TOOTH ABSCESS
A tooth abscess is a
localized collection of pus associated with a tooth. It can form inside the
teeth, in the gums, or in the bone that holds the teeth in place; it has the
origin in a bacterial infection.
abscessed tooth
A tooth abscess can be
caused by tooth decay, broken teeth or extensive periodontal disease (or
combinations of these factors). A failed root canal treatment or a broken
dental work (filling, crown etc) may also create a dental abscess.
It is important that
patients get professional help as soon as possible because abscesses don't go
away on their own. Moreover, they can sometimes spread to other parts of the
body and create some serious complications.
Types of tooth abscesses
The most common type of
dental abscess is a periapical abscess (also known as tooth-related abscess),
and the second most common is a periodontal abscess (or gum abscess). The main
difference between the two is the origin of the infection.
Gum abscess or periodontal
abscess
The gum abscess is caused
by an infection in the space between the tooth and gum. The infection may occur
after food gets trapped between the gum and tooth.
abscess tooth
gum abscess
People with poor oral
hygiene or gum disease have a higher risk of developing such an abscess because
a large number of bacteria can build up under the gum and in the bone.
Most times, the gum
abscess forms on the side of the tooth and closer to the gingival margin.
abscess tooth types
Periapical abscess
The periapical abscess is
caused by an infection inside the tooth. Bacteria from inside a tooth decay can
penetrate the enamel and dentin to reach the dental pulp (or the tooth's
nerve).
If the pulp infection is
not properly treated, it can spread through the root canal from the pulp to the
periapical tissue, which is located around the apex of the tooth's root.
periapical abscess
The periapical abscess
shows up at the tip of the tooth's root and spreads to the surrounding bone.
Signs and symptoms
Tooth abscesses can form
very quickly. Most abscesses are painful but this is not always the case. In
some cases, abscesses may be painless (or cause little pain) but still have a
swelling present on the gum. It is important to get anything that shows like
this checked by a dental professional to avoid any complications.
Symptoms of an abscess in
your tooth or gum may include:
an intense, throbbing
pain in the affected tooth or gum that may come on suddenly and gets gradually
worse
pain that spreads to the
ear, jaw, face, and neck on the same side as the affected tooth
pain can get worse:
when chewing on the side
of the affected tooth
when lying down, which
may disturb your sleep
when touching the
affected tooth
when putting pressure or
warmth on the tooth
bad breath and/or an
unpleasant taste in your mouth
in some cases, you may
find it hard to fully open your mouth and have difficulty swallowing
the swelling (which is
the collection of pus) may be present at either the base of the tooth, the gum,
and/or the cheek
shiny, red and swollen
gums
the affected tooth can
change color and become loose
if the infection spreads,
you may also develop a high temperature (fever), a bad migraine and feel
generally unwell
the lymph glands in the
neck may become swollen and tender in response to the infection
Treatment
Patients with tooth
abscesses should see a dentist as soon as possible. Dental abscesses never go
away on their own. Moreover, they can spread to other parts of the body and
create serious complications or become chronic, where the infection can last
for months or even years.
Avoid visiting a General
Practitioner, as there is little they can do to help (maybe prescribe you some
painkillers).
What can you do to relieve
your symptoms ?
While you're waiting to
see a dentist, some actions may help in relieving your symptoms:
Painkillers can help
control your pain. Ibuprofen proved to be an effective painkiller for dental
abscesses, but some patients are unable to take it for medical reasons. If this
is the case, you can take Paracetamol instead. Avoid giving Aspirin to children
under 16.
There are other
painkillers available. If you are unsure what to take, try asking your GP. You
should always check the medicine leaflet before.
Avoid hot or cold food
and drink as they will make the pain worse.
Try eating cool, soft
foods if possible, using the opposite side of your mouth.
Use a soft toothbrush and
temporarily avoid flossing around the affected tooth.
You can also rinse your
mouth several times a day with a mild salt-water solution. Use 1/2 teaspoon of
salt in a glass of water. This may help draw the pus out and relieve pressure.
These measures can help
relieve your symptoms temporarily, but you shouldn't use them to delay getting
help from a dentist.
What your dentist will do
The first goal of the
professional treatment is relieving the symptoms and reducing the risk of
further spread of the infection. For that, the area is thoroughly cleaned and
the trapped pus must be allowed to escape.
If the infection started
inside a tooth, the dentist will make a small hole in the tooth. This allows
the abscess to drain. The tooth will then need root canal treatment, followed
by a filling or a crown.
When the abscess is
larger, the drainage through the tooth is not sufficient. In this case, the
dentist makes a small cut (incision) in the gum to drain the abscess.
The dentist may prescribe
antibiotics and/or painkillers. These drugs will help the abscess heal and keep
the infection from spreading.
Depending on the location
of the abscess and how severe the infection is, there are two possible
treatment approaches:
Root canal treatment
If the tooth can be
restored, root canal therapy is needed to save the tooth. A root canal
treatment can take several appointments to be completed.
Once the treatment is
successfully completed, the tooth will be restored with a filling or a dental
crown.
Extraction
If the tooth cannot be
restored or root canal treatment is not possible, an extraction is performed
followed by curettage of all apical soft tissue.
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