Dental Abscess
Information on the most common causes, symptoms, and treatments for pus accumulation in teeth or gums.
Symptoms and causes
A dental abscess occurs when pus accumulates in a tooth or the surrounding tissue as a result of a bacterial infection. This exudate, composed of infected tissue and dead cells, can accumulate in a preexisting cavity or within a newly formed sac.
Depending on the location, there are three types:
- Periapical abscess: the most common type, located at the root of the tooth.
- Gingival abscess: forms in the gum without affecting deeper tissues.
- Periodontal abscess: located in the tissues supporting the tooth (periodontium), which include the alveolar bone, periodontal ligament, root cementum, and gum. Although less common, it is more difficult to treat.
The prognosis of a dental abscess is usually good if appropriate treatment is received. However, if not detected in time and the infection spreads, it can lead to serious complications.
Symptoms
Common symptoms of a dental abscess include:
- Severe pain.
- Sensitivity when chewing or biting, especially with very cold or hot foods.
- Swelling at the base of the mouth, jaw, or cheek (cellulitis).
- General malaise.
- Fever not exceeding 38 °C.
- Difficulty opening the mouth.
- Bad breath (halitosis).
- Headache, ear, or throat pain.
- Swollen lymph nodes in the neck.
Causes
The main cause of a dental abscess is a bacterial infection, which can occur due to various factors:
- Dental caries: cavities in teeth or molars that facilitate bacterial accumulation.
- Gingivitis: infection and inflammation of the gums.
- Periodontitis: an advanced stage of gingivitis in which the infection reaches the alveolar bone supporting the teeth.
- Trauma: if a tooth or molar breaks due to an impact and the pulp tissue becomes necrotic, bacterial proliferation is facilitated.
Risk Factors
The risk of developing a dental abscess is higher in the following cases:
- Poor oral hygiene.
- Excessive consumption of sugary foods and beverages.
- Dry mouth, since saliva helps reduce the risk of caries.
- Smoking.
- Diabetes.
Complications
A dental abscess can cause complications if the infection spreads, potentially leading to:
- Tooth loss.
- Chronic cysts in persistent infections.
- Infection of the jawbone (osteomyelitis).
- Neck infections, characterized by swollen lymph nodes.
- Rarely, brain infection.
- Sepsis: a systemic infection that can be life-threatening.
Prevention
To prevent dental abscesses, it is recommended to:
- Brush teeth for two minutes after each meal.
- Use dental floss daily.
- Avoid sugary foods.
- Undergo regular dental cleanings.
- Attend routine dental check-ups.
Which Specialist Treats a Dental Abscess?
A dental abscess is primarily managed by dentistry specialists, and in some cases, oral and maxillofacial surgery.
Diagnosis
The diagnosis of a dental abscess is primarily clinical. After reviewing the patient’s medical history and symptoms, the specialist performs a physical examination to:
- Observe the appearance of the teeth and gums for signs of infection (swelling, redness, pus).
- Assess tooth sensitivity by gently tapping them.
To confirm the presence of an abscess, a radiograph is performed, allowing visualization of the interior of the tooth and surrounding bone. This test helps determine the extent of the infection.
Treatment
Treatment of a dental abscess combines medication with a dental procedure:
- Pharmacological treatment: antibiotics are administered to eliminate the infection. Analgesics are also usually prescribed to relieve pain.
- Dental treatment: the appropriate technique is selected depending on the type and severity of the abscess:
- Drainage: an incision is made to allow pus to exit and relieve pressure in the tissues.
- Endodontic therapy: a hole is made in the tooth to remove the damaged pulp and clean the root canal.
- Extraction: if the tooth is severely damaged, it is completely removed.
