Emergency Dental Care

Dental Abscess

Dental abscesses are typically noticed by the appearance of a swollen area or “pimple” on the surface of the gums along the side of the teeth. This area known as a fistula can repeatedly swell and drain, coming and going off and on as long as the tooth remains untreated.

What To Do

An abscess means that an infection has made its way into the nerve tissue deep inside of a tooth. You’ll need to call your dental office as soon as you notice symptoms of a dental abscess, because it can result in serious side effects. Your dentist will most likely set up an exam appointment where an x-ray will be taken to capture an image of the area around the root of the tooth.

If the diagnosis is truly an abscess, the affected tooth will then have a treatment plan developed as an attempt to preserve your overall level of oral health, including the tooth involved. If infection is extensive, your dentist will also prescribe you an antibiotic to take before treatment is started. In most cases, teeth that have abscesses will require root canal therapy.

Potential Causes

Abscesses are caused by bacteria that have spread through the tooth and into the nerve chamber. As a result, infection develops and causes swelling and drainage. One of the only areas for an infection to drain when it is inside of the tooth is out the root, causing an abscess.

The nerves of a tooth can be damaged by:

  • Decay that has spread rapidly through the tooth
  • Traumatic injury to the tooth
  • Leakage around an old filling or restoration

Risks Of Not Treating

Neglecting to remove active infection associated with an abscess can cause the inside of the tooth to resorb, until it is no longer restorable. The infection can also spread into surrounding bone structure and areas throughout the head. Failing to treat an abscessed tooth typically causes:

  • Tooth discoloration due to loss of vitality
  • Chronic infections in the mouth
  • Inability to restore the tooth due to extensive damage
  • Spread of decay to other teeth
  • Bone loss
  • Loss of the tooth

In very rare circumstances, abscesses have been know to spread into the brain and even require hospitalization.

Benefits Of Treating

Treating an abscessed tooth can be very predictable and successful thanks to root canal therapy. During a root canal procedure, the remaining damaged tooth structure is removed, along with the infected nerve tissue. A medication is then placed inside of the tooth and the nerve chamber is sealed off with a filling material. This prevents infection from progressing or returning, as there is no more bacteria present and the access to the area inside of the tooth is blocked off.

By treating the tooth, abscessed teeth can remain in the mouth for several more years to come. Otherwise the tooth would be lost completely. Teeth treated endodontically are usually restored with a full coverage crown; allowing them to function just as well as it did before the abscess occurred. This is because non-vital teeth are brittle and very susceptible to chips or fractures. Placing a crown over the tooth allows the tooth to bear a normal load when you’re chewing or biting.

Alternative Treatments

One of the biggest requests that people have is to treat their infection with antibiotics and not have the tooth treated unless pain continues to return. They may complete 2 or 3 rounds of antibiotics in the meantime. This not only is an ineffective way to “treat” the tooth, but it also can result in antibiotic drug resistance. Antibiotics should only be used to remove initial infection before root canal treatment is performed.

Extraction of the tooth may be the best option if it is too damaged for root canal treatment and a crown. Or, to provide instant treatment for a patient that is not interested in restoring the tooth. If an extraction is planned, it will be necessary to decide which type of tooth replacement option is best for the patient after the extraction site has healed. An implant, bridge, or partial denture may be useful for replacing the tooth as well as retaining proper spacing and function of the teeth around it.

If you suspect that you’ve had an abscess, you should schedule an exam sooner rather than later. Simply avoiding it and hoping it will go away is not something that happens when an abscess has occurred. A short exam and x-ray can let you know if your hunch is right.