Tooth Abscess
(Dental Abscess, Abscessed Tooth)
Definition
A tooth abscess is a sac of pus (infected material) in a tooth or the gums that results from bacterial infection. There are two types of tooth abscesses:
- Abscess of the pulp (blood and nerve supply inside the tooth)
- Abscess between the tooth and gum
Tooth Abscess © 2008 Nucleus Medical Art, Inc.
Causes
A tooth abscess begins when bacteria invade and infect a tooth, resulting in the build-up of pus. When the pus is unable to drain, an abscess results.
Conditions that allow bacteria to invade a tooth include:
- Severe tooth decay
- Break or crack in a tooth that allows bacteria to invade the pulp of the tooth
Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in the area surrounding the tooth.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
- Build up of tartar or calculus beneath the gum line
- Inadequate fluoride application to teeth, via fluoridated water, toothpaste, or mouthwash
- Poor dental hygiene leading to untreated caries and periodontal diseases
- Malnutrition, including severe vitamin and mineral deficiencies
Symptoms
Symptoms include:
- Throbbing/lingering pain in a tooth or gum area
- Pain when biting on a tooth
- Spontaneous tooth pain
- Redness, tenderness, or swelling of the gums
- Fever
- Swollen glands in the neck
- Discoloration of a tooth
- Bad breath or foul taste in mouth
- Open, draining sore on the gums
If left untreated, complications of tooth abscess can include:
- Loss of tooth and surrounding tissues or bone
- Spread of infection to surrounding tissue or bone
Diagnosis
A dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.
The examination will include testing the tooth for pain and sensitivity by:
- Lightly tapping on the tooth
- Stimulating the tooth nerve with heat or cold
- Stimulating the tooth nerve with a low electrical current
- Sliding a probe between the tooth and gum to measure gaps or loss of tissue
Your dentist will also take an x-ray of the tooth and surrounding bone.
Treatment
Treatment includes:
Removal of Abscess Via Root Canal
-
If an abscess results from tooth decay or a break or crack in the tooth:
- The tooth and surrounding tissue is numbed and a hole is drilled through top of the tooth.
- Pus and dead tissue are removed from the center of the tooth.
- The interior of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
- A crown is placed on the tooth to protect it.
-
If an abscess results from infection between the tooth and gum:
- The abscess is drained and thoroughly cleaned.
- The root surface of tooth is cleaned and smoothed.
- In some cases, surgery to reshape the gum is performed to prevent recurrence of infection.
Tooth Extraction (Removal)
-
Removal of the tooth may be required if:
- Tooth decay and/or tooth infection is too extensive for filling or root canal treatment.
- The break or crack in the tooth is too severe to be repaired.
- The infection or loss of tissue/bone between the tooth and gum is extensive.
-
If the tooth is extracted, it will be replaced with:
- A partial bridge
- A denture
- A tooth implant
Medication
- Antibiotics to fight residual infection of the tooth or gums
- Nonprescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses
Prevention
Most tooth abscesses can be prevented with:
-
Proper dental hygiene, including:
- Brushing teeth with fluoride toothpaste after meals or at least twice per day
- Daily flossing between teeth and gums
- Regular dental check-ups (every six months)
- Regular professional teeth and gum cleaning (every six months)
RESOURCES:
Academy of General Dentistry
http://www.agd.org/consumer
American Dental Association
http://www.ada.org
CANADIAN RESOURCES:
Canadian Dental Association
http://www.cda-adc.ca
The Canadian Dental Hygienists Association
http://www.cdha.ca/
References:
American Dental Association website. Available at: http://www.ada.org .
The Merck Manual of Medical Information—Home Edition . Simon and Schuster, Inc.; 2000.
US National Library of Medicine website. Available at: http://www.nlm.nih.gov/ .
Last reviewed October 2007 by Laura Morris-Olson, DMD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.
