An accumulation of pus in or around the root of a tooth is known as a dental
abscess. A dental abscess can be extremely painful and may cause the affected
Tooth to loosen in its socket.
What Are The Causes?
An abscess usually develops as a complication of dental caries, which gradually destroys the layer of enamel on the outside of the tooth and the inner dentine, allowing bacteria to • invade the soft central core or pulp ol the tooth. Eventually, a dental abscess may form, which is agonizingly painful and may cause the gum adjacent to the tooth to swell and become very tender (a gum boil).
An abscess may also form as a result of certain forms of gum disease (periodontitis). Periodontitis is usually caused by a build-up of dental plaque (a deposit including food particles, mucus and bacteria) in a pocket that forms between a tooth and gum.
What Are The Symptoms?
The main symptoms of a dental abscess develop gradually and may include:
- throbbing pain in the affected tooth
- severe pain on touching the affected tooth and on biting or chewing
- loosening of the affected tooth
- red, tender swelling of the gum over the root of the tooth
- release of pus into the mouth
If the abscess is not treated, the infection may make a channel from the tooth to the surface of the gum, and a painful swelling, known as a gum boil, forms. Should the gum boil burst, foul-tasting pus is released and the pain decreases.
In some cases the channel may persist, which leads to a chronic abscess that discharges pus periodically. If the infection spreads to surrounding tissues, your face may become swollen and you may develop a fever. If you suspect you have an abscess, you should consult your dentist as soon as possible.
What Can I Do?
If there is a delay before you are able to see your dentist, you can try taking painkillers such as paracetamol, which may relieve pain. Rinsing your mouth with warm salt at may also help decrease the pain and possibly encourage a gum boil to burst. If a gum boil does burst, wash away the pus thoroughly with more warm saltwater.
What Might The Dentist Do?
Your dentist will ask you about your teeth and gums. He or she may take an X-ray of your mouth to confirm the diagnosis.
- If the abscess has been caused by tooth decay, your dentist will always try to save the tooth. Under local anaesthesia, a hole is drilled through the top of the tooth to release the pus, which will have the effect of relieving the pain. If there is a gum boil, a small cut may be made in the boil to drain the pus. The cavity is then cleaned with an antiseptic solution.
- To treat an abscess caused by gum disease, your dentist may use a probe to scrape out the plaque from the pocket between the affected tooth and gum. Afterwards, the pocket is washed out with an antiseptic solution.
- Pockets are treated with several weeks of intensive oral hygiene, including frequent brushing, flossing and the use of antiseptic gel on the floss. Most can be eradicated.
Root Canal – Sometimes, decay invades and destroys the pulp, containing nerves and blood vessels, at the centre of the tooth, and root canal treatment may be performed. The pulp is removed and an antiseptic solution is used to sterilize the cavity. If infection within the tooth is severe, a temporary filling may be inserted for a few days before the cavity is sterilized again. The root canals and the decayed area of the tooth are then filled.
- Whatever the cause of the abscess, you will probably be prescribed a course of antibiotics.
- Once the infection has cleared up, you may need root canal treatment (see box, above).
- If it is not possible to save the tooth, an extraction is the only remaining option.
- An extracted tooth can be replaced with a denture, bridge or an implant.
What Is The Outlook?
Most treatment is successful, but a small area of infection may persist and further treatment may be required.