Dental Abscess

To know dental abscess first, you must know what is abscess. Abscess is collection of pus (yellowish infected fluid) which is formed due to infection. It is typically painful, and appears as a swollen area. It is warm to touch. Surrounding skin appears pink or red.

It can develop in many parts of the body. When it affects the teeth, it is called dental abscess.

Normal Tooth Anatomy

Knowledge of outer and inner shapes and details of the tooth will help you to understand better.
Normally a tooth has 2 main parts:
Crown and Root
Crown is that part of teeth which is seen in the mouth.

Root is that part of tooth which is inside the jaw bone.

Crown is made up of: Enamel, Dentin and Pulp
Enamel: it is white hard covering over the crown. It does not have blood supply.

Dentin: It is below the enamel.

Pulp: The nerves and blood vessels present in the tooth are called pulp.

Cementum: It is covering of the roots. It has no nerve supply.

Periodontal ligament: It attaches the roots to the jaw bone. It has both nerve and blood supply.

Overview of the disease:

What is dental abscess?

A dental abscess is accumulation of pus in the teeth or gum tissue. It is also called “Dentoalveolar abscess”.

Types of dental abscess:

You may get dental abscess, but you don’t know which type of abscess it is, so let us know the types of dental abscess.

Gingival abscess: Abscess formed due to infection or trauma to the surface of gum tissue.

Periodontal abscess: Abscess formed due to infection that has moved deeper into the gum areas. This is sometimes called as “gum boil”.

Periapical abscess: Abscess of a tooth due to infection of pulp.

Symptoms of dental abscess:

You may have any one of the following:

  • Toothache
  • Continuous sharp, shooting or throbbing type of pain
  • Swelling of the gum or cheek.
  • Fever
  • Bad breath
  • Enlarged lymph nodes in the neck
  • Pain in opening or closing the mouth

What causes of dental abscess?

  • Caused by different bacteria’s.
  • Tooth decay or caries
  • Trauma or injury to tooth
  • Broken or chipped tooth
  • Poor oral hygiene
  • Faulty tooth restorations

Risk factors:

  • Dental caries and dental trauma
  • Poor oral hygiene
  • Failed root canal treatment
  • Diseases such as diabetes
  • Decreased salivation
  • Having radiation therapy of head and neck
  • Taking certain medicines

Diagnosis:

History: Your dentist will ask you about the history of pain and swelling, when the pain increases and decreases and if medications taken for the same, and any drug allergies.

Physical Examination: Examination of any carious teeth, any loose teeth, facial swelling, swelling of gums.
Lightly tapping on the tooth causes pain which indicates dental abscess.
Sliding of probe between tooth and gum to measure tooth loss.

Radiograph: X-ray of tooth and surrounding bone is taken.

Treatment:

The main goal of treatment is to relive symptoms and prevent spread of infection.

The most important thing is to find out which type of abscess is present, so that proper treatment is given.

Surgical care:

In all three types of abscesses the pus is drained.

In case of Periapical abscess, the pus is drained through an incision in the gum or by enlarging the hole in the tooth. This relieves pain and swelling.

In case of periapical abscess if tooth is restorable then the tooth is treated with root canal treatment. Here the dentist drill into dead tooth to release pus and remove damaged tissue from the center of the tooth. A root filling is then inserted into the space to prevent further infection.

If the tooth is not restorable then extraction (removal) of tooth is indicated.

In case of Periodontal abscess drainage of the inflammation and elimination of the infection is done. Draining of pus is done by careful insertion of a dull probe into the pus pocket (space between the tooth surface and gum tissue) along the tooth.

Medications:

Antibiotics along with pain killers are given, if swelling and fever is present. Antibiotics are given to fight the infection. These are given to relive pain and prevent spread of infection. But remember one thing antibiotics should not be used to delay dental treatment.

Prevention:

How can you prevent a dental abscess?

Most dental abscesses are preventable as most of them occur due to tooth decay or gum disease.

  • Regular tooth brushing and flossing
  • Use of mouthwashes, tongue cleaning, eating a healthy diet which includes limiting sugary drinks and food.
  • Avoidance of smoking and excess alcohol
  • Should treat fracture tooth.
  • Professional dental check-up at least once a year

Complications:

With proper treatment, dental abscess can be treated easily. If untreated, complications can occur in rare cases.

Ludwig’s angina: This is an infection of the floor of mouth, which can occur if the bacteria in a dental abscess spread.

Maxillary sinusitis: This is an infection of small, air –filled spaces behind cheek bones, known as maxillary sinuses.

Dental cyst: a fluid filled cavity developed at the bottom of root of the tooth.

Osteomyelitis: It is an infection of the bone.

Cavernous thrombosis: The spread of bacteria causes a blood clot to form in a large vein at the base of brain.

The prognosis for dental abscess is good if it is treated early and appropriately with elimination of infection that causes the abscess.