abscess. Take good care of their teeth to prevent tooth decay:

  • Drinking water that contains fluoride.
  • Brush your teeth for two minutes at least twice a day with a fluoride toothpaste.
  • The use of dental floss or a water flosser to clean between the teeth on a daily basis.
  • Replace your toothbrush every 3 to 4 months, or when bristles are worn.
  • Eat healthy foods, limiting sugar-sweetened items, and snacks between meals.
  • Visit your dentist regularly for checkups and professional cleanings.
  • Consider the use of an antiseptic or a mouthwash with fluoride to add an extra layer of protection against dental caries.

Dental abscess

Diagnosis

In addition to examining your tooth and the surrounding area, your dentist may:

  • Tap on your teeth. A tooth that has an abscess at its root is generally sensitive to touch or pressure.
  • We recommend an X-ray. An x-ray of the tooth pain can help identify an abscess. Your dentist may also use X-rays to determine if the infection has spread, causing abscesses in other areas.
  • We recommend a computerized tomography (CT scan). If the infection has spread to other areas within his neck, a ct scan can be used to see the severity of the infection.

Treatment

The goal of treatment is to get rid of the infection. To do this, your dentist may:

  • Open up (incise) and drain the abscess. The dentist makes a small incision into the abscess, allowing the pus comes out. The dentist, then wash the area with salt water (saline). Sometimes, a small rubber drain is placed to keep the area open to the drain, while the swelling to go down.
  • Do a root canal. This can help you to get rid of the infection and save your tooth. To do this, your dentist broken down on your teeth, removes the diseased plant tissue (pulp) and drain the abscess. The dentist then fills and seals the tooth to the pulp chamber and root canals. The tooth may be capped with a crown to make it stronger, especially if it is a tooth. If you take care of your tooth restored correctly, can last a lifetime.
  • Extraction of the affected tooth. If the affected tooth can't be saved, your dentist will pull (extract) the tooth and drain the abscess to get rid of the infection.
  • Prescribe antibiotics. If the infection is limited to abscesses in the area, you may not need antibiotics. But if the infection has spread to close to the teeth, mandible, or in other areas, your dentist will prescribe antibiotics to prevent it from spreading further. Your dentist may also recommend antibiotics if you have a weakened immune system.

Self-care

While the area is healing, your dentist may recommend these steps to help relieve the discomfort:

  • Rinse your mouth with warm salt water.
  • Take nonprescription pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), as needed.

Preparing for your appointment

It is likely to start by seeing your dentist.

What you can do

Here's some information to help you prepare for your appointment:

  • Make a list of the symptoms that you are experiencing, including any that may seem unrelated to your tooth or mouth pain.
  • Make a list of all the medications, vitamins, herbs, or other supplements you are taking and the dose.
  • Prepare questions to ask your dentist.

Questions to ask your dentist may include:

  • What is likely causing my symptoms or condition?
  • What kinds of tests do I need?
  • What is the best course of action?
  • What are the alternatives to the primary treatment that you are suggesting?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • There is a generic version of the medicine you're prescribing?
  • Is there any printed material I can have? What sites do you recommend?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your dentist is likely to ask a series of questions, such as:

  • When did you first begin experiencing symptoms?
  • You have recently had any type of trauma to the teeth or any dental work?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

Your dentist will ask additional questions based on your responses, symptoms, and needs. Prepare and anticipate the questions will help you make the most of your time.

Symptoms and treatment of a Dental abscess