What is a Dental Abscess?

If you have been diagnosed with an abscess, your dentist should schedule some further treatment to deal with the problem, and they should also make you aware of the various causes of dental abscesses. In medical terms, an abscess is a pus-filled swelling that can affect the inside of your tooth, or the soft tissue around it. There are two different types of abscess; a periapical abscess (inside the tooth) and a periodontal abscess (on the gums), both of which are signs of bacterial infection, which needs to be treated immediately, before it deteriorates to a serious degree.

What causes an abscess to form?

Periapical abscesses are normally the result of dental decay – a common ailment among adults in the UK, and can cause further problems with general health, if they are not dealt with properly. As decay begins to take hold, cavities form in the hard outer layer of the tooth, eventually eating a tunnel right through to the centre of it, where the nerve endings and blood vessels are stored in soft tissue. The area at the centre of the tooth is called the pulp chamber, and once this has been exposed to harmful bacteria, it will become infected and die. If the infection is not adequately treated, the bacteria will spread through the root and down into the supporting bone, and eventually to the rest of the teeth. It is at this point that abscesses begin to form, as the infection penetrates the bone and moves freely into the circulatory system that keeps the gums healthy. Periapical abscesses will develop when the body tries to flush the bacteria out, and without treatment the patient is putting their teeth at risk, as well as their overall health.

Periodontal abscesses are slightly more difficult to deal with, because they are caused by aggressive bacterium that are present during the first stages of gum disease, and it’s not always easy to diagnose the initial symptoms of this type of problem. As the disease progresses, it causes inflammation and bleeding around the gums – which should alert the patient that something is wrong , even if the signs are not immediately painful. If treatment is not sought – or is unsuccessful for some reason – the tissue around the teeth will begin to pull away, leaving a gap between the gums and the roots of the teeth, which is referred to as a periodontal pocket. This cavity is very difficult to clean and gives the bacteria access to the roots beneath the gum line, where the abscess will form as the infection starts to build up.

Unlike periapical abscesses, the periodontal variety are not as easy to avoid either; it’s not just a question of adequately cleaning your teeth to avoid decay. Periodontal pockets can form even if the patient does not have gum disease, sometimes as the result of a dental procedure, or perhaps after an accident that has caused trauma to the gums. This is why it is very important to have your mouth checked over by a professional, even if there is no obvious injury after an accident; often the very troublesome symptoms are lurking beneath the surface.

How are teeth abscesses treated?

If you are worried about dental abscesses, you could always give the Pearl Dental Clinic a call and speak to a member of the team about your situation; they offer the best dental care in comfortable, safe surroundings. It’s vital that you seek treatment for an abscess as soon as you notice the swellings appearing on your gums, or if you feel a painful toothache with no obvious cause. Your dentist should begin by first examining your mouth externally, and then by taking x-rays to pinpoint the nature and extent of the problem – this is particularly helpful with periapical abscesses, as they are formed out of sight, beneath the tissue.

The key to treating an abscess is drainage and disinfection, which removes the contaminated fluid and cleans out any remaining bacteria, but it’s also worth remembering that there is generally an underlying issue, such as tooth decay or periodontitis (gum disease), that is causing the problem to surface, and it’s important that these ailments are addressed as well.

Most patients who suffer with a periapical abscess will have to have a root canal performed, because there is no other way to deal with pulpitis (the diseased pulp) effectively. First the fluid has to be drained away and the dead tissue removed, then the empty canal needs to be washed out, using antiseptic solution, to get rid of any infected particles or bacteria that may still be present. In order to keep the tooth functioning as normal, the dentist will then reshape the canal so that a filling can be fitted; this holds the structure of the tooth intact, and allows the patient to avoid an extraction – although the tooth will no longer be sensitive to changes in temperature, as the nerve endings have been removed. In the majority of cases, the dentist will chose to fit a crown over the fragments, in order to protect the remaining sections and to make it more aesthetically pleasing. Crowns are generally made out of hard-wearing porcelain that is matched perfectly to the shape and shade of the surrounding teeth.

Treatment for periodontal abscesses is based upon the same principle of removing the fluid and cleaning the area, except this is carried out above the gums, and doesn’t usually require the teeth to be drilled into at any point. The periodontal pocket will be drained and then thoroughly cleaned, before a process called scaling and planing is performed; this involves cutting away dead or infected skin and smoothing out the surface of the roots, in order to allow healthy tissue to grow through from underneath.

Both treatments may also require a course of antibiotics, if the infection has taken hold to a significant extent. Antibiotics will help fight the remaining bacteria in the circulatory system, and play an essential part in getting rid of infection permanently, your dentist or GP will be able to prescribe them for you, and provide you with instructions on how to take them – always pay attention to any information you are given regarding prescription medication.