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A tooth abscess is a collection or pocket of yellowish-green pus formed around an infected tooth or teeth as a result of bacterial infection. It is mostly associated with swelling, pain, and inflammation.
When not appropriately treated, an abscess can lead to a severe infection in the teeth, jawbone, and surrounding tissue. (1)
Types of Dental Abscess
Dental abscesses are categorized into the following three types, based on their location:
1. Gingival abscess
Also known as gum abscess, it forms on the surface, at the lining of the gum tissue or gingiva.
2. Periodontal abscess
It develops in the deeper layers of the gum tissue.
3. Periapical abscess
It is found around and beyond the root apex of the infected tooth and results from severe tooth decay. A common periapical abscess is wisdom tooth abscess.
A periapical abscess can be further divided into two types:
- Acute: It forms due to the rapid death of pulp tissue.
- Chronic: It forms as a result of a gradual onset of pulpal necrosis.
Causes of a Tooth Abscess
A tooth abscess is typically a result of bacterial infections. Multiple conditions can increase the risk of bacterial entry into the tooth, including: (2)
- Infection of the gum flap called an operculum, which covers a partially erupted wisdom tooth (the condition is called a pericoronal abscess)
- Advanced periodontitis
- Improper root canal treatment
- Tooth decay, which causes pulpal necrosis
- Gum disease or gingivitis
- Cracked enamel
The following factors can predispose you to tooth abscess:
- Uncontrolled systemic conditions, such as diabetes
- Poor dental hygiene
- Diet rich in sugar and carbohydrates
- Consumption of sticky food
- Previous dental surgeries
- Tooth trauma
- Grinding and clenching of the teeth
Symptoms of a Tooth Abscess
The chief sign of a tooth abscess is throbbing pain, which may range from a mild toothache to severe pain extending to the ears and neck. Occasionally, the pain may subside as the infection prevails due to loss of sensation.
Some other common symptoms associated with tooth abscess include:
- Bitter taste in the mouth
- Fever
- Breath odor
- Dental cavity
- Uneasiness or discomfort
- Altered sense of taste
- Pain while chewing
- Sensitivity toward cold and hot food or drinks
- Swelling or redness in the face
- Difficulty in opening the mouth
- Sore, red gums
- Difficulty swallowing food
- Swollen neck glands
- Swollen upper or lower jaw
Standard Medical Treatment for Tooth Abscess
The treatment for a tooth abscess aims at controlling the infection and managing the pain. The treatment options include:
1. Painkillers
You may take ibuprofen or paracetamol to help control the pain until proper treatment is received. It is vital to visit a dentist at the earliest and refrain from taking painkillers for a long time.
2. Antibiotics
Antibiotics are prescribed if the infection has spread to nearby teeth and gum tissues to prevent further spread. You may also need antibiotics if you have a weak immune system.
3. Draining the abscess
The dentist makes a small cut on the abscess to drain the pus. In some cases, a small rubber drain may be placed on the cut to allow gradual drainage of the pus while the swelling decreases.
4. Root canal
The affected tooth is drilled to remove the diseased tissue or central pulp, and the abscess is drained. Then, the tooth is filled and capped with a crown for added strength. This treatment can last for a lifetime if the tooth is properly looked after.
5. Tooth extraction
In cases where a root canal is not possible, the dentist might need to remove your tooth altogether to prevent the spread of infection.
Diagnosing an Abscessed Tooth
To diagnose a tooth abscess, the dentist will carefully examine your teeth, gums, and mouth. They may also tap the tooth to test if the pain is felt while doing so.
A cold test or other vitality tests may be performed to evaluate the vitality of the tooth. The dentist may further suggest X-rays and other tests to determine the source of infection.
Complications Associated With a Tooth Abscess
If not treated properly, a tooth abscess may spread through the mouth and lead to complications, such as:
- Dental cysts: A fluid-filled cavity develops at the root.
- Ludwig’s angina: The floor of the mouth swells up and may obstruct the airway in severe cases.
- Osteomyelitis: The bacteria in the abscess can spread to the bloodstream and eventually infect the bone.
- Sepsis: The bacterial infection can spread to other parts of the body, such as the jaw, neck, and head, and eventually to the whole body. Such a severe infection, or sepsis, can be fatal.
- Endocarditis: If the bacteria reach the bloodstream, it may infect the inner lining of the heart (endocardium).
When to See a Doctor
It is recommended to visit a dentist at the earliest signs of a tooth abscess.
Expert Answers (Q&A)
Answered by Dr. Anirudha Agnihotry, DDS (Dentist)
Yes, a tooth abscess can be fatal if not taken care of. The infected purulent discharge, or pus, will find the least resistant path and reach the muscles and soft tissue. Eventually, the bacteria may get into the blood, causing infection of the blood and possibly death due to complications.
It is advisable to pop a tooth abscess by a health care provider in proper septic conditions if the swelling is too big, and the tooth cannot be treated at once. Sometimes, the pressure mounting from the pus makes the abscess burst by itself.
A tooth abscess never heals by itself. The offending tooth has to be treated, and the infection removed. A root canal therapy or tooth extraction must be performed as indicated.
After the intervention to remove the infection, the body heals in the natural capacity. Healing time could vary from a day to a week.
No, salt water will not help in treating the tooth abscess. It will just help relieve the discomfort from the inflammation caused by the infection. It surely helps but does not take the infection away.
An abscess starts with a toothache. The pain gets worse, and you may get a little bump, which may grow bigger and cause more pain if not addressed.
Sometimes, the swelling quickly gets big, and sometimes it progresses slowly. After a while, the swelling may burst by itself, and you get a bad taste and odor in the mouth.
It is advised to go to your dental appointments regularly and maintain good oral hygiene to catch any cavities before they get big and become an abscess.
Final Word
An abscess refers to a pus-filled pocket that forms near the root of an infected tooth. This condition can occur in individuals of all ages. Maintaining oral hygiene and taking good care of your teeth play significant roles in preventing and alleviating a tooth abscess.
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