Dental abscess and its treatment
One of the types of tooth decay is known as dental abscess. This is an advanced stage of dental decay in which the infection has established itself in the tooth and it is very painful. It is important to get immediate dental treatment for a dental abscess, as it can only be relieved through a dentist’s intervention.
How is a dental abscess caused?
A dental abscess is caused by bacterial action on the tooth, which causes breakdown of the dental tissues and a reaction from the body’s immune system, which leads to the buildup of pus in the area. It is the pus buildup which puts pressure on the dental nerves and causes the pain of a dental abscess.
There are different types of dental abscesses, namely tooth abscess, periapical abscess and gum abscess. A more detailed description of each is as follows:
- Tooth abscess: This is when the bacterial infection spreads beyond the outer hard tissues of the tooth and reaches the innermost living tissues, called the pulp. The innermost space of the tooth fills with pus and infected tissue. This causes an increase in the internal pressure of the tooth, causing pain.
- Periapical abscess: This is when the bacterial infection, after spreading throughout the pulp, reaches the roots of the tooth. Here, the infection spreads around the root tips, with the inflammation causing a walling off of the infection and accumulation of pus. The pain may cease for the period between the necrosis of the pulp and the spreading of the infection around the root, but once it establishes itself around the root, pain starts again.
- Gum abscess: This is when the infection spreads to the surrounding tissues of the tooth, which are the periodontal tissues and the gums. This may result in the collection of pus, walled off by inflammation, inside the gums.
How to tell whether the pain is from a dental abscess
The following features are characteristic of pain from a dental abscess:
- Nature of the pain: The nature of the pain is throbbing and severe.
- Duration of the pain: The pain is continuous and lasts for hours.
- Stages of the pain: At first, the pain is felt intensely. Then it tapers off as the infection builds inside the tooth and destroys the nerve supply of the tooth. Once the infection reaches the root area, the intense pain starts again.
- Pain aggravated by hot foods or drinks: The application of heat to the tooth causes pain as the gases being released from the decay process expand and increase the pressure of the tooth.
- Pain on chewing or biting: The pain may increase when the person bites or chews with the affected tooth.
How to relieve the pain of a dental abscess
As the pain from a dental abscess is mainly due to the pressure of the accumulated pus on the dental nerves, relieving the pressure relieves the pain of the dental abscess. This can be done in many ways:
- Draining the pus by use of dental instruments: This is a step carried out by a dentist, who relieves the pressure of the accumulated pus by draining it from the area. This has two benefits: it releases the pressure as well as cleaning out the infection from the area. In some cases, the pus may form a pathway through to the surface of the tissues and drain into the mouth by itself. Such a pathway is called a fistula. While this relieves the pressure, it still requires treatment by a dentist.
- Use of painkillers: Over the counter painkillers may help by reducing the pain and swelling associated with a dental abscess.
- Use of antibiotics: The dentist may prescribe antibiotics in addition to the treatment procedure of the dental abscess. The function of the antibiotics is that it helps clear out the infection in the area, but only when the pus is drained, as a walled off accumulation of pus cannot be affected by antibiotics, as there is no way for the antibiotics to reach the abscess.
- Application of cold externally: Placing an ice pack to the cheek at the area of the infected tooth can help relieve the pain and counteract inflammation.
- Rinsing the mouth with warm salt water: Rinsing the mouth with salt mixed in warm water can help relieve the pain and clear out the mouth of any pus that has drained out into the mouth on its own.
What the dentist can do for a dental abscess
There are different ways a dentist can approach the treatment of a dental abscess. The first step of treatment is to remove the infection and the following step is to restore the tooth. The two options for dental treatment are:
- Root canal: After draining the pus from the abscess, the dentist has to carry out a root canal. The root canal treatment involves removing the innermost infected pulp tissue from the tooth, treating it with chemicals, filling the roots with an inert material, and restoring the tooth with a crown. The root canal treatment ensures that all the infection is removed from the tooth, as well as the diseased pulp, and the tooth is restored in both structure and function. The dentist may carry out the root canal in stages, opting first to drain the pus, then allow the time between dental appointments for antibiotics to act, then following up with the root canal treatment itself.
- Extracting the tooth: If the tooth is decayed beyond saving, or all other treatments fail, the dentist has to remove the tooth itself. This ensures that all the infection has been removed from the mouth, as keeping a decayed tooth in the mouth when it cannot be saved is a way of keeping the infection in the mouth.
A dental abscess must be considered a dental emergency and dental care must be sought immediately in order to remove the infection before it spreads further. If you cannot get a timely appointment with your regular dentist, seek emergency dental care as soon as possible.