A tooth abscess is a dental emergency that can cause significant pain and discomfort. It occurs when tooth decay or an injury allows bacteria to enter the tooth, and a pus-filled sac forms around on tooth root, gum tissue, or the bone supporting the tooth. If left untreated, a tooth abscess can spread to other teeth, the jawbone, or the rest of the body.
It is essential to be aware of the different tooth abscess stages so that you can seek treatment as soon as possible. If you think you may have a tooth abscess, contact a dentist immediately to avoid any future complications.
What is a Tooth Abscess?
A tooth abscess is a potentially serious dental emergency that can occur due to bacterial infection. It typically develops after a tooth becomes cracked or chipped, allowing bacteria to enter the pulp. However, an abscess can also occur in cases of severe gum disease, where bacteria has already damaged the tissue around the tooth.
An untreated tooth abscess can spread through the tooth’s roots and into the surrounding bone. There are typically three types of tooth abscesses:
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Gingival Abscess
A gingival abscess is a localised collection of pus within the tissues of the gums. The most common cause of a gingival abscess is an infection that develops in response to plaque buildup on the teeth.
However, other factors such as trauma, foreign bodies, and underlying medical conditions can also contribute to the development of a gingival abscess. Symptoms of a gingival abscess include pain, redness, and swelling in the affected area. Treatment for this dental emergency typically involves draining the pus and addressing the underlying cause. Your dentist may also prescribe antibiotics to clear the infection.
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Periapical Abscess
Periapical abscesses are pus-filled infections at the root of the tooth. They most often happen due to untreated tooth decay or a crack in the tooth that allows bacteria to enter.
Symptoms of a periapical dental abscess include pain, swelling, and sensitivity to heat and cold.
Treatment for a periapical abscess dental emergency typically involves antibiotics to clear the infection and a root canal procedure to remove the damaged tissue from the tooth. In some cases, the tooth may need to be extracted.
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Periodontal Abscess
A periodontal dental abscess is a pocket of pus that develops in the tissues and bones that support the teeth, such as the periodontal ligament. The infection occurs when bacteria get trapped in the spaces between the teeth and gums, where they can multiply and cause damage to the tissue.
Periodontal abscesses can be very painful, and they may make it difficult to eat or drink. If left untreated, they can also lead to tooth loss.
Common Symptoms of Tooth Abscesses
The most common symptom of a tooth abscess is severe pain, which may be constant or intermittent. Other possible symptoms include:
- Swollen gums: The gums may appear red, swollen, or hot to the touch. A large pimple-like growth may also appear on your gums.
- Bad breath: The bacteria in a dental abscess often release sulphur compounds which emit a foul-smelling odour that can be detected in your breath.
- Fever: A fever may occur due to the infection spreading to other body parts. Contact an emergency dentist immediately if your fever reaches over 39°C, and you have accompanying abscess symptoms.
- Difficulty opening the mouth due to pain or discomfort: This may make it difficult to eat or speak.
Tooth Abscess Stages
When a tooth becomes infected, the body responds by trying to fight the infection. This process often results in an abscess, a collection of pus that forms around the site of the infection.
There are typically five tooth abscess stages, each characterised by different symptoms. Treatment will vary depending on the stage of the abscess. The tooth abscess stages include:
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Enamel Decay
Enamel decay is the first of the tooth abscess stages. Enamel is the hard outer layer of the tooth that protects it from damage. When bacteria build up on the outer layer of the tooth, the acidic byproduct of their metabolism erodes and damages the enamel surface. When enamel decay begins, the tooth starts to break down, allowing bacteria to enter the tooth and causing a tooth abscess.
Enamel decay can be treated with dental fillings. However, once tooth decay has progressed to the next stage, it can only be treated with dental surgery.
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Dentin Decay
Dentin decay is the second of the tooth abscess stages at which tooth enamel is broken down and destroyed. Dentin is the semi-hard layer between the enamel and the pulp. It contains minuscule tubules that connect to the nerves in the pulp; this means an infection that has progressed to this stage can be severely painful.
At this stage, the acid has eroded through the enamel and infected the dentin. The tubules also allow the bacteria to pass through to the pulp, often resulting in a tooth abscess.
Once bacteria has reached the tooth’s pulp, it can only be treated with a root canal procedure or tooth extraction.
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Infected Tooth Pulp
If a tooth abscess is left untreated, it can eventually lead to the infection spreading to the tooth’s pulp. This third stage of the tooth abscess stages most often occurs due to prolonged exposure to bacteria over time.
At this stage, the affected area may become very sensitive and painful, making it difficult to eat or drink. In severe cases, the infection can spread to other body parts like the brain or lungs, which can be life-threatening.
Treatment for an infected tooth pulp usually involves a root canal procedure, in which the damaged pulp is removed, and the tooth is cleaned and sealed.
Although it may be uncomfortable, this treatment is typically effective in eliminating the infection and restoring the tooth’s health.
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Tooth Loss
If a tooth abscess is left untreated for an extended period, it will eventually become a dental emergency and lead to the loss of the affected tooth. This occurs when the infection severely damages the periodontal ligament and erodes the jawbone that holds the tooth in place.
Treatment at this stage usually involves extracting the damaged tooth. In some cases, replacing the tooth with a dental implant or another prosthetic device may be necessary.
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Systemic Infection
At the final stage of a tooth abscess stages, a systemic infection or sepsis can occur if the infection spreads to other parts of the body. This often happens due to bacteria from an infected tooth entering the bloodstream.
Symptoms of sepsis may include fever, chills, rapid heartbeat, shortness of breath, confusion, and excessive sweating. If left untreated, sepsis can potentially lead to organ failure, shock, and even death.
Treatment for a Dental Abscess
Several different approaches can treat a dental abscess, depending on the severity of the infection and the underlying cause. The most common non-invasive treatment method is using antibiotics to clear the infection. Other possible treatments may include:
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Incision and Drainage
To treat an abscessed tooth, a dentist will perform a procedure known as incision and drainage. This involves making a small cut in the gum tissue to allow the pus and bacteria to drain out.
In some cases, your emergency dentist may also need to place a drainage tube in the affected tooth to prevent the infection from returning. In most cases, incision and drainage successfully treat an abscessed tooth and restore oral health.
You’ll also be prescribed antibiotics such as amoxicillin, penicillin, azithromycin, metronidazole, or cefoxitin. Ensure you notify your dentist if you are allergic to antibiotics before undergoing treatment.
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Root Canal Treatment
In a root canal treatment procedure, the dentist opens the crown with a dental burr to expose the root canal. The emergency dentist removes the pulp and tooth nerve, and the root canals are smoothed and sterilised. The tooth is then filled with a material called gutta-percha and sealed with a dental filling. In some cases, you may also need a dental crown to cover the tooth if it has insufficient remaining structure.
The procedure is usually performed under local anaesthesia, but sedation may be used for patients with anxiety or severe dental phobia.
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Tooth Extraction
If the tooth is too badly damaged to be treated with a root canal, it may need to be extracted by an emergency dentist. This procedure involves removing the entire tooth and its root from the dental socket using a dental elevator, forceps, and a dental drill.
In some cases, removing some of the surrounding bone or tissue damage may also be necessary to fully extract the tooth.
Discuss tooth replacement options with your dentist to prevent complications from a missing tooth, such as tooth misalignment or continued bone resorption. Some common treatments for missing teeth include bridges, dentures, and dental implants.
Visit an Emergency Dentist for Dental Abscess Treatment
A dental abscess is a serious dental emergency that can cause severe pain and lead to other health complications if left untreated. If you think you may have a dental abscess, it is essential to see an emergency dentist as soon as possible for treatment.
At Port Macquarie Dental Centre, our experienced team can provide the care you need to effectively treat your dental abscess to avoid a more invasive dental emergency. We also offer a wide range of general dentistry services to help keep your smile healthy and beautiful. Contact us on (02) 6105 9853 today to book an appointment.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Incision and Drainage
https://www.ncbi.nlm.nih.gov/books/NBK556072/
Gutta-Percha: What Is It?
https://www.colgate.com/en-us/oral-health/root-canals/gutta-percha-what-is-it-and-when-is-it-used
Tooth Extraction: Procedure, Cost, Aftercare & Recovery Time
https://askthedentist.com/tooth-extraction/