Tooth Abscess: Causes, Prevention & Treatment

A tooth abscess is a pocket or collection of pus. It can occur in different places like inside the teeth, in the gums or in the bone that holds the teeth in place. It can also be called a dental abscess. It is usually caused by a bacterial infection.  It can spread to other parts of the body and make you ill.

Tooth Abscess: Causes, Prevention & Treatment

An abscessed tooth is an infection within a tooth that has spread to the root tip or around the root. This infection originates from the tooth’s inner chamber which is called the ‘pulp chamber. Inside the pulp chamber, there are vessels and nerves called the ‘pulp’. Once the abscess is formed,  the tooth has essentially lost its ability to fight off infection, and bacteria are able to invade the pulp chamber and multiply. As the bacteria multiply, the bacterial infection usually spreads from the pulp chamber and exits through the bottom of the root into the bone.

Three types of tooth infections can cause abscesses:

  • Gingival: This infection develops in the gums. It does not usually affect the tooth or supporting structures.
  • Periapical: A periapical abscess is an infection that forms at the tip of the root. This occurs because bacteria can spread to the inside of the tooth to the pulp through a fracture or cavity. The pulp is the innermost part of the tooth that contains nerves and blood vessels. When bacteria invades the pulp, they can spread to the tip of the tooth’s root causing the infection to spread to the bone eventually leading to an abscess.
  • Periodontal: This infection starts in bone and tissues that support the tooth. A periodontal abscess usually results from periodontitis or gum disease and is more common among adults.

Causes

Many different things can cause a tooth or dental abscess. A very common cause is dental cavity or tooth decay.

  • Poor dental hygiene

Plaque can build up on the teeth if you do not floss and brush your teeth regularly.

  • Severe tooth decay

A tooth or cavity decay is the destruction of the hard surfaces of the tooth. This occurs when bacteria break down sugars in food and drink thereby creating acid that attacks the enamel.

  • Breakdown in the protective enamel of teeth

Breakdown in the protective enamel of teeth allows for bacteria to enter the tooth cavity causing a local infection. As this infection within the pulp cavity grows within the limited space of the tooth, it compresses the inner dentine walls causing severe pain. This infection then tracks down through the root canal and inferiorly into the mandible or superiorly into the maxilla depending on the location of the infected tooth.

  • Partially erupted tooth

This is when bacteria gets trapped between the crown and soft tissues causing inflammation. It is most usually a wisdom tooth. Also, when a tooth is broken, chipped or cracked, bacteria can seep into an opening and spread to the pulp.

  • Amelogenesis

A dental abscess can be caused by genetic reasons. Amelogenesis is one of them.It predisposes individuals to weakened enamel which is more susceptible to wear

  • Gum Disease

This is also called periodontitis. It is an inflammation and infection of the tissues around the teeth. As gum decrease progresses, the bacteria gain access to deeper tissues.

  • Sjogren syndrome

Tooth abscesses can also be caused by this syndrome. It causes dry mouth which accelerates oropharyngeal microbial growth.

  • Injury to the tooth

Injury or trauma to a tooth can injure the inner pulp even if there is no sign or visible crack. The injury could make the tooth susceptible to infection.

  • Root canal Procedure

A tooth that has been previously treated with a root canal procedure can also develop an abscess. This is due to the lack of adequate seal from bacteria within the tooth or even a fracture of the tooth roots.

  • Heartburn

Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to flow into your mouth (reflux), wearing away the enamel of your teeth and causing significant tooth damage. This exposes more of the dentin to attack by bacteria, creating tooth decay. Your dentist may recommend that you consult your doctor to see if gastric reflux is the cause of your enamel loss.

  • Eating disorders

Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach acid from repeated vomiting (purging) washes over the teeth and begins dissolving the enamel. Eating disorders also can interfere with saliva production.

Symptoms

Signs and symptoms of a tooth abscess include:

  • Sensitivity to the pressure of chewing or biting
  • Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
  • Sensitivity to hot and cold temperatures
  • Swelling in your face or cheek
  • Tender, swollen lymph nodes under your jaw or in your nec
  • Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures
  • A general unwell feeling
  • Difficulty breathing or swallowing
  • Bitter taste in the mouth
  • Puffy gums
  • Swallowing difficulties
  • Insomnia
  • Fever

Diagnosis

An abscessed tooth won’t go away on its own. It’s important to take care of it so it doesn’t spread to your jaw or other parts of your head or neck.

  • Tap on your teeth

 A tooth that has an abscess at its root is generally sensitive to touch or pressure.

  • Recommend an X-ray

An X-ray of the aching tooth can help identify an abscess. Your dentist may also use X-rays to determine whether the infection has spread, causing abscesses in other areas.

  • Recommend a CT scan

If the infection has spread to other areas within the neck, a CT scan may be used to assess the extent of the infection.

Treatment

There are different ways to treat an abscess but the goal of treatment is to get rid of the infection.

  • Incision

The abscess needs to be cut out and the pus, which contains the bacteria, drained away. The doctor will administer a local anaesthetic.

  • Antibiotics

If the infection is limited to the abscessed area, you may not need antibiotics. But if the infection has spread to nearby teeth, your jaw or other areas, your doctor will likely prescribe antibiotics to stop it from spreading further. Also, if you have a weakened immune system, you may be required to take Antibiotics.

  • Root canal treatment

This is a procedure to remove the abscess from the root of an affected tooth before filling and sealing it. To do this, your dentist drills down into your tooth removes the diseased pulp and drains the abscess. Then the tooth gets filled with the pulp chamber and root canals.

  • Extraction

If the tooth cannot be saved, it will have to be removed.

10 ways to prevent Tooth Abscess

  • Brush with fluoride toothpaste after eating or drinking

Brush your teeth at least twice a day and ideally after every meal, using fluoride-containing toothpaste. To clean between your teeth, floss or use an interdental cleaner.

  • Rinse your mouth

If your dentist feels you have a high risk of developing cavities, he or she may recommend that you use a mouth rinse with fluoride.

  • Visit your dentist regularly

Get professional teeth cleanings and regular oral exams, which can help prevent problems or spot them early. Your dentist can recommend a schedule that’s best for you.

  • Consider dental sealants

A sealant is a protective plastic coating applied to the chewing surface of back teeth. It seals off grooves and crannies that tend to collect food, protecting tooth enamel from plaque and acid. The Centers for Disease Control and Prevention (CDC) recommends sealants for all school-age children. Sealants may last for several years before they need to be replaced, but they need to be checked regularly.

  • Drink some tap water

Most public water supplies have added fluoride, which can help reduce tooth decay significantly. If you drink only bottled water that doesn’t contain fluoride, you’ll miss out on fluoride benefits.

  • Avoid frequent snacking and sipping

Whenever you eat or drink beverages other than water, you help your mouth bacteria create acids that can destroy tooth enamel. If you snack or drink throughout the day, your teeth are under constant attack.

  • Eat tooth-healthy foods

Some foods and beverages are better for your teeth than others. Avoid foods that get stuck in grooves and pits of your teeth for long periods, or brush soon after eating them. However, foods such as fresh fruits and vegetables increase saliva flow, and unsweetened coffee, tea and sugar-free gum help wash away food particles.

  • Consider fluoride treatments

Your dentist may recommend periodic fluoride treatments, especially if you aren’t getting enough fluoride through fluoridated drinking water and other sources. He or she may also recommend custom trays that fit over your teeth for application of prescription fluoride if your risk of tooth decay is very high.

  • Ask about antibacterial treatments

If you’re especially vulnerable to tooth decay — for example, because of a medical condition — your dentist may recommend special antibacterial mouth rinses or other treatments to help cut down on harmful bacteria in your mouth.

  • Combined treatments

Chewing xylitol-based gum along with prescription fluoride and an antibacterial rinse can help reduce the risk of cavities.

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