A dental abscess is an accumulation of pus that can be found near or around a tooth. There are different types of abscesses and they must all be taken seriously and addressed by a dentist with immediacy. It is highly unlikely that an abscess will simply go away on its own, but quite likely that it will spread to other parts of the face, head and body if left untreated, thereby potentially resulting in serious health complications and sometimes even death.
Types of Dental Abscesses
A periodontal abscess is most often found in individuals who have periodontitis or gum disease. In these cases, gums become inflamed and gum tissues start to separate from the base of the tooth, forming tiny gaps known as periodontal pockets. Over time, bacteria builds up in these pockets which are difficult to clean, resulting in the formation of a periodontal abscess.
Periodontal abscesses are usually drained and followed up with the cleaning of the periodontal pocket. A process of smoothing or planing the tooth just below the gumline is then undertaken in order to promote healing and help prevent further infections.
A tooth abscess is one that starts in the soft pulp inside of the tooth. It is the most common type of dental abscess so I will focus on this type of abscess for the remainder of my article. In most of these cases, the problem starts with tooth decay caused by dental plaque bacteria. As decay continues, inflammation and infection inside of the tooth known as pulpitis begins. Sometimes the pulpitis can start as a result of a traumatic injury. The end result is the same either way. The pulpitis leads to increased pressure and eventual death of the tooth’s pulp tissue, a condition known as necrosis. The dead material is the perfect environment for bacterial growth. When this “bacterial soup” leaks out of the tooth, it creates an abscess in the boney area around the tooth root.
Symptoms
There are many different signs and symptoms of a tooth abscess. It is important to note than not all of these must be present in order for you to have an abscess.
Early signs and symptoms:
- Pain that is usually continuous, aching or throbbing
- Tooth is sensitive to pressure
- A bad taste in your mouth
- Bad breath
- A boil on or near the gums
Signs of advanced infection:
- Swelling of the face and/or neck
- Tenderness of the lymph glands in your neck
- A fever
- Difficulty breathing or swallowing
Treatments
Dentists are the only individuals who can effectively treat a dental abscess. Your dentist’s approach to treatment will largely depend on both the type and severity of the abscess. Often his or her first step will be to get the patient on antibiotics in order to get the infection under control. He or she may also prescribe pain medication until the underlying problem is properly rectified. Rinsing with saltwater is frequently advised.
Usually root canal treatment is the treatment of choice for a tooth abscess. In these situations, a hole is made in the tooth in order to allow the pus to escape. Damaged tissue is subsequently removed from the pulp of the tooth and replaced by sealing material to prevent subsequent infections.
On occasion, a tooth is simply too damaged to be a candidate for restoration. In these situations, a dentist may decide that the only recourse to remedy the abscess and to prevent the spread of infection is to remove the diseased tooth.
Possible Complications
Dental abscesses are not to be taken lightly. If left untreated, they can result in:
- Cellulitis, a dangerous bacterial infection involving the skin
- Osteomyelitis, a very serious infection and inflammation of the bone and bone marrow
- Ludwig’s Angina, a swelling which closes the airway and can even cause suffocation
- Sepsis or infection of the blood
- Myocarditis or infection of the heart muscle
- and even in rare cases, brain abscesses
I must reiterate that it is important to get regular dental checkups and to seek the advice of a dentist if you suspect that you might have an abscess. Do not wait. And if he or she informs you that you do indeed have an abscess, I cannot urge you strongly enough to have it treated promptly and properly – even if you are not experiencing any pain or discomfort at the moment. Waiting could cost you more money, grief and pain in the not-so-distant future. Even your life could be at risk.
Steven Deskin is a Brantford Dentist in general practice.
