Dental abscess or an abscessed tooth is an accumulation of pus enclosed in the teeth or gums. It is commonly caused by bacterial infection in the tooth’s pulp, severe tooth decay, gingivitis, gum disease, broken teeth, or an unsuccessful root canal treatment. These dental problems can result in openings in the tooth’s enamel, allowing the bacteria to enter the pulp. Infection may spread from the root of the tooth to the jaws.
Symptoms and signs linked to dental abscess:
Symptoms are what the person feels and reports about his or her condition while signs are what other people, like a dentist or a doctor, may see or detect. Tooth abscess is diagnosed collectively by the symptoms and signs reported by the person, tests and evaluation done by the dentist, and results from routine dental radiographs such as X-rays. Several signs and symptoms of a dental abscess are:
- Difficulty in swallowing and/or breathing
- Foul smell and taste in your mouth
- General discomfort or ill feeling
- Inflammation on the upper or lower jaw
- Open sore on the side of the gum
- Pain when chewing
- Painful, throbbing, and persistent toothache
- Sensitivity of the teeth to hot and cold
- Severe infection can cause vomiting, fever, nausea, diarrhea, and chills
- Spasm of the jaw muscles in severe cases
- Swelling, pain, and redness of the mouth and face
- Swollen neck glands
- Swollen gums
Causes of dental abscess:
The major cause of infection results from the growth of the bacteria from a tooth cavity directly to the tissues and bones of the neck. If the infected tooth is left untreated, tooth abscess will form and the infection may spread to the gums, jawbone, and other areas which can be very painful. Any tooth can have abscess, but the wisdom teeth are more prone to developing dental abscess because of the difficulty to reach and clean them. Most of the time, wisdom teeth are extracted to avoid complications of dental abscess.
A dental abscess usually results from a complication of tooth decay or other causes such as:
- Injury that may result in chipped or broken tooth
- Dental proceduresthat gets too close to the pulp chamber of the tooth like crown, filling, or in certain cases, root canal treatment
- Trauma to the tooth from too much clenching or grinding (Bruxism)
Types of dental abscess:
A tooth abscess differs from a gum abscess through the source of bacterial infection. The periapical or tooth abscess starts from the tooth’s pulp while a periodontal or gum abscess originates from a gum pocket which is next to the root of the tooth. Another type is gingival abscess which affects only the gum tissues. Tooth abscess can develop quickly, sometimes within a day or two when the infection starts. Treatment of these types of dental abscess depends on where the infection originates.
- Periodontal abscess or “gum boil”
Bacterial infection in the gums is called periodontitis. It is an infection where the gums get inflamed, making the periodontal ligament (tissue around the root of the tooth) to separate from the root, froming a periodontal pocket. Continuous growth of bacteia in the periodontal pocket will result in periodontal abscess. The infection is caused by the food trapped between the tooth and the gum, which can result in build up of bactertia. Periodontal abscess can also be a result of injury to the gums.
- Periapical abscess
Dental caries that develops in the tooth enamel can can lead to tooth decay which can form tiny holes where bacteria might enter and penetrate the pulp of the tooth. Pulpitis, or infection of the pulp occurs, spreading to the alveolar bone (a bone that surrounds and supports the tooth), and periapical abscess is formed. This is the most common type of abscess and often caused by a complication of dental decay.
- Gingival abscess
This abscess is confined to the gum or soft gingival tissue and does not have an effect on the periodontal ligament or the tooth.
Treatment of dental abscess:
Treatment of tooth abscess may involve tooth extraction, root canal treatment, or draining and getting rid of the infection. The procedure usually begins by administering oral antibiotics and then draining and clearing the tooth and other affected areas with infection. If the tooth can be restored after clearing it of infection, a root canal is performed where the pulp chamber and inner parts of the tooth is thoroughly cleaned and then sealed to protect it from future decay or infections. However, if the tooth cannot be restored after the initial procedure of clearing and draining it, tooth extraction is done or surgery in cases of severe infection. In rare cases, treatment of dental abscess may fail because of several factors:
- Associated periodontal issues
- Foreign objects in the lesion
- Formation of cyst
- Insufficient root canal therapy
- Maxillary sinus have been penetrated
- Vertical fractures in the root
Complications of a dental abscess:
Treating a tooth abscess is not only to cure the pain but also to prevent other possible complications in the future. Most of these complications are caused by the spread of the bacterial infection if the abscess is not treated immediately. People who are diabetic or who have poor immune system are more prone to suffer from complications if they have dental abscess.
Other possible complications are listed below:
- A condition called Maxillary sinusitis, where the bacteria from the infected tooth spread behind the cheekbones that can result in tender cheeks and fever
- Accumulation of pus on the infected area can become more painful unless surgically drained or ruptures and drain on its own
- Bacteria from a tooth cavity can spread to the gums, beneath the tongue, throat, cheek, or jaw bones and can be very painful when tissues gets inflamed
- Cavernous sinus thrombosis where a blood clot is formed at the large vein at the base of the brain (cavernous sinus)
- Dental cysts may develop under the root of the tooth and if the cyst gets infected, surgery might be needed
- Ludwig’s angina, a condition hwre the floor of the mouth gets infected, causing great pain under the tongue and in the neck. In severe cases, there is difficulty in breathing and can be fatal
- Osteomyelitis, where the bacteria infects the bone ner the abscess and spread into the bloodstream
- Swelling and inflammation may become severe causing blockage in air passages and make breathing difficult.
Prevention of tooth decay through proper oral care is important in avoiding a dental abscess. The following are some measures to take to have good dental hygiene:
- Add extra protection to your teeth by rinsing with antiseptic or fluoride mouth wash
- Avoid sugary foods and drinks
- Brush and floss your teeth regularly as recommended by your dentist
- Make it a point to visit your dentist for regular check ups and cleanings
- Replace your toothbrush when the bristles are frayed, or every 3 to 4 months
- Use fluoride toothpaste and fluoridated drinking water
Bacteria from plaque or tooth decay can spread to the soft tissue inside the tooth or gum making them infected and as a result can cause dental abscess. Tooth abscess is usually a result of complications from tooth decay or gum disease and can be very painful. The risk of developing a tooth abscess can be reduced and prevented by following good dental hygiene. proper oral care includes regular brushing and flossing of teeth, eating a healthy diet, and having regular checkups with your dentist at least once a year.
Source by Joe R. Stewart