(Abscessed Teeth)
DEFINITION
The Dental Abscess is the accumulation of pus (infected material) in a tooth or in the gums. There are two types of dental abscesses:
- Pulp abscess (storage of blood and nerves inside the tooth)
- Abscess between the tooth and the gum
CAUSES
A dental abscess is caused by bacteria. It originates when bacteria invade and infect a tooth. This produces a collection of pus. When the pus cannot be drained, an abscess forms. Conditions that allow bacteria to invade a tooth:
- severe tooth decay
- Breakage or crack in a tooth that allows bacteria to invade the pulp
RISK FACTORS
These factors increase the chance of developing a dental abscess. Tell your dentist if you have any of these risk factors:
- Tartar buildup below the gum line
- Improper application of fluoride to the teeth, using fluoridated water, toothpaste, or mouthwashes
- Poor dental hygiene (leading to tooth decay and periodontal disease)
- Malnutrition, including severe vitamin and mineral deficiencies
SYMPTOMS
If you have any of these symptoms, do not assume it is due to an abscessed tooth. These symptoms may be caused by other conditions. Tell your dentist if you have any of these symptoms:
- Persistent throbbing pain in a tooth or gum area
- Tooth pain when biting
- spontaneous tooth pain
- Redness, tenderness, and swelling of the gums
- Fever
- swollen cervical glands
- tooth discoloration
- Bad breath or unpleasant taste in the mouth
- Open, oozing sore on the gums
If left untreated, complications from an abscessed tooth can include:
- Loss of the tooth and surrounding tissue or bone
- Spread of infection to surrounding tissue or bone
DIAGNOSIS
The dentist will ask about your symptoms and medical history, as well as perform a detailed examination of your teeth and gums. The dentist will check the tooth for pain and sensitivity by:
- tooth tapping
- Stimulation of the dental nerve with heat or cold
- Stimulation of the dental nerve with mild electrical impulses
- Placing a probe between the tooth and gum to measure gaps or tissue loss
The dentist will also take an x-ray of the tooth and surrounding bone.
TREATMENT
Abscess Removal By Endodontics
If the abscess comes from a decay or break in the tooth:
- The tooth and surrounding tissue are numbed, and a hole is made through the top of the tooth.
- Pus and dead tissue are removed from the center of the tooth.
- The inside of the tooth and the root (nerve) canals are cleaned and filled with a filling.
- A crown is placed on the tooth to protect it.
If the abscess is due to an infection between the tooth and the gum:
- The abscess is drained and carefully cleaned.
- The root surface of the tooth is cleaned and smoothed.
- In some cases, surgery is required to reshape the gums and prevent recurrence of infections.
Tooth Extraction
It may be necessary to extract the tooth if:
- Tooth decay and/or infection is too extensive to fill or root canal.
- The breakage or crack of the tooth is too serious to be repaired.
- Infection or loss of tissue or bone between the tooth and the gum is serious.
If the tooth is removed, it will be replaced with:
- partial bridge
- Dental prostheses
- Dental implant
Medicines
- Antibiotics to attack residual infection in the teeth or gums
- Over-the-counter pain relievers (ibuprofen or acetaminophen) and warm salt water mouthwashes
PREVENTION
To reduce your chance of getting an abscessed tooth, take the following steps:
Proper dental hygiene, including:
- Brush your teeth with fluoride toothpaste after meals or at least twice a day
- Floss daily between teeth and gums
- Undergo regular dental check-ups (every six months)
- Have your teeth and gums professionally cleaned on a regular basis (every six months)