What is a Dental Abscess?

Last Updated on May 9, 2023 by Dr Gustavo Assatourians DDS

A dental abscess is a frequent reason for a consultation with your dentist. According to the World Health Organization, more than 10% of the population has  suffered the consequences of dental abscess. Pain, swollen gums, and a bad taste in the mouth are some of the symptoms of infection, which if not treated in time can cause health problems in general. 

What is a dental abscess?

A dental abscess is an accumulation of pus caused by a bacterial infection that manifests in the gums and tooth roots. A bag begins to fill with pus and becomes inflamed and increasingly painful. Sometimes, it can spread to other areas of the mouth, face, jaw, and even the throat in severe cases.

Depending upon the location, there are various types. We speak of a periapical abscess in the root of the tooth or a periodontal abscess in the gums. Both are caused by the presence of oral bacteria, which have reached the innermost areas of the teeth or gums as a result of different factors.

 

Signs and symptoms of dental abscess

The symptoms of a dental abscess are clear and manifest together. Once a sharp, intense and continuous pain is present, it is usually the main alarm. 

1. Pain: sharp and persistent throbbing that can rapidly radiate to the temporal area of ​​the head, ear, neck, or jaw.
2. Dental sensitivity:  hypersensitivity to hot or cold stimuli. It is also common to notice sensitivity or discomfort when biting and chewing food.
3. Fever: considered a serious symptom, it denotes an advanced stage of infection.
4. Fistula: a lump of pus in the area near the infection. 
5. Swelling in the face, cheeks, or neck that causes difficulty breathing or swallowing
6. Swollen and tender lymph nodes under the jaw or in the neck.
7. Bad breath and bad taste in the mouth: a bad taste in your mouth, as well as an unpleasant smell on your breath is an indication that something is not going well.
8. Exudate or suppuration of pus: the mouth is suddenly flooded with a salty liquid with an unpleasant odor and taste, along with pain if the abscess ruptures
9. Swollen gums: the gums may become red and considerably swollen.

The affected tooth can cause serious complications, such as tooth loss, a jaw infection, and even a blood infection. When not treated promptly, in very severe cases, a dental abscess can be responsible for pneumonia, inflammation of the heart, and even a brain abscess.

 

Risk factors for dental abscess

The following can increase the risk of presenting a dental abscess: 

• Dental caries: when not treated in time, it can access the tooth pulp. Bacteria find an optimal medium to proliferate and spread to the root of the tooth, forming the dental abscess.
• Trauma or dental blows: a blow to the mouth can cause small fissures or breaks in the surface of the tooth, allowing bacteria to filter through these cavities and damage the tooth, causing an abscess. Severe trauma can also cause pulpal death, giving bacteria an opportunity to multiply in the dead tissue.
• Periodontal disease: when inflammation of the gums is not treated and progresses, it can cause periodontitis, a serious condition that destroys the tissues and advances into the interior of the gums and teeth, giving rise to growth of bacteria and the formation of dental abscesses.
• Poor oral hygiene: Patients who do not practice good oral hygiene are the most likely to suffer from a dental abscess, since the bacterial plaque that accumulates turns the oral cavity into an acid medium that favors the proliferation of bacteria and starts an infection.
• An unbalanced diet of rich in sugar and carbohydrates.
• Diseases that affect or alter the immune system: people with a weakened immune system are more likely to develop an infection, even more so if their oral hygiene is not adequate. For example, those who have arthritis, lupus, HIV, and diabetes, among others.

 

Causes of a tooth infection

Identifying its origin is also very important to propose personalized and safe treatments. Among these causes, we  highlight:

• Periapical abscess: this type of abscess originates in the pulp of the tooth at the tip of the tooth root. Left untreated, it causes dental caries or a cracked tooth where the damaged enamel allows the passage of bacteria that attack the soft tissue (pulp). This is why this type of abscess is also known as pulpitis.
• Gingival abscess: when a foreign body is embedded in the gum, for example, a popcorn hull.
• Periodontal abscess: usually generated as a result of periodontal disease. In these cases, a lesion originates in the gums, located in areas surrounding the dental root; a purulent fluid is impossible, so the periodontal abscess spreads to adjacent tissue, including the jaw bone.

Dental abscesses are quite dangerous for the health of the teeth and all oral structures. For this reason, we advise you to visit a dentist periodically to detect cavities or any other oral disease that will require prompt treatment.

 

Treatment of a dental abscess

The main objectives of the treatment for a dental abscess are to eradicate the infection and fundamentally preserve the affected tooth. To achieve the first goal, the dentist usually prescribes antibiotics to counteract the infection and pain relievers for the pain. It is possible that before moving forward, the dentist will request a dental X-ray. 

Depending upon the severity of the abscess, there are various options:

1. Drainage of the abscess: Your dentist will make a small incision in the abscess to drain the pus. The dentist will clean the area with a saline solution.
2. Root canal treatment or endodontics: the procedure consists of drilling the affected tooth to drain the abscess and remove any infected pulp. Next, your dentist will fill and seal the pulp chamber.
3. Tooth extraction: If the tooth is badly damaged, your dentist may remove it before draining the abscess.
4. Antibiotics: If the infection has spread beyond the area of ​​the abscess or if you have a weakened immune system, your dentist may prescribe oral antibiotics to clear the infection. Another option is opting for natural antibiotics you can use at home. 
5. Foreign object removal: If your abscess is caused by a foreign object in the gums, your dentist will remove it. They will finish by cleaning the area with a saline solution.
6. Hospitalization: If swelling or fever increases despite antibiotics and other treatments, the patient may need to be treated in a hospital.

 

Complications of an abscessed tooth

Certain complications may occur. If the infection spreads to the jaw or the periodontal ligament, it may require the extraction of one or more teeth depending upon the extent of the damage. In either case, dental extraction will always be the last option.

Another complication of a dental abscess in the upper jaw is recurrent sinusitis.

If left untreated, the infection can spread to the jaw and other parts of the head and neck, including the brain. In rare cases, it can even lead to sepsis, a life-threatening complication of an infection.

If you have an abscess and exhibit the following symptoms, go to the emergency room right away:

1. High fever
2. Facial swelling
3. Difficulty swallowing
4. High heart
5. Confusion

 

How to prevent a dental abscess? 

To prevent dental abscesses, as well as most oral diseases, it is essential to maintain good oral hygiene. To keep the oral cavity in excellent condition, the main task is preventing cavities. There are certain steps to follow:

1. Brush your teeth at least twice a day, using fluoride toothpaste and a soft bristle brush that should be changed every 3 months. In addition, it is advisable to complement brushing with the use of dental floss to remove an accumulation of food between the teeth.
2. Maintain a balanced diet, increasing the consumption of fruits and vegetables. void sugary, starchy, and sticky foods and drinks that increase the incidence of cavities.
3. Schedule regular visits to the dentist, especially if tooth decay or any other oral problem is present or suspected. It is best to receive proper treatment before an abscessed tooth can form.

If you are experiencing any of these signs or suspect a dental abscess, do not delay in contacting one of our dentists. At Channel Islands Family Dental we are experts in treating various diseases of the mouth and improving oral health.

 

Contact us

If you have any questions about this or other topics, you can contact us at Channel Island Family Dental as well as our Facebook page. We look forward to your visit and we will make a timely diagnosis. Our dentists in Oxnard, Saint Paula, Venture, Newbury Park, and Port Hueneme will be able to guide you towards the best treatment to take care of your health and give you back your best smile.

Bibliography

1. Mayo Clinic Staff. Tooth abscess (Internet). Mayo Foundation for Medical Education and Research (MFMER). Updated June 29, 2022. (Accessed August 24, 2022). Available in: https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901
2. Tim Newman. What’s to know about dental abscesses? (Internet). Medical NewsToday. Updated December 4, 2017 (Accessed August 23, 2022). Available in: https://www.medicalnewstoday.com/articles/170136
3. Adrienne Santos-Longhurst, Christine Frank, DDS. Abscessed Tooth: What You Need to Know (Internet). HealthlineMedia. Published on July 2, 2019 (accessed August 24, 2022). Available at: https://www.healthline.com/health/abscessed-tooth