A dental abscess, is an accumulation of pus which forms inside the teeth or gums. The abscess typically originates from a bacterial infection, often one that has accumulated in the soft pulp of the tooth.
Bacteria exist in plaque, a by product of food, saliva and bacteria in the mouth which sticks to the teeth and damages them, as well as the gums. If the plaque is not removed by proper tooth brushing and flossing the bacteria may spread within the soft tissue inside the tooth or gums which eventually results in an abscess.
There are three types of dental abscesses...
The abscess is only in the gum tissue and does not affect the tooth or the periodontal ligament.
This abscess starts in the supporting bone tissue structure of the teeth. When bacteria are present in plaque infect the gums the patient has periodontitis. The gums become inflamed, which can make the tissue surrounding the root of the tooth separate from the base of the tooth. A periodontal pocket which is a tiny gap is formed when the periodontal ligament separates from the root. The pocket gets dirty and is usually very difficult to clean. As bacteria build up in the periodontal pocket a periodontal abscess is formed.
This abscess commences in the soft pulp of the tooth. Bacteria enter the teeth through tiny holes caused by decay that form in the tooth enamel (hard outer layer of the tooth). The caries eventually break down the softer layer of tissue under the enamel, called the dentine. If the decay continues, the hole will eventually penetrate the soft inner pulp of the tooth. This type of infection is referred to as pulpitis. As the pulpitis progresses the bacteria make their way to the bone that surrounds and supports the tooth, called the alveolar bone, and a periapical abscess is formed.
Some common signs and symptoms of a dental abscess are:
- Pain in the affected area when biting.
- Touching the affected area may be painful.
- Sensitivity to hot and cold food or liquids.
- A foul taste in the mouth.
- General unwell feeling.
- Pain in opening the mouth.
- Small white pimple like blister on the gum.
- Swallowing difficulty.
The main symptom of a dental abscess is pain. This may be a throbbing pain, and is often quite intense. The pain usually starts suddenly, and becomes more intense over the day. In some cases the pain radiates to the ear, jawbone and neck. A dental abscess usually requires treatment as the infection can worsen and therefore result in the destruction of bone tissue.
If you feel you may have a developed a dental abscess it is important to contact your dental practice immediately. Please note a GP can not treat an abscess however he/she may prescribe medication. The most common treatment for an abscess is root canal treatment followed by a crown or extraction. Antibiotics are only a temporary solution and in most cases the infection will return.
People with swelling to their face and neck and who are experiencing breathing difficulties are advised to go to their nearest hospital. It is important to treat a dental abscess as soon as possible but the best prevention is to ensure you are keeping good oral hygiene and maintain visits to your dentist on a six month basis.