Abscess

A dental abscess is a collection of pus (a thick fluid which contains dead tissue, white blood cells and bacteria) which forms around the teeth or gums due to a bacterial infection. Bacteria occurs in plaque, a byproduct of saliva, bacteria in the mouth and food. This can damage your gums and teeth and may eventually spread and infect the soft tissues to form an abscess. There's two main kinds of abscess; the Periapical and the Periodontal abscess. If left untreated abscesses can 'burst' leading to discharges of pus and several other complications including; infections of the surrounding bone, spread of infection to the sinus, dental cysts and other serious infections.

Periapical Abscess

This kind of abscess begins in the centre of the tooth in an area known as the dental pulp. This is by far the most common type of abscess and usually occurs due to a complication of tooth decay. Almost everyone experiences some form of dental decay and this can damage and erode the outer layers of the tooth known as the enamel and dentin. The damaged tooth allows bacteria to access the inner tooth and cause an infection. A pulp infection can often progress to form a fully blown abscess but this may also occur if the nerve of the tooth 'dies' whether due to injury or because of a medical issue, the dead nerve tissue has a greater tendency to become infected.

Periodontal abscess

This kind of abscess begins life in the support structures of the teeth in areas like the periodontium, located between the gums and teeth. In the vast majority of cases periodontal abscess develop due to a complication of gum disease or any infection of the tissues surrounding the teeth. In many cases of gum disease, the gum can become separated from the tooth causing nooks and crannies where bacteria can collect and gather to form an abscess. Periodontal abscesses can also form as a side effect of injury to the gums or surrounding structures. They are also known as 'gum boils' due to the fact they sometimes cause swelling to develop.

Symptoms

The most common symptom associated with abscesses is toothache, which can quickly worsen, this can be severe and may accompany swelling in the gums. Swelling of the face may also occur with the kin directly above an abscess becoming inflamed. Abscesses can loosen teeth and may cause excessive sensitivity. Medical issues can also occur due to abscesses such as spasms in the jaw muscles and a fever, you may also experience difficulty breathing or swallowing.

Treatment

If you think you have an abscess it's important to contact your dentist as soon as you can. The initial treatment is to drain the pus which usually provides relief for several symptoms. This is usually performed by drilling a small hole in the affected tooth so the pus can escape or by lancing the abscess. It's not uncommon to be prescribed antibiotics for a few days following draining in order to clear any remaining infections but for many cases draining is sufficient. If, for any reason you can't get to see a dentist you may be prescribed antibiotics to help prevent the spreading of the abscess by a doctor. It's important to note that this won't drain the pus or cure the abscess and you will still need to see a dentist. Until you can get treatment you may need painkillers like ibuprofen or paracetamol to deal with any discomfort. If the pain becomes excessive you may need stronger painkillers to be prescribed by a doctor. In addition to this different types of abscess may require different treatments. For instance, in the case of a periapical abscess the treatment is a normal root canal operation. This treatment is used in order to save and restore the inner part of the tooth which has been damaged. Your dentist will drill a tiny hole into the tooth, which will allow any pus to escape before removing any dead tissue and inserting a root filling. This will help to fill the space and protect against any more infection. If this treatment is unsuccessful and the infection carries on then your dentist may be required to extract the offending tooth. For periodontal abscesses your dentist firstly cleans the 'pocket' in which the abscess has formed before smoothing out the root surfaces of your tooth which should prompt the gum to close back onto the tooth. This will help protect against any future infections, however if more infections do occur it may be necessary to undergo oral surgery to reshape the affected gum tissue.

Prevention

It's possible to protect against the formation of dental abscesses by maintaining a decent level of oral hygiene. Regular brushing and flossing along with maintaining a healthy diet with a minimum of sugary food and drinks. Similarly if you smoke then quitting will greatly improve your oral hygiene. It's also important to have regular dental check ups to make sure everything is normal.