What is a Tooth Or Dental abscess?
A Tooth abscess or Dental abscess occurs when the nerve of a tooth has become infected. This is usually due to dental decay, but may also be caused by injury to the tooth. Pus is formed, which can only escape through the root of the tooth. This causes pressure under the tooth, which makes it painful if touched. The pain is intense and throbbing may affect the side of the face.
An abscess usually develops as a complication of dental caries, which gradually destroys the layer of enamel on the outside of the tooth and the inner dentin, allowing bacteria to invade the soft central core, or pulp, of the tooth. Eventually, a dental abscess may form. the pulp may also become infected if a tooth is damaged by a blow to the mouth.
An abscess may also form as a result of certain forms of gum disease. Periodontitis is usually caused by a buildup of dental plaque in a pocket that forms between a tooth and gum.
Usually the abscess originates from a bacterial infection that has accumulated in the soft pulp of the tooth. This is usually but not always associated with what is commonly described as a dull throbbing excruciating ache.
A tooth abscess typically originates from dead pulp tissue, usually caused by untreated tooth decay, cracked teeth or extensive periodontal disease. A failed root canal treatment may also create a similar abscess.
There are two types of dental abscess. A periapical abscess starts in the dental pulp and is most common. A periodontal abscess begins in the supporting bone and tissue structures of the teeth.
A dental abscess can be extremely painful and may cause the affected tooth to loosen in its socket.
What are the symptoms?
Common symptoms of an acute tooth abscess is a toothache or a persistent, throbbing pain at the site of the infection.Putting pressure or warmth on the tooth can induce extreme pain.
In some cases, a tooth abscess may perforate bone and start draining into the surrounding tissues creating local facial swelling. The lymph glands in the neck in some cases will become swollen and tender in response to the infection.
The main symptoms of a dental abscess develop gradually and may include:-
Â· Dull aching around either or both of the cheekbones.
Â· Severe pain on touching the affected tooth and on biting or chewing.
Â· Loosening of the affected tooth.
Â· Red, tender swelling of the gum over the root of the tooth.
Â· Release of pus into the mouth.
If the abscess is not treated, the infection may make a channel from the tooth to the surface of the gum, and a painful swelling, known as a gumboil, may form. If the gumboil bursts, foul-tasting pus is released and the pain decreases. In some cases, the channel may persist, leading to a chronic abscess that discharges pus periodically. If the infection spreads to surrounding tissues, your face may become swollen and painful, and you may also develop a fever. If you suspect that you have a dental abscess, you should consult your dentist as soon as possible.
What should you do if you get a dental abscess?
You should seek advice from a dentist urgently to get the abscess drained. It may be possible to drain the pus through the tooth itself so the tooth can be saved (root canal treatment). If not, the tooth will need to be extracted to prevent the abscess recurring.
Sometimes, a dental abscess may burst. This allows the pus to drain and can ease the pain. The process can be encouraged by using a hot salt-water mouthwash (a teaspoon of salt to a cup of water).
Do not apply any heat directly to the face – a hot-water bottle, for example – as this will make the swelling worse. However, something cold on the face may ease the swelling, while painkillers occasionally help reduce the pain. In severe cases, antibiotics may be necessary.
Your dentist will ask you about your symptoms and examine your teeth and gums. He or she may take an x-ray of your mouth to confirm the diagnosis.
One treatment for an abscessed tooth is to extract it, thereby removing the source of infection. However, in select cases a root filling or root canal therapy may be able to save the tooth by cleaning the source of infection in the pulp chamber and root canal system (for more information see Root canal therapy). Another possible treatment of an abscessed tooth is an invasive surgery through the cheek.The doctor will then remove the tooth, ridding the source of infection. Finally, the doctor will insert a tube through the cheek routing it the site of the tooth so any other pus may drain out through the tube in to either a Jackson-Pratt bulb or directly onto a surgical sponge.
If the abscess has been caused by decay, your dentist may try to save tooth. under local anesthesia, a hole is drilled through the top of the tooth to release the pus and relieve the pain. if there is a gumboil, a small cut may be made in the boil to drain the pus. The cavity is then cleaned with an antiseptic solution. a small tube may be left in place for a few days to allow any remaining pus to drain, and you will probably be given a course of antibiotics. Once the infection has cleared up, you will probably need root canal treatment. If it is not possible to save the tooth, it will be extracted.
To treat an abscess caused by gum disease, your dentist may use a probe to scrape out the plaque from the pocket between the affected tooth and gum. afterward, the pocket is washed out with an antiseptic solution. In severe cases, the tooth may be extracted.
What is the prognosis?
Most treatment is successful, but a small area of infection may persist and further treatment may be required.
An untreated severe tooth abscess may become large enough to perforate bone and extend into the soft tissue. From there it follows the path of least resistance. Largely dependent on the location of the infected tooth; the thickness of bone, muscle and fascia attachments, the infection then spreads either internally or externally.
External drainage may begin as a boil which bursts allowing pus drainage from the abscess, intraorally (usually through the gum) or extra orally. Chronic drainage will allow an epithelial lining to form in this communication to form a pus draining canal (fistula). Sometimes this type of drainage will immediately relieve some of the painful symptoms associated with the pressure.
Internal drainage is of more concern as growing infection makes space within the tissues surrounding the infection. Severe complications requiring immediate hospitalisation include Ludwig’s angina, which is a combination of growing infection and cellulitis which closes the airway space causing suffocation in extreme cases. Also infection can spread down the tissue spaces to the mediastinum which has significant consequences on the vital organs such as the heart. Another complication, usually from upper teeth, is a risk of septicaemia (infection of the blood), from connecting into blood vessels. Brain abscess, while extremely rare, is also a possibility.
Depending on the severity of the infection, the sufferer may feel only mildly ill, or may in extreme cases require hospital care.
How can a dental abscess be avoided?
Keeping your teeth healthy is the best way to prevent dental abscess.
Try to avoid cavities by reducing your intake of sugary foods and drinks – have them as an occasional treat, at mealtimes only. Brush your teeth twice daily using a toothpaste containing fluoride. To get the most benefit from the fluoride, do not rinse the toothpaste away after brushing.
Visit your dentist regularly, at agreed intervals. This way, problems can be diagnosed early and your treatment will be more straightforward.Remember that even if the abscess drains by itself, you should seek advice from your dentist for further assessment.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose