DENTAL ABSCESS
DENTAL
ABSCESS
A
dental abscess (also termed a dentoalveolar abscess, tooth abscess or
root abscess), is a localized collection of pus
associated
with a tooth. The most common type of dental abscess is a periapical
abscess, and the second most common is a periodontal
abscess.
In a periapical abscess, usually the origin is a bacterial infection
that has accumulated in the soft, often dead, pulp
of
the tooth. This can be caused by tooth
decay,
broken
teeth or
extensiveperiodontal
disease (or
combinations of these factors). A failed root
canal treatment may
also create a similar abscess.
A
dental abscess is a type of odontogenic
infection,
although commonly the latter term is applied to an infection which
has spread outside the local region around the causative tooth.
TYPES
OF DENTAL ABSCESS
There
are 3 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.
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.
signs and symptoms of an abscessed tooth:
- There is pain with eating or with pressing on the tooth. The abscess that has spread out the root tip causes the supporting structures (gum and bone) to be affected. Sometimes the throbbing or pulsating pain is so severe it can't be relieved with pain medications. This is usually related to the infection spreading and causing more pressure on the surrounding structures of gum and bone.
- There is swelling and/or a pimple on the gum that is filled with pus. This pimple is called a "draining fistula" and oftentimes can rupture to release pus. This is an obvious sign of infection. Other signs of a tooth abscess are a bad taste or bad odor in the mouth.
The
tooth turns dark in color compared to surrounding teeth. The
by-products of the necrotic pulp that leach into the porous tooth
layer cause this discoloration.
It
is also important to note that an abscessed tooth may not have any
symptoms at all. Because the tooth has lost vitality (or the ability
to feel stimuli), there may be no pain associated with it. However,
the abscess is still present and could be further spreading the
infection. On occasion, an abscessed tooth is discovered during a
routine radiographic (X-ray) exam where the patient has not
experienced any symptoms of an abscessed.
Dental
abscess causes:
The
cause of these infections is direct growth of the bacteria from an
existing cavity into the soft tissues and bones
of
the face
and
neck.
An
infected tooth that has not received appropriate dental care can
cause a dental abscess to form. Poor oral hygiene, (such as not
brushing and flossing properly or often enough) can cause cavities
to
form in your teeth. The infection then may spread to the gums
and
adjacent areas and become a painful dental abscess.
Complications
of a dental abscess:
With the right treatment, a dental abscess is easily cured. However, in rare cases, complications can occur.
Most
complications arise due to the spread of the bacterial infection when
an abscess is left untreated.
Possible
complications are outlined below.
Loss of the tooth
The
affected tooth may need to be removed (extracted). This is more
likely if a dental abscess returns, or if your tooth is severely
broken down.
Sinusitis
Sinusitis
is an infection of the small air-filled cavities inside your skull.
It
is usually the cavities behind your cheekbones that can become
infected as a complication of a dental abscess. These are known as
the maxillary sinuses.
Symptoms
of sinusitis include:
- a blocked or runny nose
- facial pain and tenderness
- a high temperature (fever) of 38°C (100.4°F) or above
Sinusitis
often clears up without treatment but, if necessary, antibiotics can
be prescribed.
Osteomyelitis
Osteomyelitis
is an infection of the bone. It can be caused by the bacteria in a
dental abscess spreading and causing inflammation.
Osteomyelitis
can cause symptoms such as fever, nausea (feeling sick) and severe
pain in the affected bone, which can often be in the area surrounding
a dental abscess.
However,
as the infection is spread through your blood, it can affect any bone
in your body. Osteomyelitis can be treated by taking oral antibiotics
or injecting them into a vein.
Cavernous sinus thrombosis
Cavernous
sinus thrombosis is a rare, but serious, condition where a blood
vessel in the brain becomes infected and a clot develops..
Ludwig's angina
Ludwig's
angina is a potentially life-threatening infection of the tissues of
the floor of the mouth, under the tongue.
Symptoms
can include:
- swelling
- pain when moving the tongue
- neck swelling
- fever
- difficulty swallowing (dysphagia)
- difficulty breathing
In
severe cases, you may have trouble breathing or experience an
abnormal breathing sound, caused by a blocked airway.
Treatments and drugs:
The
goal of treatment is to get rid of the infection. To accomplish this,
your dentist may:
- Open up (incise) and drain the abscess.The dentist will make a small cut into the abscess, allowing the pus to drain out, and then wash the area with salt water (saline).
- Perform a root canal. This procedure can help eliminate the infection and save your tooth. To do this, your dentist drills down into your tooth, removes the diseased central tissue (pulp) and drains the abscess. He or she then fills and seals the tooth's pulp chamber and root canals, and caps the tooth with a crown to enhance strength, especially for molar teeth. If you care for your restored tooth properly, it can last a lifetime.
- Pull the affected tooth.If the affected tooth can't be saved, your dentist will pull (extract) the tooth and drain the abscess to get rid of the infection.
- Prescribe antibiotics. If the infection is limited to the abscessed area, you may not need antibiotics. But if the infection has spread to nearby teeth, your jaw or other areas, your dentist will likely prescribe antibiotics to stop it from spreading further. He or she may also recommend antibiotics if you have a weakened immune system.
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