Dental abscesses are pus-filled pockets that can form in various locations near the tooth. A dental abscess is formed due to an untreated bacterial infection; they are a relatively common ailment but should be considered a dental emergency.
Since they result from an infection, it is vital to receive early treatment from an emergency dentist to prevent the infection from spreading or tooth abscess symptoms from worsening. If left untreated, the infection can cause bone deterioration, tooth loss, and spread to other body parts, causing severe complications or death.
Types of Dental Abscess
There are three types of dental abscesses: gingival, periapical, and periodontal. The location of the dental abscess can influence the symptoms you experience and the treatment you need.
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Gingival Abscess
A gingival abscess is a dental abscess located in the gums above the teeth and is one of the more common types of dental abscesses. It typically only affects the gums’ soft tissues, not the periodontal ligaments or underlying bone.
This type of dental abscess often initially appears as a discolouration on the gums. As it progresses, this discolouration gradually grows and swells, and a pocket filled with pus forms. In the advanced stages, a gingival abscess looks like a pimple on the gums.
If left untreated, a gum abscess can cause severe complications; as the abscess grows, the bacteria eats at the gum and bone, which creates a tunnel-like cavity called a fistula. To avoid the progression of a gingival abscess, it is important to see an emergency dentist at the first sign of formation.
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Periapical Abscess
A periapical dental abscess forms at the end of the tooth’s root. They are most commonly caused by a bacterial infection, usually due to bacteria collecting in a dental crack or cavity. These abscesses are often accompanied by severe pain, which generally worsens with chewing. In severe cases, the pain can radiate to other areas of the head or neck.
Like gingival abscesses, periapical abscesses should be considered a dental emergency and must be treated promptly to avoid the progression of symptoms or the spread of infection.
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Periodontal Abscess
Periodontal abscesses are different from the other two types since they are usually associated with periodontal disease. An infection causes the gums to pull away from the teeth, forming pockets where bacteria can develop and form into pus. When the pus can’t drain, it forms an abscess.
This dental abscess is associated with severe pain and develops more rapidly than other abscesses. Periodontal abscesses should be considered a dental emergency and must be treated by an emergency dentist at the initial onset of symptoms to avoid severe complications.
Tooth Abscess Symptoms: Swelling
One of the most common tooth abscess symptoms is inflammation or swelling. In the early stages of the condition, the swelling may be localised to the affected tooth or gum region.
As the abscess progresses, the swelling may spread to nearby areas, including the lymph nodes, face, cheeks, or neck. If left untreated, the swelling can make breathing or swallowing difficult.
Tooth Abscess Symptoms: Tooth Pain
The pain typically associated with a dental abscess can be described as constant and throbbing pain in the affected area. While the severity of the pain can vary, it is usually severe, particularly in the advanced stages.
In severe cases, the pain may radiate to the jaw, ears, or neck. Often, the pain is worsened by exposure to hot or cold temperatures, contact with the affected area, or chewing.
Tooth Abscess Symptoms: Bitter Taste in the Mouth
Individuals affected by a dental abscess often report a foul taste in their mouth while the abscess is present. The taste is usually described as bitter and results from pus draining from the abscess into the mouth.
Tooth Abscess Symptoms: Increased Tooth Sensitivity
Another of the most common tooth abscess symptoms is increased tooth sensitivity. While this sensitivity can vary between patients, hot, cold, or sweet sensitivity is the most common. Some types of tooth abscesses (periodontal abscesses, in particular) can lead to sensitivity to touch. Sometimes, the sensitivity can spread to nearby teeth.
Tooth Abscess Symptoms: Bad Breath
Bad breath is another commonly-experienced symptom of tooth abscesses. Pus drainage causes an increased presence of bacteria. Bacteria produce sulphur byproducts, which can cause the saliva to take on a rotten egg-like odour.
Tooth Abscess Symptoms: Open Draining Sore
Patients suffering from a tooth abscess often experience an open, draining sore on the side of their gums. The drainage is fluid pus that accumulates as a result of the infection. This sore often causes a burning pain aggravated by contact or chewing.
Tooth Abscess Symptoms: Fever and Nausea
Like other infections, dental abscesses can cause fever and nausea. Since abscesses are infections, patients will often experience general symptoms of illness. Fever and nausea indicate a spreading, systemic infection; if you are experiencing those symptoms, you must visit the Emergency Department (ED) immediately, as the spreading infection may be life-threatening.
A high-grade fever is usually defined as a temperature over 38.5°C; if you have an elevated body temperature below that threshold, you should take an over-the-counter medication like acetaminophen or ibuprofen to control the fever.
Is an Abscess a Dental Emergency?
An abscess should be considered a dental emergency. If caught in the early stages of the infection, the abscess can likely be easily treated, and you can avoid the worst of the associated symptoms.
However, the abscess can become a severe dental emergency if you are not treated when the first signs are detected. This includes the spread of the infection to nearby structures and bones, which could put your life at risk.
The infection may affect the bloodstream if your abscess continues to go untreated. To fight this, your body will initiate a body-wide inflammation response called sepsis. This can lead to various serious outcomes, from organ failure to septic shock.
Another potentially life-threatening complication that can arise as a result of an untreated dental abscess is a brain abscess. If left untreated, the dental abscess infection may spread to the brain, causing potentially fatal brain inflammation. Watch for the following symptoms, which can indicate a brain abscess:
- Fever
- Severe headache, often in only one portion of the head
- Confusion, irritability, or other mental state changes
- Blurry, grey, or double vision
- Muscle weakness
- Speech problems
- Partial paralysis
- Seizure
Dental Abscess Treatment
Depending on the type and severity of your abscess, there are several treatments your dentist can use, including:
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Draining
To drain your abscess, your dentist makes a small incision into the abscess. This incision allows the pus to drain. Once the abscess is clear of fluid, your dentist cleans and disinfects the affected area. If there is still swelling after this procedure, your dentist may place a small drain in the abscess to allow the fluid to continue to evacuate the area.
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Root Canal
Your dentist may perform a root canal procedure to eliminate the infection and save your tooth from extraction.
To perform a root canal, your dentist opens the tooth’s crown, removes the pulp, and drains the abscess.
Your dentist then disinfects and shapes the pulp chamber, fills the cavity with gutta-percha and adds a temporary dental filling.
If you have minimal tooth structure remaining, they may place a dental crown over the top at a follow-up visit to improve the structural integrity.
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Tooth Extraction
If the abscess is so severe that the affected tooth cannot be saved through other means, your dentist may pull the tooth and drain the abscess to stop the infection.
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Antibiotic Treatment
If the abscess is treated early, the infection may not have had time to spread; if this is the case, your dentist might prescribe antibiotics to stop the infection. Your dentist may also prescribe antibiotic treatment in conjunction with other courses of dental abscess treatment as a precautionary measure.
Restore Your Dental Health with Port Macquarie Dental Centre
If you are seeing early signs of the development of a dental abscess, it is important to see an emergency dentist immediately. By seeking immediate treatment from an emergency dentist, you may be able to avoid the worst symptoms of an abscess and save your tooth.
If you think you may be developing an abscess, call Port Macquarie Dental Centre at (02) 6105 9853 to schedule an examination.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Dental Abscess
https://www.ncbi.nlm.nih.gov/books/NBK493149/
Periodontal Abscess
https://www.ncbi.nlm.nih.gov/books/NBK560625/
Dental Abscess: A Microbiological Review
https://pubmed.ncbi.nlm.nih.gov/24348613/
Dental Abscess Treatment Algorithm
https://bestpractice.bmj.com/topics/en-us/1206