MORE ABOUT DENTAL ABSCESSES

 

                          MORE ABOUT DENTAL ABSCESSES

 

Written by Manuel Chikwaya

                                                        

By definition, a tooth abscess is a build-up of pus inside the tooth or the structures close by.

 

When a tooth, gums, or jaw bone get infected with germs, tooth abscesses start to form. These infections may be brought on by oral injuries, gum disease, or tooth decay.

Plaque, a by-product of food, saliva, and oral bacteria that clings to the teeth and harms the gums, contains bacteria.

 

The germs may spread into the soft tissue of the tooth or gums if the plaque is not eliminated by routinely brushing and flossing properly. An abscess may develop as a result of this.

There are basically three types of dental abscess:

Periapical abscess: this type of abscess starts in the pulp tissue of the tooth and affects the root tip.

Gingival abscess: This type of abscess is only in the gum tissue and does not affect the periodontal ligaments of the tooth itself.

Periodontal abscess: this type of abscess is common and results from bacterial accumulation or foreign body impaction in periodontal pockets. It affects the periodontal structures of the tooth.

 

                                                        

 

Symptoms

Signs and symptoms of a dental abscess include:

-Fever

-Tooth pain that may radiate to the jaw, ear, or face

-Swelling of the mouth, face, or neck

-Swollen lymph nodes around the face or neck

-A foul taste in the mouth

-Difficulties opening the mouth/trismus

-Pain in the affected area when biting or when touching the affected area

-A generally unwell feeling

-Swallowing difficulties

-Sensitivity to cold or hot food and liquids

The main symptom of a dental abscess is pain. This may be a throbbing pain and is often intense. The pain usually starts suddenly and becomes more intense over the following hours or days.

 

Stages to a dental abscess

1)Tooth decay from untreated cavities is the most frequent reason for abscesses on teeth. However, gum disease or having an open sore inside the mouth can also cause them to appear

Enamel decay: Involves injury to the tooth's outer layer. While some people may notice an increased sensitivity to heat and cold, others may not feel any symptoms at all. White patches on the teeth can result from enamel deterioration.

2)Dentin decay: This refers to deterioration of the tooth's layer of dentin. Some folks might experience discomfort or sensitivity. There could occasionally be a noticeable crack or cavity in the tooth.

3)When bacteria penetrate a tooth's deepest layer, pulp decay results. Bacteria in the tooth pulp can attack the tooth's nerve, resulting in excruciating pain. Sometimes, nerve injury results in a person experiencing intense pain at first, followed by no discomfort at all.

4)Abscess formation: An abscess develops when dental decay has advanced to the pulp of the tooth or deeper into the gums or jawbone. Along with swelling and redness of the gums, a person may experience pain close to the tooth. Fever might also be brought on by a serious abscess.

5)Loss of teeth: A tooth with serious decay may shatter or fall out.

 

CAUSES OF ABSCESSES

Periapical Abscess

Bacteria enter the tooth through microscopic holes brought on by dental decay, also known as caries, which develop in the tooth's tough outer covering. The dentine, a softer tissue layer under the enamel, eventually deteriorates due to caries. If the decay persists, the hole will eventually reach the tooth's delicate inner pulp and develop an infection.

Pulpitis is the term for this. A periapical abscess develops as the pulpitis worsens because the bacteria invade the alveolar bone, the bone that surrounds and supports the tooth.

 

Periodontal Abscess

The patient gets periodontitis when the gums are infected by bacteria found in plaque. The gums swell, which may cause the tissue encircling the tooth's root to split from the tooth's base.

When the periodontal ligament separates from the root, a minute gap called a periodontal pocket is created. The pocket is quite difficult to keep clean. An abscess called a periodontal abscess develops as germs accumulate in the periodontal pocket.

Periodontal abscesses can occur in patients after a dental operation that unintentionally create periodontal pockets. A periodontal abscess can also arise from the use of medications in untreated periodontitis, which might conceal the signs of an abscess. Gum disease can occasionally result in periodontal abscesses even if no periodontitis is not present

  

Gingival Abscess

This is caused by bacterial infection due to tooth decay, fractured teeth, rough brushing, food impaction in the gum line, or when bleeding happens in the gum line. Traumatic injury or excessive orthodontic force on the teeth can also cause gingival abscess.

 

COMPLICATIONS FROM DENTAL ABSCESSES

                                                             

Complications due to dental abscesses can occur if the abscess is left untreated. Other causes may be due to the following:

Ludwig's angina: When bacteria from a dental abscess spread, the mouth's floor became infected. Under the tongue and in the neck, there is swelling and excruciating discomfort. In serious circumstances, the patient can have trouble breathing. A potentially lethal ailment, Ludwig's angina. Antibiotics are used to treat patients. If breathing becomes difficult, those with severe Ludwig's angina might need to have an operation to open the airway.

Osteomyelitis: This condition occurs when germs from an abscess enter the bloodstream and infect a bone. The patient will feel hotter than normal, have excruciating pain in the damaged bone, and possibly feel queasy. Usually, the abscess' location will be close to the damaged bone. However, any bone in the body could be damaged since it can have entered the bloodstream. Antibiotics are administered intravenously or orally during treatment.

Maxillary sinusitis: The germs invaded the tiny cavities, or maxillary sinuses, located behind the cheekbones. Although not serious, this ailment can be uncomfortable. The patient may become feverish and experience flushed cheeks. Sometimes the illness gets better on its own. Antibiotics may be prescribed by the doctor depending on the severity.

Dental cysts: If the abscess is not treated, a cavity filled with fluid may form at the tooth's base. The term for this is a dental cyst. The cyst has a high chance of contracting an infection. The patient will require antibiotics and perhaps surgery if this occurs.

 

TREATMENT OF DENTAL ABSCESSES

Any person with signs and symptoms of a dental abscess should immediately visit a Dental Therapist, Dentist or Medical Doctor who will be able to diagnose and prescribe correct medication and a treatment plan.

People who have swallowing and breathing problems due to a dental abscess should go straight to the emergency or casualty department of their local hospital or clinic or health centre.

1) ANALGESICS AND ANTIBIOTICS MEDICATIONS

The drugs must be taken exactly as directed. Your illness could get worse if you skip doses or don't take the antibiotic at the right interval. This can necessitate more surgery and even a stay in the hospital. Painkillers serve simply to lessen pain; they cannot take the place of a trip to the dentist.

                                                                 

                                                   

 2) INCISION AND DRAINAGE

To assist in controlling an aggressive infection, a technique of incision and drainage is carried out. The doctor will administer a local anaesthetic. The tooth or teeth that are infected are frequently removed during this surgery. At the location of the infection or near the gums, a drain (rubber tube) has to be sutured in. The infection is able to "drain" through this channel.

                                                                         

                                          

 3) SCALING AND ROOT PLANING

Scaling and root planing is carried out to deep clean in and around the periodontal pockets. This procedure removes the plaque and calculus on the tooth and underneath the gum line. Scaling and root planing helps to shrink periodontal pockets and heal gum tissue.

                                                             

                                                               

                                                     

4) ROOT CANAL TREATMENT                                                      

Root canal treatment be performed when treating a periapical abscess. It involves drilling the tooth to drain out the pus. A root filling is then done to prevent subsequent infections.

                                                          

                                                     

 HOME REMEDIES

There are actions one may take to mitigate the pain and effects of dental abscesses at home.

-Use a mouthwash to reduce the bad breath

-Do not floss on the affected tooth/teeth

-Use a soft toothbrush, do not avoid brushing your teeth

-Avoid chewing food on the side that is affected/infected

-Use an Over the Counter pain reliever like Paracetamol/Tylenol

-Avoid foods and drinks that are either too cold or too hot

 

 

IN CONCLUSION

When a person exhibits signs of a tooth abscess, they should schedule an appointment with their Dental Therapist or Dentist at once. Both the abscess and its underlying causes can be treated with the proper care. A tooth abscess can be avoided by practicing good oral care and getting regular dental cleanings.

 

 

 

 

 

Acknowledgement: pixabay.com . Images for illustrations only