A dental abscess is one of the many reasons that you may have to see your dentist, apart from decay, bad breath, or bleeding gums. An abscess is a cavity or sac filled with pus, bacteria, fluid and other micro-organisms. A dentoalveolar or a dental abscess is of two types depending on its location and they are a Periapical abscess and Periodontal abscess. A periapical abscess is found near the roots or around the root apex. A periodontal abscess is associated with our gums.
Both periapical and periodontal abscess present with symptoms like pain, swelling, and bad breath. You must visit your dentist for treatment of these, and maintain proper oral hygiene to prevent recurrence.
A delay in visiting your dentist, despite having symptoms of pain or decay can also cause an abscess. (1)
Dental abscess types
As the name tells us, a periapical abscess is seen around the apex of the roots, or sometimes even around the length of the root. It is associated with a decayed tooth where the decay spreads to the pulp through the enamel and dentin.
The pulp is the innermost layer of the tooth containing blood supply and nerves. Once the decay has spread downward from the tooth, a defense mechanism to avoid further spread leads to the formation of an abscess.
A periapical abscess may also be formed around a tooth that has previously undergone some dental work like a filling or a root canal treatment. In such cases, there is a possibility that the previous treatment may have failed, due to which infection arises again and spreads.
Supporting structures of the tooth, like the gums and the bone, form the periodontium. A periodontal abscess is associated with these structures. It arises due to unhealthy gums and when there is an accumulation of food and tartar between your teeth and gums.
As the accumulation increases, the gum line recedes. Due to this, the infection spreads inwards from the gums. The spread causes the formation of an abscess either near the gum line, or deeper inside the periodontal tissues. (2)
A gingival abscess is a type of periodontal abscess which is formed just near the gum line. Possibly, gingival abscess when left untreated spreads to become a periodontal abscess.
A periodontal abscess may also be formed due to some external trauma to the gums, like poking them with a toothpick, instrumentation, etc. (3)
What does a dental abscess look like?
The best way to describe a dental abscess is as a swelling or bump around a tooth or gums. You will experience pus discharge from its small yellow or white center.
A periapical abscess is not always visible clinically. Though it may appear as a swelling in the root region, a radiograph will give you a better picture.
Symptoms of a dental abscess
A dental abscess shows signs which are reflective of its cause. For example, an abscess caused due to a decayed tooth will give you pain. Additionally, you may have a swelling in the region of the abscess.
Pus discharge accompanied by a foul smell is typical from an abscess. Even on slight touch, it may be painful, and the area may become red and inflamed.
When you have a gingival abscess, the tooth associated with it could be slightly mobile and will show increased deposits of plaque and calculus. A characteristic feature of a gingival abscess in pocket formation.
A pocket is formed between the tooth and the gums, causing the loss of attachment of the gums to the tooth. The infection spreads further once the pocket is formed more rooted into the tissues.
Additionally, you may also feel sensitivity to eating hot or cold foodstuff or drinks. This is because abscess formation causes your gums to recede, exposing the roots which are sensitive.
If a dental abscess ruptures for any reason, the fluid discharged from it is foul smelling and leaves a bad taste in your mouth. You could also face difficulty in brushing over that area.
You are likely to feel a swelling in your neck accompanied by radiating pain to the ear or shoulders if the infection spreads rapidly.
Dental abscess treatment
If you feel a swelling around any of your teeth, you must make an appointment with your dentist right away. In the meanwhile, here is what you can do at home to control the symptoms.
Locally available painkillers help to reduce the pain. Saltwater rinses help to control and reduce the spread of the infection, by killing the bacteria.
It is imperative to keep the area clean and try your best not to let any food accumulate there. The primary objective of the treatment is to remove the infection, which is achieved through drainage.
There are several ways to drain an abscess. An abscess around a tooth is drained by making a cavity in the tooth. The cavity is then cleaned and filled with a restorative material, or by carrying out a root canal.
A hole can also be made to through the bone in the gum, to allow the abscess to drain.
For a gingival abscess, your dentist will clean the area to remove the debris and tartar. Tooth scaling is done to make the surfaces smooth and prevent any bacteria from accumulating there.
If there is a pocket, scaling is done even below the gum line and the area is disinfected. The dentist may have to perform a surgery in case the pocket is very deep. (4)
If the abscess is enormous, the tooth may have to be extracted to prevent the infection from spreading to the other teeth.
Apart from these measures, the dentist will also prescribe you some painkillers and antibiotics to stop the infection from spreading.
Complications of an untreated dental abscess
It is not advisable to leave an abscess untreated, for it can cause complications that are even more troublesome.
If the abscess spreads, it forms a pathway or a small tunnel through the bone, which opens into the mouth. Very rarely, it may also pierce through the skin and appear outside the mouth on your cheek or jaw. This is called a fistula or a sinus tract.
An abscess can also form a cyst. A cyst is a cavity that is free of pus and looks like a small sac or bubble. It may require surgery or removal of the tooth if it cannot be treated by medicines.
Over to you on a dental abscess
Like most other dental problems, a dental abscess is also a painful condition. You must visit your dentist on time, and maintain oral hygiene with regular brushing and flossing to prevent recurrence.
It is essential to control the spread of the infection before the abscess develops into a more complicated disease which can affect your overall health.