Dental abscess

Dental abscess

A dental abscess is a bacterial infection that can be painful or not, and usually containing pus. This type of infection is usually located in the edge of the root of a tooth, or at the gum level around a tooth.

For an abscess to develop, a tooth must either brake, or have tooth decay which would have reached the pulp, the central cavity of the tooth. If the infection comes from the gums, the abscess occurs due to periodontitis (gum disease). If not treated, A dental abscess can reach the jawbone and cause severe complications.

Abscess originating from a tooth

Evolution of dental caries

Abscess originating from a toothA dental carie (cavity or decay) is a bacterial infection of a tooth. When it is small and limited to enamel or dentin, it can be repaired by a filling or by an inlay or onlay if necessary. But when the decay reaches the pulp (where the nerve is located), the pulp becomes infected and an abscess may develop at the edge of the root (apex).

It's important to note that a carie and an abscess may develop slowly without causing any pain. But if the infectious expansion is suddenly accelerated, it can cause swelling and a lot of pain. The best way to detect a cavity or an abscess is by undergoing a dental exam by a dentist with dental x-rays.

Abscess originating from gums

Evolution of gum disease

Tarter in the mouthIf someone has poor oral hygiene and dental plaque is not remove regularly, this plaque can become tartar which sticks to teeth and gums. Tartar can accumulate and cause inflammation and infection of the gums.

If tartar is not removed by a dental cleaning, it digs slowly through the gums, and destroys the bone that holds teeth. This condition is called periodontitis. It's a disease that can generate an abscess at the level of the gums with swelling and pain. But periodontitis can also develop very slowly without pain but by destroying bone. The tooth then moves more and more until it falls off by itself or needs to be extracted.

Symptoms

Tooth acheThe main symptom of a dental abscess is an acute and intense pain from the infected tooth. There may be long periods without pain, that can go on for days or months before you notice that you have an abscess. Other symptoms can also be noted:

  • Redness and swelling of the gums
  • Pain while chewing.
  • Headache, fever and general fatigue.
  • A significant amount of green and foul-smelling pus that eventually drifts out and the pain stops right after.

Complications

Advanced dental abscessIf a dental abscess is not treated, it can lead to serious complications that can affect a person's health dramatically and that sometimes can even be fatal:

A fistula is an opening that appears on the gum when the abscess is chronic. The pus drains out in the mouth by itself. When there is a fistula, the pain generally decreases, and you may see a small red or white button on the gum.

Tooth loss may occur because the abscess can infect the bone that holds the tooth, and if too much bone damaged (periodontitis), the tooth moves more and more and eventually falls out.

Brain abscess may occur. The infection could spread from teeth to the brain through blood vessels. An infection of the brain can lead to a coma.

Sinus infection can take place since the roots of upper molars are located near the sinuses. If the dental abscess produces pus, sinuses may fill with pus that comes from teeth.

Bacterial endocarditis may occur when bacteria from a dental abscess reaches the heart through blood vessels. These bacteria reaching the heart may infect it, which sometimes lead to fatal consequences.

Ludwig’s angina is a serious infection, and sometimes fatal, which affects parts of the face and the lower jaw. It usually occurs in adults suffering from a tooth abscess that was never treated. The danger is that it can grow enough to block the airways of the person who’s suffering from it, and cause suffocation leading to death.

Treatments

Caring for an abscessed tooth can vary depending on the severity of the infection, and whether it originates from the gum or the tooth:

  • taking antibiotics may be necessary beforehand, but this is not a final treatment because antibiotics only reduce the abscess temporarily;
  • pus drainage may be indicated if the abscess is very developed;
  • if the abscess comes from the gums, drainage and curettage may be needed;
  • if the abscess comes from the tooth itself, an endodontic cleaning (root canal), followed by an eventual placement of a crown, allows a proper treatment;
  • if someone does not have the financial means to procede with a root canal and a dental crown, they should not keep the abscess in the mouth; the tooth should be extracted instead to avoid serious health consequences; it's always better to keep our own teeth but partials or dental implants can eventually replace missing teeth;
  • if a tooth is destroyed too much or if it does not have enough bone to support it, extracting that tooth may be necessary.

Prevention

Lady flossingHaving a dental abscess can be an unpleasant or a very painful event. But there are several ways to avoid it:

  • Daily dental hygiene, including brushing your teeth 3 times a day, and flossing twice a day.
  • Seeing your dentist for regular dental exams, preferably twice a year.
  • Regular dental scalings and cleanings.
  • Reducing the use of tobacco products, or stopping altogether.

References

  1. Wikipedia (Dental abscess).
  2. Emergency Dental Care (How to Temporarily Relieve My Abscessed Tooth Pain).
  3. Kits Family Dental (Gum Boil in Children – AKA Dental Abscesses).
  4. The Queen of Dental Hygiene (It's all About the Plaque (No Tartar!) ).
  5. WebMD (Dental Care for a Beautiful Smile ).

The information above should be used as a reference only. Any medical decision should not be done before consulting a health care professional.

The masculine gender has been used without prejudice to make reading easier.


Dental and oral problems

  Abfraction Abrasion Abscess Ankylosis Anodontia Attrition Broken Fillings Bruxism Candidiasis Canker sore (aphthous ulcer) Cavity Cold sore (Oral Herpes) Crossbite Denture Irritation Denture stomatitis (prosthetic stomatitis) Dry Socket Erosion Fluorosis Gingival hyperplasia Gingival pocket Gingivitis Gum Disease Gum Recession Halitosis Jaw Problems Hyperdontia (supernumerary teeth) Hypocalcification Hypodontia Impacted tooth (tooth impaction) Leukoplakia Lichen planus Malocclusion Micrognathia (micrognathism) Mucocele Oligodontia Oral Cancers Overbite Overjet Pericoronitis Periodontal pocket Periodontitis Plaque Prognathia (prognatism) Resorption Retrognathia (retrognatism) Sleep Apnea Tartar Tooth Discolouration Tooth Sensitivity Torus Trismus Ulcer Xerostomia