Dental Abscess

A dental abscess is an infection in a tooth or the surrounding gums. When cavities and gum-related issues are left untreated, teeth can decay and bacteria can spread to surrounding areas of the mouth and jaw, causing deeper infection. Dental abscesses can have serious medical ramifications, so it is important that they be treated promptly.

Causes of Dental Abscess

A dental abscess is usually caused by poor oral hygiene and a lack of proper dental care, though serious dental infections can sometimes result from underlying medical conditions that affect the immune system such as diabetes or chemotherapy. Dental abscesses can also be triggered by minor oral trauma, like an injury that causes a chipped or loosened tooth.

Symptoms of Dental Abscess

There are many possible symptoms of a dental abscess, but the primary one is severe toothache in which the pain is described as "throbbing" or "shooting." Other common symptoms of a dental abscess may include:

Pain when chewing
Foul-smelling breath
Bitter taste in the mouth
Extreme sensitivity to heat or cold
Red and swollen gums
Swollen neck glands
Open, draining sore on the gum

If the dental abscess is allowed to progress without treatment, the patient may experience fever, chills and general feelings of disease. In rare and extreme cases, the condition can become systemic and life-threatening.

Patients should be aware that pain may stop while a dental abscess is still active. This happens if the pulp in the root of the tooth dies. It is therefore essential to see a dentist when there has been severe dental pain, even if that pain abates.

Diagnosis of Tooth Abscess

The dentist is usually able to diagnose a tooth abscess during a dental examination since the patient typically feels pain when the affected tooth is tapped or probed. Patients normally feel an increase in pain level when they bite down or close their mouths tightly. The dentist may also notice red and swollen gums in a patient with a dental abscess. In order to confirm the diagnosis and to check for possible bone erosion, the doctor is likely to have dental X-rays taken as well.

Treatment of Dental Abscess

There are a number of methods used to treat a dental abscess, depending on how far the condition has advanced. The first goal is always to eradicate the infection and prevent complications; the second is to preserve the tooth wherever possible.

Treatments of a dental abscess, depending on severity of the condition, may include one or more of the following:

Drilling out a cavity and filling it
Regional drainage of the abscess through the gum
Performing a root canal
Crowning the affected tooth
Extraction of the affected tooth
Administration of antibiotics

It is also possible for the inflammation and pain of an abscess to be treated with a low-level laser, also known as phototherapy. Whichever type of therapy is used, a patient with a dental abscess typically takes nonsteroidal anti-inflammatory drugs (NSAIDs) or prescribed medication to alleviate pain.

Complications of Dental Abscess

Left untreated, dental infections can be extremely serious, and in rare cases deadly. If bacteria from the tooth infection enter the patient's bloodstream through the gums, they can affect any number of tissues, causing:

Sepsis, infection of the blood
Cellulitis, infection of the soft tissue
Osteomyelitis of the jaw
Endocarditis, affecting the heart
Pneumonia, affecting the lungs

Although these complications rarely occur, they present real dangers, so any patient with a dental abscess should seek prompt medical attention.

Scott Siegel MD DDS

Clock Tower Dental Associates

Patient Education