Dental Abscess

A dental abscess is a confined, pus filled area that forms as a result of persistent bacterial infection. Whenever the body suffers from an infection, the immune system is activated, and white blood cells in the blood are transported to the affected site, to counter the infection. The pus, which is a mixture of dead white blood cells, bacteria, and cells from the effected tissue, is formed as a result of the body’s attempt to fight off the infection. Mostly, the pus finds a way to drain itself; however, under certain conditions, the pus becomes confined in a region, and manifests as abscess formation.

Signs and Symptoms of an Abscess

• Pain –the most common symptom is a sharp, continuous, and throbbing pain, which may or may not be relieved upon the intake of anxiolytics. In case of a periodontal involvement, pain on biting may also be present.
• Pus Drainage – although it is usually seen around the effected tooth, pus tends to find a path of drainage that allows minimal resistance to its flow. A salty or a bitter taste of the pus is noticed in the mouth.
• Sensitivity- since the cause of abscess formation is tooth exposure and dental caries, it is not uncommon to find the affected tooth sensitive to hot or cold foods.
• Halitosis- a foul smell emanating from the oral cavity can be due to the presence of pus.
• Swollen Lymph Nodes- naturally, due the protective role they play in fighting the infection, patients may notice swelling over the area where a lymph node lies under the skin.
• Fever – develops as a result of inflammation, and may be accompanied with redness of the affected area.

Where Can An Abscess Form?

An abscess can form virtually anywhere within the body. In case of the oral cavity, it mostly forms in and around the tooth roots, gingivae, and some parts of the oral mucosa.  The drainage of pus usually occurs in the vicinity of the affected tooth. However, in very long standing cases or when the pus cannot find a suitable path to drain out of the oral cavity, internal drainage starts to occur, and can result in development of life threatening maxillofacial and mediastinal infections.

Diagnosis of Dental Abscess

Diagnosis is made by evaluating the history of onset of the infection, as well as the development of classical clinical symptoms, which include pain, swelling, and pus formation. Similarly, upon taking an X-ray of the patient, the dentist may observe bone resorption around the tooth, which is caused by pus drainage. With continued bone loss, loosening of the teeth is also observed at times.

Management of Dental Abscess

The basic principle around treatment of an abscess is elimination of the source of infection. Usually, a root canal treatment, in conjunction with anti-biotic therapy and drainage of the pus, is sufficient for treating the infection. However, if the infection still persists, surgical options such as Apicocectomy, or tooth extraction, can be considered where the prognosis is found to be poor.

Prognosis

The prognosis after treatment of a dental abscess is generally good. Symptoms start to subside gradually after complete drainage of the pus, and the affected tooth is frequently saved, provided it is not grossly carious or broken down. If the infection is left untreated, the pus may create a hole in the alveolar bone and even start draining directly into the face or the neck.

Prevention

It is commonly said that prevention is the better cure. This wise statement holds true for dental infections, such as caries or an abscess. Development of virtually any dental pathology can be prevented if an immaculate oral hygiene is maintained. Similarly, visiting your dentist regularly will ensure that any signs of caries development can be diagnosed and treated at an early stage, in order to avoid future dental infections.