A dental abscess is a pus-filled pocket or lump formed on a tooth. A dental abscess is caused by a bacterial infection. This condition can occur around the root of a tooth or in the gums.
Bacterial infections that cause dental abscesses generally occur in people with poor dental hygiene and health. The pus that collects in the lump will gradually worsen the pain.
Dental abscesses are divided into several types, namely:
- Periapical abscess, which is an abscess that appears at the tip of the tooth root.
- Periodontal abscess, which is an abscess that appears on the gums next to the tooth root and can spread to the surrounding tissue and bone.
- Gingival abscess, which is an abscess that appears on the gums
Causes and Risk Factors of Dental Abscess
Dental abscesses occur due to the growth of bacteria in the oral cavity. Bacteria can enter the tooth through a hole or crack in the sufferer’s tooth, then cause swelling and inflammation at the tip of the root.
This bacterial infection will be more likely to occur in someone with the following conditions:
- Poorly cleaned teeth
Not caring for your teeth and gums properly can increase the risk of dental and oral diseases, including tooth abscesses. - High sugar foods
Frequently consuming foods and drinks with high sugar content can cause cavities and develop into dental abscesses. - Dry mouth
Dry mouth can also interfere with dental health and cause infections and dental abscesses.
Symptoms of Dental Abscess
The main symptom of a dental abscess is the appearance of pain in the tooth or gums that can come suddenly and get worse. Other symptoms that can appear in people with tooth abscesses are:
- Fever
- Swollen gums
- Pain when chewing and biting
- Toothache that spreads to the ear, jaw, and neck
- Teeth change color
- Sensitive to hot or cold food
- Bad breath
- Redness and swelling of the face
- Swollen lymph nodes in the neck or a lump under the jaw
- Hard to breathe
When to see a dentist
It is advisable to see a doctor immediately when symptoms appear so that the tooth abscess does not get worse. A tooth abscess can cause dangerous complications for the sufferer, namely an infection that spreads deeper into the jaw, head, and neck.
Go to the emergency room at the nearest hospital immediately if you experience symptoms of a tooth abscess accompanied by swelling of the gums and lymph nodes, especially if you have shortness of breath.
Dental and oral health checks need to be done routinely to the dentist. This aims to maintain oral health, as well as prevent or detect early if a disease appears. A dental check-up is recommended every 6 months.
Diagnosis of Dental Abscess
In the initial stage of the examination, the dentist will ask about the complaints and symptoms experienced by the patient. The doctor will also perform a physical examination, such as on the teeth and oral cavity as a whole.
During a physical examination, the doctor will tap the patient’s teeth. The goal is to find out if the teeth are more sensitive to touch and pressure, as is common in people with tooth abscesses.
Next, the doctor will carry out supporting examinations which include:
- Dental X-rays
Dental X-rays are performed to determine how extensive the infection is and whether it has spread to other parts. - CT scan
CT scan aims to detect the possibility that the infection has spread to other areas further away, for example to the neck area.
Dental Abscess Treatment
To remove infection and pus, the dentist can perform the following actions:
1. Production of pus
The doctor will make a small incision in the abscess lump and drain the pus. After the pus is drained and the tooth area is cleaned with salt water, the swelling will go down.
2. Administration of antibiotics
Antibiotics are not actually needed if the pus has been removed. Antibiotics are only given if the infection has spread.
3. Root canal treatment
Root canal treatment can help eliminate the infection. The doctor will drill the tooth all the way to the bottom to remove the soft tissue that is the center of the infection and drain the pus. After that, the tooth that has been drilled will be fitted with a dental crown.
4. Tooth extraction
If the abscessed tooth cannot be saved, the doctor will extract the tooth. After that, the pus will be removed to eliminate the infection.
While still in the healing stage, patients will be advised to undergo home treatment to relieve pain, namely by gargling with salt water and taking painkillers.
Complications of Dental Abscess
People with untreated tooth abscesses are at risk of experiencing several complications, including:
- Dental cyst
- Sinusitis
- Osteomyelitis or bone infection
- Ludwig’s angina or submandibular abscess in the floor of the mouth
- Sepsis or a fatal immune system reaction due to infection spreading throughout the body
Prevention of Dental Abscess
The most important way to prevent a tooth abscess is to prevent tooth decay. Some steps you can take are:
- Brush your teeth twice a day with toothpaste containing fluoride.
- Use dental floss to clean between your teeth every day .
- Replace your toothbrush regularly every 3 months.
- Avoid using mouthwash after brushing your teeth, as it can eliminate the benefits of toothpaste.
- Reduce consumption of foods and drinks containing sugar and flour, especially between meals or before bedtime.
- Regularly check your dental health with a dentist every 6–12 months.
References:
Ahmadi, H., Ebrahimi, A., & Ahmadi, F. (2021). Antibiotic Therapy in Dentistry. International Journal of Dentistry, 2021, pp. 1–10.
Haque, M., Sartelli, M., & Haque, S. (2019). Dental Infection and Resistance—Global Health Consequences. Dentistry Journal, 7(1), pp. 1–19.
American Dental Association (2022). Mouth Healthy. Abscess (Toothache).
Kids Health (2020). For Kids. Going to the Dentist.
National Health Service UK (2019). Health A to Z. Dental Abscess.
National Institute of Health (2020). MedlinePlus. Tooth Abscess.
Cleveland Clinic (2020). Disease & Conditions. Abscessed Tooth.
Mayo Clinic (2021). Diseases & Conditions. Sepsis.
Mayo Clinic (2019). Diseases & Conditions. Tooth Abscess.
Bhargava, H, M. WebMD (2020). Tooth Abscess.
Santos-Longhurst, A. Healthline (2019). Abscessed Tooth: What You Need to Know.