Is Dental Abscess an Emergency?

What is a dental abscess?

A dental abscess is an infectious mass that can form inside a tooth, gum, or bone that holds teeth in place. A tooth infection can be due to tooth decay. A tooth abscess is the accumulation of pus caused by an infection in the teeth and gums. Dental abscesses are very painful that can sometimes spread to your ears or neck and make you feel sick.

If abscesses and infections of the teeth or gums are not treated, the condition exacerbates, and the bones around the infected area are destroyed. Inside of the mouth is full of bacteria that form a sticky layer on the teeth called plaque. If plaque is not removed by brushing and flossing, the bacteria may spread to the soft tissues of the teeth or gums. This condition can lead to tooth abscesses.

Dental trauma, caries, and gum disease can lead to dental or gingival abscesses. Tooth extraction and implant surgery can also cause abscesses in the mouth.

Types of dental abscesses

There are three types of dental abscess:

1. Gingival abscess: This type of abscess is only in the gum tissue and has no effect on the teeth or periodontal ligament.
2. Periodontal abscess: This abscess occurs on the gums near the root of the tooth. It may also spread to surrounding tissue and bone.
3. Periapical abscess: This abscess occurs at the apex of the tooth root.

The following factors can increase the risk of dental abscess:

Lack of dental hygiene: Poor gum and dental hygiene – for example, not brushing or flossing at least twice a day – can increase your risk of tooth decay, gum disease, dental abscess and other oral diseases.

High-sugar diet: Excessive consumption of sugary foods such as sugary drinks and sweets can cause tooth decay and subsequent tooth abscess.

Suffering from related diseases: Having diseases that weaken your immune systems, such as diabetes or autoimmune diseases, can also increase the risk of tooth infection and tooth abscess.

To diagnose gum and tooth abscesses, the dentist usually first examines the condition of your mouth. The dentist may press on the swollen area of the gums. In addition, the pulp of the damaged tooth may be examined to determine if it is alive. Dental pulp examination can include the following activities:

Percussion test: In the percussion test, the dentist uses dental instruments to strike your tooth. Teeth that need root canal treatment usually respond to this test with pain or tenderness. However, sometimes healthy teeth may react in the same way.

Temperature test: Exposing a tooth to a cold or hot temperature can give the dentist a great deal of information about the health of the pulp and the possibility of needing root canal treatment. For this purpose, there are two tests, cold and heat. An important factor in identifying tooth conditions is the duration of the tooth reaction. In healthy teeth, the response usually ends immediately after the stimulus is removed. If the pain lasts longer, it indicates that the tooth may need endodontic treatment.

Electrical test: Electrical testing is performed by a device called a pulp tester. The dentist holds the device in front of the tooth and applies a certain electricity flow through it.

Symptoms of Dental Abscess

Signs and symptoms of a dental abscess include:

• The most common symptoms of dental abscess are severe and persistent toothache when biting or touching the affected area
• Spread of pain to the ear, jaw and neck on the same side of the damaged tooth
• Pain exacerbates when you lie down and disrupts sleep
• Swelling of the gums or around the mouth
• Inflammation of the lymph nodes
• swallowing difficulties
• Be sensitive to heat or cold in the mouth
• Feeling pain when breathing
• A feeling of toothache and gum pain
• Bad breath or unpleasant taste in the mouth
• Fever
• Redness of the gums
• A generally unwell feeling
• Difficulties opening the mouth

What Causes Dental Abscess

The entry of bacteria into the tooth or gums leads to tooth abscess. However, how an abscess occurs depends on the type of abscess:

• Periapical abscess. Bacteria usually enter the tooth pulp through a cavity. The pulp is the inner, soft part of a tooth composed of nerves, connective tissue, and blood vessels.
• Periodontal abscess. Gum disease usually causes this type of abscess, but it can also occur due to injury.
• Gingival abscess. The entry of a foreign object such as corn shells or toothbrush bristles into the gums.

Treatment for Dental Abscess

Any person with symptoms linked to a dental abscess should see a dentist immediately. A qualified dentist easily diagnoses dental abscesses.

People who have swallow and breathing problems should go straight to the emergency department of their local hospital.

The type of treatment a person receives for a tooth infection depends on several factors, including:

• The initial location of the abscess
• Prevalence of infection
• How much does the immune system react to infection?

Incision: The dentist makes an incision on the gum to drain out the pus. When the pus has drained away, the area will be cleaned from the bacteria. Then the site where the abscess is located is washed with normal saline.

Root canal therapy: The patient undergoing a root canal will be given a local anesthetic injection to numb the parts of the jaw and mouth affected by the abscess. This procedure involves making access to the tooth to remove accumulated pus and bacteria from the roots. So the dead or infected pulp is removed, and the inside of the pulp canals are smoothed. Then the dentist fills the area with a substance called gutta-percha. After the tooth heals, it is repaired with a crown or permanent filling to prevent further infections. A few months later, an X-ray and dental checkup will be done to check that the site is healing properly.

Pain management or antibiotics: While these abscesses require dental treatment, they can reduce their pain with the help of medications. Painkillers are only there for pain reduction and cannot replace a visit to a dentist. Paracetamol and ibuprofen are effective painkillers for reducing abscess pain.

If the infection and abscess have spread to other parts of the face, such as the jaw, the dentist will prescribe antibiotics to prevent the further spread of the condition. Antibiotics help to reduce the spread of the infection, but they do not completely cure the abscess. Examples are prescription antibiotics to control infection with amoxicillin or metronidazole.

Tooth extraction

Teeth should be extracted if:

• Caries or tooth infection is so severe that it cannot be treated by fillings or endodontic therapy.
• A broken or cracked tooth is like that it cannot be restored.
• Infection or destruction of tissue between teeth and gums is very severe.

Home Remedies for Dental Abscess

There are actions you can take at home to relieve the pain.

• Avoid food and drink that is too hot or too cold.
• Chewing on the side of your mouth without an abscess.
• Do not floss around the affected area.
• Use a very soft toothbrush.

Prevention of Dental Abscess

To prevent tooth abscesses, it is very important to prevent caries. The most important thing to avoid tooth decay is good care and oral hygiene.

The thing to consider is:

• Use fluoridated drinking water.
• Brush your teeth at least twice a day with fluoride toothpaste.
• Use dental floss or an interdental cleaner to clean between your teeth.
• Replace your toothbrush every three or four months or whenever the bristles are frayed.
• Limit sugary foods and drinks.
• Visit your dentist for regular dental check-ups.
• Use an antiseptic or fluoride mouth rinse to add a protective layer against tooth decay.