A dental abscess is a collection of pus caused by a bacterial infection. An abscess can occur in different areas near a tooth for a variety of reasons. A periapical abscess occurs at the root tip, while a periodontal abscess occurs in the gum, near the root of the tooth. The information included here relates to periapical abscesses.
Typically, a periapical tooth abscess results from untreated caries, trauma, or previous dental surgery. The resulting infection with irritation and swelling (inflammation) can lead to an abscess at the root tip.
Dentists will treat a tooth abscess by draining it and removing the infection. They can save the tooth with a treatment known as a root canal procedure. However, in some cases, tooth extraction may be necessary. Leaving a tooth abscess untreated can lead to serious and even life-threatening complications.
Signs and symptoms of a tooth abscess include the following:
Severe, persistent, throbbing toothache that may radiate to the jaw, neck, or ear.
Pain or discomfort in hot and cold temperatures
Pain or discomfort when chewing or biting
Swelling of the face, cheeks, or neck, which may cause difficulty breathing or swallowing
Swollen and painful lymph nodes under the jaw or in the neck
The mouth suddenly fills with a salty liquid with an unpleasant odor and taste and painkillers if the abscess opens
In addition to examining the tooth and the area around it, the dentist may do the following:
Light tapping on the teeth. A tooth with a root abscess is often painful to touch or pressure.
Recommend an x-ray. X-ray examination of a diseased tooth can help identify an abscess. The dentist may also use x-rays to determine if the infection has spread and caused abscesses in other areas.
Recommend CT. If the infection has spread to other areas of the neck, a CT scan may be used to determine the severity of the infection.
The goal of treatment is to get rid of the infection. To do this, the dentist can do the following:
Open (make an incision) and drain the abscess. The dentist makes a small incision in the abscess, which allows the pus to drain, and then flushes the area with salt water (saline). Sometimes a small rubber drain is placed to keep the area open and drain until the swelling subsides.
Do a root canal procedure. This can help get rid of the infection and save the tooth. To do this, the dentist drills out the tooth, removes the affected central tissue (pulp), and drains the abscess. It then fills and seals the pulp chamber and root canal of the tooth. The tooth can be covered with a crown to make it stronger, especially if it is a molar. If properly cared for, a fixed tooth can last a lifetime.
Remove the affected tooth. If the affected tooth cannot be saved, the dentist will pull it out (extract) and drain the abscess to remove the infection.
Give antibiotics. If the infection is limited to the area of the abscess, antibiotics may not be needed. But if the infection has spread to nearby teeth, jaw, or other areas, your dentist may prescribe antibiotics to stop the spread. He may also recommend antibiotics if you have a weakened immune system.