A dental abscess, a common yet serious dental condition, demands immediate attention and professional care. Characterized by a buildup of pus in the teeth or gums due to infection, it can lead to severe discomfort and serious health complications if left untreated.
At The Lakewood Dentist, we prioritize your dental health and provide the urgent care needed to tackle such dental emergencies. With our experienced dentists, you will learn the causes and symptoms of dental abscesses. We offer effective treatments and professional dental care.
If you are experiencing symptoms (explained below) of a dental abscess, contact our dental clinic to schedule a consultation.
An Overview of Tooth Abscess
A dental abscess is a painful condition caused by a bacterial infection resulting in a collection of pus around a tooth or in the gums. The two main types of dental abscesses are periapical and periodontal. Periapical abscesses occur at the tip of the tooth’s root, while periodontal abscesses affect the gums and bone supporting the teeth.
The Different Stages of Tooth Abscess
A tooth abscess can occur at various stages of tooth decay. The progression of an abscess is generally divided into five stages. These include:
- Enamel Decay. The outermost layer of the tooth, the enamel, is the first to be affected. Plaque buildup can lead to enamel decay, often without symptoms initially. Some people may experience tooth sensitivity or white spots indicating early decay.
- Dentin Decay. If enamel decay is left untreated, the infection progresses to the dentin layer, which is softer and yellowish. This stage is characterized by increased tooth sensitivity and, possibly, small cavities.
- Pulp Decay. The decay then reaches the dental pulp, the innermost part of the tooth containing nerves and blood vessels. Infection and inflammation of the pulp can cause severe pain. Some people may not experience symptoms due to nerve damage.
- Abscess Formation. The bacteria can then spread deeper into the gums or jawbone. The immune system’s response leads to pus formation, resulting in a painful, swollen abscess. This stage can include symptoms like throbbing pain, redness, swelling, and swollen lymph nodes.
- Serious Complications and Tooth Loss. If left untreated, the abscess can lead to severe complications such as tooth loss, bone infection (osteomyelitis), and even life-threatening conditions like sepsis. The affected tooth may become so damaged that it breaks or requires extraction.
Symptoms of a dental abscess in its various stages can vary but typically include severe toothache, swelling, redness, swollen lymph nodes, sensitivity to temperature, bad breath, and difficulty biting or chewing. If the abscess ruptures, foul-tasting fluid may be released, temporarily relieving pain.
Symptoms of Tooth Abscess
A tooth abscess requires prompt attention. The symptoms can vary, but commonly include:
- Severe, Constant Toothache. This pain can be described as gnawing, throbbing, sharp, or shooting. It may spread to the jawbone, neck, or ear.
- Sensitivity to hot and cold temperatures.
- Pain When Chewing or Biting. The pressure of biting or chewing can exacerbate the discomfort.
- Fever, which indicates the body is fighting an infection.
- Facial Swelling. Swelling in the face, cheek, or neck can sometimes lead to breathing or swallowing difficulties.
- Swollen lymph nodes under the jaw or neck.
- Bad Breath and Bitter Taste. Foul odor and taste in the mouth, especially if the abscess ruptures, releasing a foul-smelling, salty fluid.
- General Discomfort. This includes uneasiness or an overall feeling of being unwell.
What Causes Abscess?
Dental abscesses are primarily caused by bacterial infections, often resulting from neglect of oral hygiene or other factors leading to bacterial access to the tooth or surrounding tissues. Key causes include:
- Cavities. Severe cavities, resulting from bacteria breaking down sugars in food and drink, create acid that attacks tooth enamel. This decay can progress to the formation of an abscess.
- Broken, Chipped, or Cracked Teeth. Any opening in a tooth can allow bacteria to seep in and spread to the pulp, eventually causing an abscess.
- Gum Disease. Advanced gum disease allows bacteria to access deeper tissues, potentially leading to abscess formation.
- Tooth Injury. Trauma to a tooth, even without visible cracks, can injure the inner pulp, making it susceptible to infection.
Risk Factors
Various factors can increase the risk of a dental abscess, primarily from a bacterial infection. Understanding these risk factors is crucial for prevention and early intervention. The main risk factors include:
- Poor Dental Habits and Care. Inadequate oral hygiene, such as not regularly flossing and brushing, increases the risk of dental problems, including abscesses. Neglecting oral care can lead to tooth decay, gum disease, and other complications.
- High Sugar Diet. Consuming foods and drinks rich in sugar contributes to dental cavities, which can become a tooth abscess if not treated properly.
- Dry Mouth. A dry mouth, often a side effect of certain medications or aging, increases the risk of tooth decay, which can lead to abscesses.
- Dental Trauma and Damage. Injuries or deep cracks in teeth allow bacteria to penetrate deeper parts of the teeth or gums, leading to an abscess.
- Underlying Medical Conditions & Medications. Individuals with weakened immune systems, such as those undergoing chemotherapy, taking steroids, or with conditions like diabetes, are at higher risk of developing abscesses. Long-term use of antibiotics, a dry mouth, and a weakened immune system can disrupt the balance of bacteria in the mouth, leading to infections and abscesses.
- Poor Diets High in Sugar. A diet rich in sugary and processed foods leads to dental plaque buildup, which can harden into calculus. Without proper oral hygiene, this can result in gum disease, tooth decay, and an abscess.
Diagnosing Dental Abscess
Diagnosing a dental abscess involves several steps and methods to accurately identify and assess the extent of the infection. The following is how dentists typically diagnose a dental abscess:
- Dental Examination. The dentist will examine the tooth and surrounding tissue for signs of infection. They will look for symptoms such as tooth sensitivity, gum redness and swelling, and a possible open, draining sore on the gums.
- Dental X-Ray. X-rays are crucial in identifying sources of dental disease that may have led to the abscessed tooth. They can also determine if the infection has spread to other areas.
- CT Scan. If the infection has spread to other areas within the neck, a CT scan may be recommended to identify the extent of the infection.
- Tooth Tests. The dentist may tap and press on the teeth to check for sensitivity or pain, indicating an abscess. Thermal tests might also be conducted to assess the health of the tooth pulp.
- Patient’s Medical History. Understanding the patient’s medical history, including any recent trauma to the teeth or dental work, is important in diagnosing a dental abscess.
- Assessment of Symptoms. The dentist will assess symptoms like severe toothache, swollen lymph nodes, ear, neck, or jaw pain, and general discomfort indicative of a dental abscess.
Dental Abscess Treatment
The treatment for a dental abscess focuses on eliminating the infection and preventing further complications. The primary treatment methods used are:
Incision and Drainage Procedure
A dental abscess incision and drainage procedure involves several critical steps and considerations. For local anesthesia, topical anesthetic ointments and injectable local anesthesia like lidocaine or bupivacaine are used with a dental aspirating syringe and needles of appropriate sizes.
Local anesthetic injections directly into an abscess may be ineffective because of the low pH environment, which necessitates a higher volume of solution. However, care must be taken not to overdose. Local injections could also risk spreading the infection, so specialists prefer procedural sedation, dental nerve block, or other anesthesia.
If additional local infiltrations are needed, they should be placed in uninfected tissue near the abscess.
Before treatment, a periapical or panographic x-ray is commonly performed to determine the infection source, bone destruction extent and position, and the abscess type and extent. In some cases, a computed tomography (CT) scan may be used if the infection has spread to other areas within the neck.
The dentist or oral surgeon will make a small incision into the abscess to allow the pus to drain out, then wash the area with saline. Sometimes, a small rubber drain opens the area for further drainage as the swelling goes down.
Using Antibiotic Medication
Antibiotic therapy is crucial, particularly when the infection has spread beyond the tooth. The 2019 guideline from the American Dental Association for the management of dental pain and swelling emphasizes the following points:
- Antibiotics are not recommended for most pulpal and periapical conditions. Instead, dental treatments such as pulpotomy, pulpectomy, nonsurgical root canal treatment, or incision and drainage are prioritized.
- Antibiotics are prescribed when a patient’s condition shows systemic involvement, such as fever or malaise.
- Dentists are encouraged to use antibiotics responsibly to prevent overuse and resistance.
Root Canal
Before a root canal, the dentist or endodontist will take dental X-rays of the affected tooth and may perform tests to determine the condition of the tooth pulp. After determining the infected tooth’s condition, the following steps occur:
- Anesthesia is administered to numb the infected tooth and surrounding gum.
- A dental dam is placed to keep the tooth dry.
- A small hole is drilled into the tooth’s crown to access the pulp.
- Infected pulp tissue is removed.
- The pulp chamber and root canals are cleaned, disinfected, and filled with gutta-percha.
- A temporary dental filling is placed.
- Finally, a dental crown is placed on the treated tooth.
Recovery from a root canal typically takes less than a week. Patients are advised to eat soft foods, avoid chewing on the treated tooth if awaiting a permanent crown, practice good oral hygiene, and use an antibacterial mouthwash.
While the procedure can be uncomfortable, especially during the injection of anesthesia, most people experience less pain post-treatment. If throbbing pain occurs, it may indicate a residual infection and should be addressed immediately.
Tooth Extraction
Tooth extraction is a common treatment for dental abscesses, particularly when the affected tooth cannot be saved. The dentist assesses the affected tooth and surrounding gums and takes dental X-rays to check bone levels and the extent of damage. Patients must inform their dentist about any medications, vitamins, or supplements they take. Sedation options are discussed based on the patient’s needs and preferences, including nitrous oxide, oral conscious sedation, or intravenous (IV) sedation. In complex cases, general anesthesia in a hospital
Tooth Scaling and Root Planing
Tooth scaling and root planing, a deep cleaning procedure for treating gum disease, involves removing plaque and tartar from below the gum line and smoothing the roots to promote healing. Follow-up care is essential to ensure the treatment’s success and prevent gum disease recurrence.
Recovery time varies depending on the gum disease’s severity and overall oral health. Some discomfort and sensitivity are common after the procedure, but these usually subside within a few days. Patients often start feeling better soon after treatment, significantly improving gum health and reducing symptoms like bleeding or swelling within a week or two. Regular dental check-ups and good oral hygiene are crucial for maintaining the benefits of the treatment.
Do Dental Abscesses Have Complications?
A dental abscess, if left untreated, could result in serious and potentially life-threatening complications. Here are some key complications associated with dental abscesses:
Ludwig’s Angina
Ludwig’s Angina, a rare but severe infection, typically originates from an abscessed tooth, often in the lower jaw’s second or third molars. This condition, named after Wilhelm Friedrich von Ludwig, who described it in 1836, can be a serious complication of dental abscesses. The infection primarily affects the sublingual space under the tongue, the submandibular space beneath the lower jaw, and the submental triangle in the front of the neck below the chin.
The primary cause of Ludwig’s angina is a tooth infection, with about 90% of cases starting in the lower jaw’s molars. It’s a specific form of cellulitis – a bacterial skin and tissue infection. Common bacteria like Group A streptococci and staphylococci, when involved, can cause rapid spread of the infection to the mouth, tongue, and throat areas. This can result in significant swelling, making breathing difficult.
People with conditions such as diabetes, malnutrition, oral cancer, poor oral hygiene, or a weakened immune system are more likely to develop Ludwig’s angina. Symptoms to watch out for include difficulty speaking, fever, jaw pain, neck pain, swelling or redness, swollen cheeks and jaw, tongue pain, and toothache.
Facial Cellulitis
Facial cellulitis often originates from oral abscesses and can rapidly become a severe infection. Bacteria like Streptococcus anginosus, commonly found in oral abscesses, underscore the potential for this infection to escalate beyond the oral cavity. These bacteria can lead to complications such as pharyngitis, bacteremia, and infections in internal organs like the lungs and liver.
Dental Abscess Can Also Cause Sepsis
Dental abscesses, if not managed properly, can escalate into a severe systemic infection known as sepsis. Sepsis is the body’s extreme response to an infection. It occurs when an infection you already have triggers a chain reaction throughout your body. In the case of dental abscesses, the infection can spread beyond the oral cavity into the bloodstream, leading to this potentially life-threatening condition.
Dental abscesses, particularly when left untreated, can become the source of bacteria entering the bloodstream, potentially leading to sepsis. This underscores the critical importance of addressing dental infections promptly and effectively. The spread of infection from a localized area in the mouth to the bloodstream is a dangerous progression that requires immediate medical attention.
Maxillary Sinusitis
The proximity of the roots of the upper teeth to the maxillary sinuses means that infection from a dental abscess can easily spread to these sinuses. When bacteria from an abscessed tooth infiltrate the sinus cavities, it can lead to inflammation and infection of the sinus, known as sinusitis.
Dental Cysts
Dental cysts typically develop around the roots of infected teeth. They start as fluid-filled sacs and can grow gradually over time. If left untreated, dental cysts can lead to bone destruction or displacement of adjacent teeth, making early detection and treatment crucial.
Osteomyelitis and Dental Abscess
Osteomyelitis, an infection of the bone, occurs when the bacteria from a dental abscess penetrate the jawbone. This can happen in severe, untreated dental abscesses or where the infection is particularly aggressive.
Preventing Tooth Abscess
Tooth abscesses are a common yet preventable dental issue. The key to preventing these painful infections lies in maintaining robust oral hygiene habits, including:
Brushing Your Teeth
Regular brushing removes plaque, a sticky film of bacteria that forms on your teeth. If plaque isn’t removed, it can lead to tooth decay and gum disease, which can contribute to the formation of an abscess.
For effective brushing, consider the following tips:
- Brush at least twice a day, especially after meals, using a fluoride toothpaste.
- Use a soft-bristled toothbrush to avoid damaging your gums and enamel.
- Follow a proper brushing technique: brush at an angle of 45 degrees to your gums with gentle, anti-clockwise motions.
- Brush your tongue and the roof of your mouth, as bacteria can accumulate there, too.
- Replace your toothbrush every three to four months or sooner if the bristles become frayed.
Use An Antibacterial Mouthwash Daily
Incorporating an antibacterial mouthwash into your daily oral hygiene routine can provide additional protection against tooth abscesses. Mouthwash can reach areas of the mouth that brushing and flossing may miss, helping to eliminate bacteria that could lead to infection.
Below are key points about using mouthwash:
- Antibacterial mouthwashes can help reduce the amount of harmful bacteria in your mouth.
- Use mouthwash after brushing and flossing to maximize its effectiveness.
- Look for a mouthwash with fluoride, which can help strengthen tooth enamel and prevent decay.
- Swish the mouthwash around your mouth for 30 seconds to a minute, following the product’s instructions.
While mouthwash is valuable to your oral hygiene routine, it should not replace brushing and flossing. Together, these practices form a comprehensive approach to preventing tooth abscesses and maintaining oral health.
Flossing
Flossing is vital to oral health, particularly in preventing conditions like tooth abscesses. While brushing cleans your teeth’ surfaces, flossing is essential for removing plaque and food particles from between your teeth and along the gum line — areas where a toothbrush can’t always reach.
Effective flossing involves:
- Using about 18 inches of floss, wind most of it around your middle fingers and hold a small section taut between your thumbs and index fingers.
- Gently guide the floss between your teeth using a rubbing motion and curve it into a C shape against each tooth, sliding it beneath the gum line.
- Use clean floss sections as you move from tooth to tooth to avoid redistributing bacteria.
- Regular flossing, at least once a day, helps prevent the build-up of plaque, which can lead to tartar, a hardened form of plaque that can irritate the gums and form an abscess. Integrating flossing into your daily teeth cleaning routine protects you from tooth abscesses and ensures healthier gums and a cleaner mouth overall.
Visit Your Dentist Every Six Months
Visiting your dentist every six months for a professional cleaning and examination can help catch and address potential issues before they develop into serious problems like abscesses.
During a dental visit, you can expect:
- A thorough cleaning is needed to remove plaque and tartar that regular brushing and flossing might miss.
- Examine your teeth, gums, and mouth for signs of decay, gum disease, or other oral health issues.
- X-rays, if necessary, to detect problems that aren’t visible during a regular exam, such as impacted teeth or jawbone damage.
Drink A Lot Of Tap Water With Fluoride
Drinking tap water with fluoride is an easy and effective way to support oral health and prevent tooth abscesses. Fluoride, a natural mineral, has been proven to strengthen tooth enamel and reduce the risk of tooth decay.
The merits of fluoridated tap water are:
- Fluoride helps rebuild weakened tooth enamel and reverse early signs of tooth decay.
- Drinking fluoridated water is a preventive measure that benefits all ages.
The Centers for Disease Control and Prevention (CDC) has recognized water fluoridation as one of the ten great public health achievements of the 20th century.
Eat A Well-Balanced Diet
A well-balanced diet is essential for overall health and maintaining strong teeth and gums, thereby reducing the risk of tooth abscesses. Nutritious foods contribute to a robust immune system, which is vital in fighting oral infections that can lead to abscesses.
Key dietary considerations for oral health include:
- Eating plenty of fruits and vegetables, which are high in vitamins and minerals, promotes oral health.
- Avoiding excessive sugar, as it can contribute to tooth decay and gum disease.
- Including calcium-rich foods like dairy products, leafy greens, and almonds to strengthen teeth.
- Opting for crunchy fruits and vegetables, like apples and carrots, can help clean teeth naturally.
Find an Emergency Dentist Near Me
When dealing with a dental emergency, such as a tooth abscess, have a reliable and compassionate dentist you can turn to. At The Lakewood Dentist, we understand the urgency and discomfort of dental emergencies.
Our experienced team is committed to providing prompt, gentle, and effective treatment to alleviate your pain and address the underlying cause. Contact us at 562-423-1441 for compassionate, expert care. Our team is here to provide the relief and treatment you need, ensuring your oral health is restored and maintained.