TOOTH ABSCESS

INTRODUCTION

Toothache is generally not as simple as it may seem. If a tooth constantly hurts and aches, there might be an underlying tooth abscess. An abscess in the tooth is an infection that is in or around the root of the tooth. Such infections originate in the pulp matter, and exit through the bottom of the root, and into the bone. An abscess is a collection of pus, which is made up of dead white cells, tissue debris and bacteria.

A tooth abscess differs from a gum abscess by the source of the original infection. The tooth abscess (or “periapical abscess”) originates from the pulp of the tooth and exits out the tooth’s apex at the bottom of the root. A gum abscess (or “periodontal abscess”) starts in a gum pocket outside of the tooth next to the root. Treatment will depend on where the infection originates.

A dental abscess occurs when bacteria infect and spread inside a tooth or your gums.

The bacteria responsible for this are found in plaque, which also contains food particles left over from eating combined with saliva.

SIGNS AND SYMPTOMS

The main symptom of a dental abscess is pain in your affected tooth, which can be intense and throbbing. The pain usually comes on quite suddenly and gradually worsens over a few hours to a few days.

The pain may spread to your ear, lower jaw and neck on the same side as your affected tooth.

Other symptoms of a dental abscess include:

  • tenderness of your tooth and surrounding area
  • sensitivity to very hot or cold food and drink
  • an unpleasant taste in your mouth
  • fever
  • a general feeling of being unwell
  • difficulty opening your mouth
  • difficulty swallowing (known as dysphagia)
  • disturbed sleep

 MANAGEMENT

he only way to cure a dental abscess is with dental treatment. Your dentist will treat your abscess using dental procedures and, in some cases, surgery.

Dental procedures

The first and most important step in treating a dental abscess is to cut out the abscess and drain away the pus that contains the infectious bacteria. These procedures are usually carried out under local anaesthetic, which means you will be awake but the affected area will be numb.

  • If you have a periapical abscess, the abscess will be removed using root canal treatment. Your dentist will drill into your dead tooth to release the pus and remove any damaged tissue from the centre (pulp). A root filling is then inserted into the space to prevent further infection, or the tooth can be extracted.
  • If you have a periodontal abscess, your dentist will drain it to release the pus and thoroughly clean out the periodontal pocket. Your dentist will then smooth out the surfaces of the root of your tooth by scaling and planing (filing) below your gum line to help your tooth heal and to prevent further infection.

Surgery

If you have a periapical abscess and your infection recurs, you may need to be referred to an oral surgeon who can surgically remove any further diseased tissue.

If you have a periodontal abscess and your infection recurs, you may be referred to an oral surgeon who can reshape your gum tissue to permanently remove the periodontal pocket.

In some cases, a dental abscess infection can recur even after dental and surgical procedures. If this occurs or if your tooth is severely broken down, it may need to be removed altogether (extracted).

Dr. Annie

Physician, mom and wife

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