An abscessed tooth goes by many names- tooth abscess, periapical abscess, dental abscess and tooth infection. However, the pain, danger, and expense is equivalent…no matter what you call it. An abscessed tooth is essentially just an often very painful infection that occurs at the tip of the tooth root, between the gums, and the tooth itself.
The infection is mainly caused by tooth decay, but can also occur from trauma or excessive pressure from gum disease. The tooth is made of layers. The center, or dental pulp, is the only part of the tooth that is sensitive to pain; so, it is the most well protected part of tooth. However, if a tooth cracks or develops a deep cavity, the pulp of the tooth can be exposed to bacteria. As the infection progresses, the pulp dies, pockets of pus may form, and left untreated…the infection may spread to alveolar bone, neighboring teeth, and other tissue.
Symptoms vary per person and degree of infection. Often the tooth and surrounding gum area is very painful and swollen. At other times, the person may have a little tooth sensitivity or no pain at all. The general symptoms are:
- Tooth pain/ toothache
- Pain when chewing
- Pain when drinking hot or cold fluids
- Bad breath odor
- Bitter taste in the mouth
- Flu like symptoms
- Swollen glands
- Swelling in jaw
- An open/draining sore on the gums
- Redness around the gums
- Pain opening and closing the mouth
It is also important to note that if the infection goes on untreated, the root of the tooth may die, and the tooth pain may stop. This does not mean that the infection has stopped, though.
Complications and Dangers:
An untreated abscessed tooth can be very serious, dangerous, and even life threatening. Left untreated, the infection in the tooth can spread to the sinuses, jaw, throat, heart, brain, etc.. It can compromise the immune system, result in loss of tooth, disfiguring jaw bone damage, neighboring tooth damage and/or loss, heart damage (endocarditis) , brain abscess, sepsis, etc… At worst, the infection may become life -threatening, causing coma, extended hospitalization, and even death.
Mediastinitis and Ludwig’s angina are rare complications of tooth abscesses, but have very high mortality rates. Mediastinitis occurs when the inflammation from the infected tooth spreads to the mediastinum. The mediastinum area includes your heart, major blood vessels, esophagus, larynx (windpipe), etc.. Ludwig’s angina is when the infection spreads to the soft tissues around the floor of the mouth. The cellulitis and infection compromises the airway, and makes breathing and swallowing difficult.
Treatment of Tooth Abscess:
This is the part that no one wants to talk about, but it is so important to avoid the complications listed above with routine dental exams and early intervention at the first sign of a problem.
The primary treatment goal with an abscess is to eliminate and stop the spread of infection and preserve or repair the tooth. To remove the infection, the infected pulp tissue, bacteria, and debris are removed (root canal.) The tooth is then left open to allow pus to drain. In severe infections, the tooth may have to be removed. The pus will then drain directly from the socket or from an incision into the swollen gum tissue. Antibiotics before and after dental work are also used to fight the infection. You don’t want to wait and end up with this-
Prevention of Tooth Abscess:
Unless you are sadist, the above most likely does not sound like an appealing experience. Prevention can save you a lot of pain and money.
- Good oral hygiene program
- Develop a specialized dental plan with your dentist if you have certain diseases, like diabetes, that increase the risk of dental problems.
- Brush and floss teeth regularly
- Antiseptic mouthwash
- Low sugar diet
- Regular dental checkups
- Prompt treatment tooth injury and trauma
- Prompt treatment of dental caries