Tooth Abscess

An abscess is an inflammatory disease that occurs due to poor oral hygiene, deep caries, medical errors made during canal filling, and other reasons. If it is not treated in time, complications are possible, up to a fatal outcome. The AESTHETE dental clinic provides services for treating tooth abscesses. The high qualifications and extensive practical experience of the doctors allow them to solve complex tasks and provide assistance in difficult situations.

Tooth abscess: what it is and how it looks

An abscess is a pocket of pus that appears in the soft tissues near the tooth roots due to a bacterial infection. This is an inflammatory disease, but it differs from the well-known gum boil (periostitis) in that the periosteum is not involved in the inflammatory process.
A healthy tooth is protected from pathogenic microorganisms by enamel. But cracks, chips, and cavities allow microbes to enter inside. They affect the soft part of the tooth – the pulp. Since it contains nerve endings, the inflammation is accompanied by severe pain.
The blood supply to the affected area increases, so the gum turns red. Leukocytes in the blood try to destroy dangerous microorganisms in the infected area. As a result, pus is formed, consisting of dead leukocytes and bacteria. It accumulates, leading to purulent inflammation. The accumulation of pus is a dense ball that causes the gum to swell. Pressing on the swelling can cause pain.
The intensity of the pain may vary, increasing and decreasing. But the reduction in pain does not mean that the disease has gone away. This is a temporary respite. Soon, the pain will intensify again.
Upon detecting symptoms of an abscess, you should see a dentist. The earlier you start treatment, the easier it will be to solve the problem. Conversely, if you postpone the visit to the doctor for too long, it will be more difficult to treat the disease, and serious complications may arise.

Symptoms of an abscess

In most cases, the disease affects one tooth. But if the disease is left untreated for a long time, the abscess may spread to neighboring teeth. The onset of the inflammatory process is well noticeable, accompanied by severe pain in the affected area. The pain can be so intense that painkillers only relieve it for a short time or merely reduce it, but cannot completely eliminate it.
Characteristic symptoms of an abscess:

• constant throbbing pain that intensifies, becoming sharp when pressing on the tooth or during chewing;
• discomfort when consuming hot or cold foods and drinks;
• gum pain, which also worsens when pressing on the swollen area;
• redness and swelling of the gums;
• bad breath;
• a bitter taste in the mouth;
• facial asymmetry;
• swelling of the cheeks and neck, to the point where swallowing becomes difficult;
• swollen lymph nodes that hurt when touched;
• fever;
• bouts of headaches.

If the problem is ignored for a long time, small sores may appear on the gums, from which pus is released.

An abscess rupture is possible, in which the contents enter the mouth. The pain eases after this. But this does not mean the end of the disease, because bacteria remain in the tooth tissues, and after some time, everything will start again.

Causes of occurrence

Bacterial damage to the tooth tissues, which leads to inflammation, can arise for various reasons.

1. Poor oral hygiene – neglecting to brush teeth, using unsuitable toothpaste – leads to the accumulation of a large number of pathogenic bacteria in the mouth.
2. Deep caries contributes to microorganisms penetrating the pulp through the cavities formed. If the problem is not solved in time, pathogenic microorganisms will affect the soft tissues near the root, and inflammation will begin.
3. Periodontitis, that is, inflammation of the gums, which causes periodontal pockets to form, can also cause an abscess. Food particles accumulate in these pockets, creating an environment where bacteria multiply.
4. Errors during root canal filling, made by the dentist due to inattention, lack of experience, or failure to follow the protocol, mean that voids remain inside. Pathogenic microorganisms also multiply in them.
5. Pericoronitis is a disease that can occur during the eruption of a wisdom tooth and consists of a flap of mucosal tissue forming over the tooth. Infection penetrates under it, the inflammation spreads to the gum, and as a result, an abscess develops.
6. If, after tooth extraction, the doctor's recommendations are not followed, food residues and bacteria may enter the unhealed socket. This also provokes the development of an infection.
7. Another cause of an abscess is mucosal trauma caused by careless tooth brushing, blows, or falls. Once microbes enter the wound, the likelihood of inflammation and subsequent suppuration increases immediately.

There are factors that do not cause an abscess themselves but increase the likelihood of its occurrence. These include:

• dry mouth caused by age-related changes in the body or the use of certain medications;
• excessive consumption of products and drinks with high sugar content – candies, sweet pastries, soda.

Classification

Doctors distinguish four types of abscesses depending on where the suppuration occurred.
Gingival abscess responds particularly well to treatment. In this case, the mucosa in the area of the interdental papillae becomes inflamed. If the disease is not detected and treated, the infection will go deeper and spread to neighboring teeth and bone tissue. This can lead to complications.
In the case of a periodontal abscess, the infection focus is inside the gum. Inflammation begins in the area between the jawbone and the healthy surface of the soft tissue. A pocket forms, in which pus accumulates, and it cannot escape. Gradually, a hard lump forms. If treatment is not started in time, the infection will spread to the remaining healthy soft tissues as well as the bone.
With a periapical abscess, the inflammation occurs in the root canals. Pus accumulates at the root apex, which can cause a growth, a lump, to appear on the gum surface. Another possible outcome is the formation of a fistulous tract.
Pericoronal abscess occurs when the inflammatory process begins in the area of the gum over an erupting tooth. Pus also accumulates there. This situation can arise, for example, if a wisdom tooth is growing and a flap of soft tissue has formed over it.

Stages of pathology development

An abscess is a disease whose development can be divided into stages. It usually starts with a slight gum inflammation. Since it does not cause significant discomfort, the person does not pay attention to it.

Then a small ball filled with purulent contents forms. Its diameter is 1-5 mm.
At the next stage, a hollow pocket forms in the gum. It fills with purulent contents. The size of the pocket gradually increases.

Finally, a fistula forms on the gum surface.
If the disease is not treated, it will progress from the acute form to the chronic one. The stages described above will periodically repeat themselves.
The acute form is characterized by pronounced symptoms:

• sharp pain;
• enlargement of the sac with purulent contents;
• discomfort while eating, unpleasant sensations with temperature changes.

In the chronic form, the abscess is less noticeable. The pain becomes less sharp, and instead of a pocket filled with pus, a fistula forms. But even if all the contents drain, the disease will not resolve on its own. After a while, it will manifest itself again in the acute form.

Possible complications

If an abscess is not treated in time, the patient’s condition will worsen. They risk facing serious consequences. These are:

1. Phlebitis or thrombophlebitis. Purulent inflammation can spread to the walls of the veins and blood vessels. Pathogenic bacteria enter the bloodstream from the surface of the affected gum, infecting it. At the same time, the body temperature rises, pain appears in the infected area, and the patient feels general weakness and malaise.
2. Sinusitis – inflammation of the mucous membranes of the nasal sinuses. The cavities, known as maxillary sinuses, or antra of Highmore, are located near the roots of the upper teeth, from the fourth to the eighth. The patient experiences nasal congestion, has difficulty breathing, and may experience facial pain.
3. Osteomyelitis – an infectious inflammatory process that affects bone tissue. It occurs because pathogenic microorganisms spread from the tops of the tooth roots to the jawbone. The bone can deform, and the shape of the jaw becomes distorted.
4. Sepsis – blood poisoning caused by infection. This is a serious problem that affects the entire body. Characteristic signs are fever, chills, and a rapid heartbeat. Sepsis can cause breathing difficulties, and it disrupts the patient’s mental state. In a negative development of the situation, this leads to a fatal outcome.
5. Meningitis – infection entering the brain tissue. This is also possible if the abscess is ignored for a long time and not treated. Brain inflammation causes confusion and changes in the mental state. Meningitis can lead to death, and in about 20% of cases, people become disabled after recovery.

Treatment

You should not try to treat an abscess on your own. You cannot try to drain the abscess at home; this may lead to a new infection entering the wound, which will worsen the condition.
At the first signs of the disease, you need to see a dentist. They will diagnose the problem and offer treatment based on the clinical situation and the individual characteristics of the patient. The choice of treatment methods depends on the nature of the disease and the extent of the infection.
If there is a possibility to save the tooth, the doctor will do everything possible to do so. In this case, it is first necessary to remove the pus. This requires:

• drainage – removing the purulent contents;
• disinfecting the affected area.

The abscess can be drained through the root canals or an incision in the gum.
If the inflammatory process has affected the pulp, depulpation will be required. The dentist creates a cavity in the tooth to access the infected soft tissues, cleans the affected area, and fills the cavity.

If drainage does not help or the inflammatory process has advanced so far that the tooth and root are destroyed, it is necessary to remove the affected tooth. After this, the doctor carefully cleans the socket to ensure that no pus or pieces of dead tissue remain.
Regardless of the chosen treatment method, anesthesia will be necessary. Usually, local anesthesia is sufficient. Patients with high sensitivity or those who fear dental procedures are offered general anesthesia or sedation – a state resembling sleep, induced by safe medications.

Medication therapy can be used independently or as a supplement to the main treatment. The doctor prescribes antibiotics if symptoms of general intoxication are detected, which is possible in patients with moderate to severe conditions.

Antibiotics, antibacterial, and pain-relieving medications are also prescribed after surgery. They provide additional protection against reinfection of the wound. Usually, if the recommendations are followed precisely, the patient will feel well 4-5 days after the operation.

How to relieve pain caused by a tooth abscess

At home, it is possible to relieve pain and other unpleasant symptoms. This is especially important if there is no way to quickly get to a dentist.
You can:

• make saline and soda baths – they disinfect the oral cavity, draw out pus, and have an anti-inflammatory effect;
• use chamomile and calendula decoctions – they have a calming effect and also have antibacterial properties;
• clean an aloe leaf and apply it to the gum to draw out pus.
  Under no circumstances should hot compresses or rinses be used. They will increase inflammation, and the patient's condition will worsen.

Prognosis and prevention

With timely detection of an abscess and proper treatment, the prognosis is usually favorable. Most often, the doctor decides on a tooth-preserving surgery. But much depends on how the body responds to therapy or surgery.
Factors that the dentist considers:

• the overall resistance of the body – how successfully it fights the infection;
• the cause of the disease;
• the condition of the alveolar bone – whether it is destroyed or intact;
• the condition of the tooth's root system – whether it is affected and involved in the inflammatory process;
• the anatomical and functional characteristics of the affected tooth unit.

The success of treatment largely depends on the patient's age, the condition of their dentoalveolar system, and the presence of other pathologies.

After surgery, it is essential to follow the dentist’s recommendations. This will help avoid complications and shorten the rehabilitation period.

But it is better not to allow the development of an abscess at all. For this, it is necessary to treat caries and other diseases of the teeth and gums in time. It is important to:

• regularly brush your teeth twice a day, using a brush with the appropriate bristle stiffness, dental floss, and mouthwash;
• visit the clinic for preventive check-ups and professional cleaning at least twice a year to get rid of not only soft plaque but also hard deposits, the so-called tartar;
• monitor your diet, eliminate sweets and soda, and eat less hard food.

The AESTHETE dental clinic is located in Dubai (UAE), Bluewaters Island. Our medical center has modern equipment for accurate diagnosis, and the necessary tools and materials to treat a tooth abscess. The doctor will consult, diagnose, and develop a treatment strategy.
The clinic's administrators will answer your questions, help you choose a time for your dental visit, and explain how to make an appointment.