A tooth abscess is a short but serious inflammation of the tooth root and surrounding tissues, with local fever and pain. If left untreated, it turns into osteitis, periostitis, cellulitis or osteomyelitis. When it becomes chronic, it turns into a radicular cyst or pierces the oral mucosa or facial skin by giving a fistula and discharges into the external environment.
Formation of a Tooth Abscess
It usually starts as a result of inflammation of the tooth pulp due to tooth decay. Pulp inflammation (pulpitis) spreads to the root tip-periodontium of the tooth. During this painful process, the tooth is sensitive to vertical pressure from the moment the inflammation spreads to the root tip. Even the slightest contact with the tooth is painful.
Some people do not see tooth decay as a serious health problem. However, if not treated in a timely and correct manner, it can lead to a more problematic disease. Since the pus (inflammatory fluid) in the abscess is fluid, it spreads to the weakest areas under the mucosa and opens to the external environment by piercing the mucosa or skin from a weak point. This is called fistulization (fistulation, fistula formation).
Symptoms of Tooth Abscess
- Constant or throbbing pain in the tooth;
- Sensitivity to hot or cold foods and drinks;
- Pain during chewing;
- Swollen lymph nodes in the neck
- Fever and general malaise.
- Swelling that can be noticed from the outside if it is advanced
Treatment of Tooth Abscess
- Control of acute infection with antibiotics,
- If there is an abscess that is close to fistula, open and drain the abscess and apply a drain,
- Extract the tooth that is the source of the infection or completely dry the source of inflammation with endodontic treatment.
Before going to your dentist, you can try to relieve the abscess pain by taking aspirin or another pain reliever. However, do not apply aspirin directly to your tooth or the surrounding tissue. Rinsing your mouth with warm, salty water every hour can be soothing but is not curative.
In the past, the only treatment for an abscessed tooth was to have the tooth extracted. Under certain circumstances, tooth extraction may still be appropriate. However, dentists today usually treat abscessed teeth. As a first step, your dentist will likely prescribe a course of antibiotics to clear up the infection. This will prevent the infection from spreading to other parts of your body. He or she may also prescribe painkillers to help you relax.
To save your tooth, your dentist may numb the area and then drill a hole into the pulp chamber of that tooth. This will relieve the pressure. The pulp chamber is cleaned, disinfected, and filled with a material that will hold it in place. If the swelling persists after the abscessed tooth is cleaned, your dentist may order a culture to check for a disease called actinomycosis.
The next step is to place a temporary filling in the tooth. Once the infection has cleared, your dentist will likely want to see you again in a few months. When he or she sees you again, he or she will take X-rays of the tooth to see if bone and tissue have grown into the space left by the abscess. If the space looks healthy, treatment is complete. If the infection persists, additional treatments are necessary and the dentist may refer you to a specialist who will perform surgery to remove the diseased tissue (sometimes a small section including the tip of the root).
Applying Heat and Cold
This is an application that is treated with utmost care even by experts in the field. Incorrectly applied treatment can aggravate the abscess. Therefore, people who are not experts in the field (dentist or oral surgeon) should definitely not attempt such an intervention.
Applying heat or cold is related to the stage of the abscess. Heat is not applied to an acute dental abscess. This increases the fluidity of the abscess, causing it to spread into the tissue and worsen the abscess. In acute abscesses, cold can be applied to relax the patient and reduce the spread of inflammatory fluid. During the drainage of chronic abscesses, heat is applied to increase the fluidity of the abscess and ensure that it is completely drained through the opened drainage channel.
Treatment with Antibiotics
Unlike other abscesses, dental abscesses cannot be treated with antibiotics. Antibiotics relieve the dental abscess for a while, but since new infectious materials are constantly flowing from the oral environment to the dental pulp, the abscess reoccurs and the condition becomes chronic. Therefore, antibiotics are used in dental abscess treatments to relieve the abscess and control its spread. The main abscess treatment is to extract the source of the abscess, that is, the tooth, or to clean and fill it with endodontic treatment.
