Dental Abscesses

What is a dental abscess?

A dental abscess is a pocket of pus that can form when decay, cracks, chips or injuries to a tooth cause trauma/infection within the nerve canal system of that tooth. An abscess does not always present in the mouth, but when it does it can look like a red, swollen bump, boil or pimple.

Toothache caused by pressure and swelling around the tooth may be one of the clearest signs of a dental abscess. However it is possible that the pressure can be relieved naturally, and as a result you may not feel any symptoms. For this reason, it is important to check with your dentist as soon as possible otherwise the infection can spread and cause more severe issues.

Other symptoms may include:

• Bad breath
• Pain when biting down
• Swollen glands in the neck
• Swollen area around the upper or lower jaw

Leaving an abscessed tooth untreated can lead to life threatening complications and warrants an emergency dentistry visit at the first signs of discomfort.

Should a dental abscess be drained?

When cavities or other oral infections are left untreated, they can spread to the jawbone and soft tissues of the mouth. If an infection has been allowed to develop into an abscess, you may notice swelling in the mouth or face.

We understand the seriousness of problems like tooth and gum infections. When a patient presents signs of significant infection or a dental abscess, we perform a comprehensive exam to first reach an accurate diagnosis. In some cases, infection requires prompt and aggressive treatment to preserve both the tooth and oral and general health. Incision and drainage is one way we can achieve this. The incision and drainage procedure is performed using a local anesthetic to numb the area of the mouth being treated. After a small incision is made in the gums, a small drain may be inserted to siphon off the fluid that has accumulated in a pocket.

After thorough drainage, the infection site is irrigated with sterile saline. Antibiotics may be applied into the pocket that has been drained or may be prescribed to take orally for several days.

How do you treat an abscess after draining? How long does it take for incision and drainage to heal?

Aftercare is an important aspect of incision and drainage treatment, and your dentist will instruct you on at home care steps you should follow. A few Important steps to take include:

• Do not disturb the part of the mouth that has been treated. Do not touch with the tongue or the fingers.
• Antibiotics must be taken as prescribed. Over-the-counter medication such as ibuprofen or acetaminophen can be taken to manage comfort. If pain is severe, the dentist may prescribe mild pain medication.
• Soft foods should be consumed until swelling and pain improve.
• Plenty of fluids should be consumed throughout the day to prevent dehydration.
• Aside from walking, patients should avoid exercise and activities that increase heart rate.

Fever is a common symptom of infection. If the fever rises above 101 degrees Fahrenheit, the dentist should be contacted. If the fever rises when the office is closed, the patient should go to the nearest emergency room or urgent care.

Is a dental abscess considered an emergency?

Yes. A tooth abscess is an infection that creates a pocket in soft tissue. This pocket fills with pus that contains bacteria. Typically, these sores result from untreated cavities or poor dental health in general. Two common types of abscesses occur:

• Periodontal abscesses form in the space between a tooth and the gums. The presence of bacteria in the gums can lead to serious periodontal disease if not addressed quickly enough.
• Periapical abscesses form at the tip of a tooth’s root. This sore cannot be seen because it happens inside the tooth. Untreated abscess at the root can spread bacteria and infection to surrounding bone.

A dental abscess can form in a matter of a few days. This infection does not go away on its own. Without treatment, an abscess can continue for several months, possibly even years. Most abscesses cause intense tooth pain, indicating to a patient that prompt treatment is needed. Yet, some abscesses do not cause pain, but can be equally damaging to hard and soft tissues in the oral cavity.

If not treated, an abscess can lead to additional problems. These include:

• Fistula, or an opening through the bone and tissue that allows pus to drain. Fistula can leave an odd taste in the mouth.
• Cysts can also develop from a dental abscess. Like the abscess itself, a cyst is a fluid-filled sac. From a dental abscess, a cyst may form in the jaw bone. Surgery may be needed to remove it.
• Sepsis. This is the most severe and concerning consequence of a dental abscess. If the abscess drains without intervention from a dentist, infection can spread to the mouth and the bloodstream. Once in the bloodstream, the infection becomes sepsis, a systemic infection that can affect the heart, the brain, and all other organs.

Sepsis is a life-threatening condition that may require hospitalization and aggressive treatment.