A dental abscess is a collection of pus that can form inside the teeth, in the gums, or in the bone that holds the teeth in place. It’s caused by a bacterial infection.
An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess.
Dental abscesses are often painful, but aren’t always. In either case, they should be looked at by a dentist.
It's important to get help as soon as possible, because abscesses don't go away on their own. They can sometimes spread to other parts of the body and make you ill.
A toothache that is severe and continuous and results in gnawing or throbbing pain or sharp or shooting pain are common symptoms of an abscessed tooth. Other symptoms may include:
- Pain when chewing
- Sensitivity of the teeth to hot or cold
- Bitter taste in the mouth
- Foul smell to the breath
- Swollen neck glands
- General discomfort, uneasiness, or ill feeling
- Redness and swelling of the gums
- Swollen area of the upper or lower jaw
- An open, draining sore on the side of the gum
A dental abscess in most cases is a complication of a dental infection. Bacteria, often bacteria present in plaque, infect and make their way into a tooth.
Bacteria enter the tooth through tiny holes caused by tooth decay (caries) that form in the tooth enamel (hard outer layer of the tooth). The caries eventually break down the softer layer of tissue under the enamel, called dentine. If the decay continues, the hole will eventually penetrate the soft inner pulp of the tooth - infection of the pulp is called pulpitis.
As the pulpitis progresses the bacteria make their way to the bone that surrounds and supports the tooth, called the alveolar bone, and a periapical abscess is formed.
When bacteria which are present in plaque infect the gums the patient has periodontitis. The gums become inflamed, which can make the periodontal ligament (tissue surrounding the root of the tooth) separate from the base of the tooth.
A periodontal pocket, a tiny gap, is formed when the periodontal ligament separates from the root. The pocket gets dirty easily and is very hard to keep clean. As bacteria build up in the periodontal pocket, periodontal abscess is formed.
Patients can develop periodontal abscesses as a result of a dental procedure which accidentally resulted in periodontal pockets. Also, the use of antibiotics in untreated periodontitis, which can mask the symptoms of an abscess, can result in a periodontal abscess. Sometimes gum damage can lead to periodontal abscesses, even if no periodontitis is present.
A doctor or dentist can determine by physical examination if there is a drainable abscess. X-rays of the mouth may be necessary to show small abscesses that are located at the deepest part of the tooth.
Dental Abscess Home Remedies
There are no home remedies for a dental infection once it is present, but it is possible to manage the symptoms of the discomfort and swelling.
- People who have cavities or toothaches can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), as needed for relief of pain and inflammation. As an alternative to or in addition to NSAIDs, acetaminophen (Tylenol) may be also taken. These medications may help the pain, but they will not treat the infection. Follow-up with a health care professional is always indicated.
- If an abscess ruptures by itself, warm-water rinses will help cleanse the mouth and encourage drainage. Even then, a follow-up visit to a dentist is important.
- Infectious swelling accompanying a dental abscess is different than inflammatory swelling, and application of ice or cold packs to the area is not recommended.
The goal of treatment is to get rid of the infection. To accomplish this, your dentist may:
- Open up (incise) and drain the abscess. The dentist will make a small cut into the abscess, allowing the pus to drain out, and then wash the area with salt water (saline).
- Perform a root canal. This can help eliminate the infection and save your tooth. To do this, your dentist drills down into your tooth, removes the diseased central tissue (pulp) and drains the abscess. He or she then fills and seals the tooth's pulp chamber and root canals. The tooth may be capped with a crown to make it stronger, especially for a molar tooth. If you care for your restored tooth properly, it can last a lifetime.
- Pull the affected tooth. If the affected tooth can't be saved, your dentist will pull (extract) the tooth and drain the abscess to get rid of the infection.
- Prescribe antibiotics. If the infection is limited to the abscessed area, you may not need antibiotics. But if the infection has spread to nearby teeth, your jaw or other areas, your dentist will likely prescribe antibiotics to stop it from spreading further. He or she may also recommend antibiotics if you have a weakened immune system.
Avoiding tooth decay is essential to preventing a tooth abscess. Take good care of your teeth to avoid tooth decay:
- Use fluoridated drinking water.
- Brush your teeth at least twice a day with a fluoride toothpaste.
- Use dental floss or an interdental cleaner to clean between your teeth on a daily basis.
- Replace your toothbrush every three or four months, or whenever the bristles are frayed.
- Eat healthy food, limiting sugary items and between-meal snacks.
- Visit your dentist for regular checkups and professional cleanings.
- Consider using an antiseptic or a fluoride mouth rinse to add an extra layer of protection against tooth decay.
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