Dental or tooth abscess is a collection of pus (infection) caused due to bacteria, which accumulates in the centre (soft pulp) of the tooth. The general causes of a dental abscess in tooth decay (commonly called cavities or caries) and damage to the tooth (breaking, cracking, chipping). It can afflict the root of the tooth, and the nearby, supporting bone as well.
The most discernable symptom of a tooth abscess is experiencing a throbbing, persistent, shooting and consuming pain in the tooth. Other accompanying warning signs may include:
- Malodorous breath
- Constant bitter taste in the mouth
- Swelling of the gum, base of tooth, cheek; in addition to being swollen, the gum may also appear red
- Swelling of lymph nodes
- In some cases facial swelling is also observed
- Swelling of upper of lower jaw (this is considered as a serious symptom)
- Fever may develop in some cases
- Teeth will be sensitive to extremely hot or cold things
- Experiencing pain while chewing
- Significant pain if you close your mouth too tightly
- Touching the infected tooth can spark off unbearable pain
- Open sore near the gum which may leak/drain if the abscess remains untreated
- The patient will experience a severe ache when the dentist taps on the infected tooth
- A general sense of uneasiness and discomfort is also reported
The treatment goals for a tooth abscess include getting the infection under control and preserve the tooth. The first step mostly taken is to prescribe an antibiotic medication, which will allow the pain to subside. Warm salt-water gargles also prove to be soothing.
This is then maybe followed by a root canal, which is mainly done to drain the pus out. A root canal is done to save the tooth. Minor gum surgeries may also be required. In case the infection is too severe, root canal will be ruled out and surgical extraction of the tooth will be resorted to.
Tooth abscesses, which are left untreated, can lead to acute complications. Firstly it could result in the loss of the tooth. In addition, it can culminate in sepsis (the bloodstream becomes infested with bacteria). The patient may suffer from Osteomyelitis (critical or chronic bone infection) if the infection permeates to the jaw. The infection can also spread to other surrounding soft tissues like the face (facial cellulitis). In the most severe and rare cases the infection may travel to other parts of the body like the brain (terminating in brain abscess or even meningitis), the lungs (leading to pneumonia) and other such complications.
There are varied reasons why dental abscesses may not heal completely:
- Formation of cysts
- Inadequate and untimely root canal therapy
- Vertical root fractures
- Presence of foreign matter in the wound
- Related periodontal infection
A tooth abscess necessitates timely medical intervention, which if provided, will lead to purging of the infection as well as conservation of the tooth.