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A dental abscess is also called an oral abscess or tooth abscess. It is a localized bacterial infection that results in a collection of pus.
According to Dr. Nandita Lilly, one of NewMouth's in-house dentists, "a dental abscess, if not treated accordingly, can lead to hospitalization. In some cases, it can be fatal."
The long-term build-up of pus inside the gums or teeth triggers an abscess. The infection affects the surrounding structures of teeth and can cause persistent toothaches and other symptoms.
Three main types of dental abscesses can form in different regions around a tooth, including:
A tooth abscess is a painful pocket of pus that develops from a bacterial infection in the mouth. There are three types: gingival, periodontal, and periapical abscesses.
A tooth abscess is one of the later stages of tooth decay. Tooth abscess stages include:
The first stage is enamel damage, the outer layer of teeth. Enamel decay is often caused by plaque build-up on your teeth.
Some people may not experience any symptoms. Others develop tooth sensitivity or decalcified white spots that are more prone to enamel breakdown.
If you don't treat your enamel decay, it will progress to the next layer of your tooth. Dentin is the yellowish second layer. Many people will experience increased tooth sensitivity in this stage. In others, a small hole in your tooth may develop.
The soft inner pulp is the deepest layer of your tooth structure. If bacteria reach this layer, they can attack the tooth's nerve.
This often causes severe tooth pain. Eventually, the tooth's nerve dies and the abscess begins to form.
Once the bacteria makes its way to your pulp, it can start to spread deeper into your gums or jawbone. Your gums may begin to swell, and you may see a small bump on your gums. This may feel like throbbing pain in your teeth, gums, and surrounding tissue.
If you do not treat your tooth abscess, it could lead to serious symptoms. The most common are:
The six stages of a dental abscess include enamel decay, dentin decay, pulp decay, abscess formation, and complications. Serious complications like sepsis (a deadly blood infection) and/or tooth loss can occur if left untreated.
Bacteria build-up from neglected oral hygiene is the primary cause of dental abscesses. Other risk factors include:
Injuries, dental damage, or deep tooth cracks allow bacteria to spread to deeper parts of the teeth or gums. This can cause an abscess.
People with weaker immune systems or those taking medications for serious health conditions are at a higher risk of developing abscesses. This includes:
Eating sugary and processed foods results in the build-up of dental plaque and calculus. Without proper brushing, cleaning, and flossing, tooth decay may develop. Untreated decay can result in a dental abscess later on.
Harmful bacteria cause dental abscesses due to poor oral hygiene. Risk factors include mouth trauma, weakened immune systems, poor diets, and tooth cracks, among others.
Good oral hygiene is the best way to prevent oral conditions and diseases.
Dental abscess prevention tips include:
Optimal oral hygiene is essential for abscess prevention. Also, make sure you keep up with professional teeth cleanings and dental exams every six months.
Depending on the type of dental abscess and how long it has been progressing, common symptoms may include:
If the abscess ruptures, you may notice a foul taste (salty fluid) and smell in your mouth. You will also feel pain relief in the infected tooth. If this occurs, call your general dentist immediately.
If you experience severe pain and difficulty breathing, call your local emergency department or 9-1-1.
The primary symptom of a dental abscess is severe pain near the infection site. Swelling, redness, and inflammation around the abscess are also common.
Three treatment options are available depending on the type and severity of the infection. They include:
Abscess draining is typically recommended if the abscess is treated early and hasn’t progressed.
During the procedure, a dentist will make a small incision into the abscess to drain the pus. A dentist cleans the infected area and prescribes antibiotics post-op.
Root canal treatment is necessary when the bacteria spread to the dental pulp and tooth roots. It is also necessary if there is an abscess at the root of a tooth (periapical abscess).
During the procedure, a dentist removes the infected dental pulp in the patient’s tooth and also drains the abscess. Then the root canal is cleaned, shaped, sealed, and restored with a dental crown.
Tooth extractions might be necessary after teeth are damaged from an injury, disease, or tooth decay. If an abscessed tooth cannot be saved, extraction is necessary.
During the procedure, local anesthesia is administered, and the tooth is removed using small instruments. After extraction, the tooth socket is covered with sterile gauze, and pressure should be applied for about 20 minutes.
Tooth abscesses must be treated quickly to prevent spreading. Your dentist must drain the infection (never try to do this at home). Root canal treatment and tooth extraction may also be necessary (depending on the severity).
After an extraction, the infection will drain through the empty socket. Your tooth can take a few weeks to fully heal after a dental abscess treatment.
Your dentist will schedule check-ups with you to ensure you are healing properly. You may still have an infection if you are experiencing:
Antibiotics are taken after the root canal or extraction procedure to help clear up the infection. Taking it without removing the infected tooth will not cure a dental abscess.
Commonly prescribed antibiotics for dental abscesses include amoxicillin and penicillin. Other antibiotics prescribed to people with tooth abscesses include:
The course of treatment for most antibiotics is 10 to 14 days. They must be taken for the entire course of treatment, even if your symptoms disappear.
Ibuprofen and similar over-the-counter (OTC) painkillers can help control dental abscess pain. However, they can't treat the condition.
Only use OTC painkillers that are safe for you and do not prolong their use. Long-term use of OTC painkillers damages your organs.
These are good to take while you wait for your treatment. You can also take them with the antibiotics your dentist prescribes afterward.
Amoxicillin can be used to treat the underlying bacterial infection. However, antibiotics will not cure an abscess. Professional drainage is still necessary. Over-the-counter medications can be used to manage pain before/after your appointment.
Dental abscesses should be treated promptly to avoid the risk of serious complications. These complications include:
A tooth abscess is serious and can be life-threatening (if left untreated). It can lead to tooth loss, bone/sinus infections, septicemia (a deadly blood infection), or a brain abscess (rare).
A tooth abscess will not go away on its own. If a dentist does not drain the abscess, it can spread to other areas of your body, including the jaw, head, or neck.
You should never try to pop or squeeze a dental or gum abscess. Doing so can push the infection into deeper tissues in your mouth.
You cannot drain a gum abscess at home. However, you can minimize the pain by applying a warm compress to the area 4 times a day for 30 minutes at a time.
Symptoms that a tooth abscess has spread to other parts of your body include fever, swelling, dehydration, increased heart rate, increased breathing rate, and stomach pain.
Predicting how a dental infection will spread is difficult, so it is best to assume that a tooth abscess is an emergency. Any visible swelling in the gums, whether it causes pain or not, could be dangerous, and you should seek urgent dental care.
Most abscesses are warm and soft to the touch. In some cases, they can be firm to the touch.
Antibiotics alone cannot treat a tooth abscess. An abscess has to be professionally drained by a dentist. Antibiotics may be prescribed if the infection has spread or is very severe.
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