Definition

What is dental abscess?

There are three types of dental abscess:

  • Gingival abscess – the abscess is only in the gum tissue and does not affect the tooth or the periodontal ligament.
  • Periodontal abscess – this abscess starts in the supporting bone tissue structures of the teeth.
  • Periapical abscess – this abscess commences in the soft pulp of the tooth.

A dental abscess usually requires treatment; otherwise it can worsen and result in the destruction of bone tissue.

How common is dental abscess?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of dental abscess?

The common symptoms of dental abscess are:

  • Pain in the affected area when biting
  • Touching the affected area may be painful
  • Sensitivity to cold or hot food and liquids
  • A foul taste in the patient’s mouth
  • Fever
  • General malaise (the patient feels generally unwell)
  • Trismus – the patient finds it harder to open his/her mouth
  • Dysphagia – swallowing difficulties
  • Insomnia

The main symptom of a dental abscess is pain. This may be a throbbing pain, and is often intense. The pain usually starts suddenly, and becomes more intense over the subsequent hours or days. In some cases, the pain may radiate to the ear, jawbone and neck.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes dental abscess?

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.

Periapical abscess

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.

Periodontal abscess

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.

Risk factors

What increases my risk for dental abscess?

Please consult your doctor for further information.

 

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is dental abscess diagnosed?

Please consult your doctor for further information.

How is dental abscess treated?

The only person who can effectively treat a dental abscess is a dentist. Treatment may involve typical dental procedures, and in some occasional surgery.

Incision

The abscess needs to be cut out (incised) and the pus, which contains bacteria, drained away. The patient will be given a local anesthetic.

Treating a periapical abscess

Root canal treatment will be used to remove the abscess. A drill is used to bore a hole into the dead tooth so that the pus can come out. Any damaged tissue will be removed from the pulp. A root filling is then inserted into the space to prevent subsequent infections.

The abscess will be drained and the periodontal pocket cleaned. The surfaces of the root of the tooth will then be smoothed out by scaling and smoothing (planing) below the gum line. This helps the tooth heal and prevents further infections from occurring.

Surgery for dental abscesses

Patients with a periapical abscess and a recurring infection may need to have diseased tissue surgically removed. This will be done by an oral surgeon.

Patients with a periodontal abscess and a recurring infection may have to have their gum tissue reshaped and the periodontal pocket removed. This procedure will be performed by an oral surgeon.

If the dental abscess recurs, even after surgery, the tooth may be extracted (taken out).

Treatment for pain

OTC (over-the-counter, no prescription required) painkillers (analgesics) may help reduce the pain while the patient is waiting for treatment. It is important to follow the information on the packet carefully. Painkillers are only there for pain reduction, they cannot replace the visit to a dentist.

Aspirin, ibuprofen or Tylenol (paracetamol) are effective painkillers. However, some are unsuitable for certain types of patients:

  • Ibuprofen and asthma – if you are asthmatic do not take ibuprofen.
  • Ibuprofen and stomach ulcers – do not take ibuprofen if you have, or ever had stomach ulcers.
  • Aspirin and children – do not give aspirin to children under 16 years of age.
  • Aspirin and pregnancy and breastfeeding – do not take aspirin if you are pregnant or breastfeeding.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage dental abscess?

The following lifestyles and home remedies might help you cope with dental abscess:

  • Avoid cold foods and drinks
  • Avoid hot foods and drinks
  • Moderately cool foods, chewed on the “good” side of your mouth will probably be less painful
  • Do not floss around the affected area
  • Use a very soft toothbrush.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 3, 2017 | Last Modified: November 3, 2017

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