Tooth Abscess: Causes, Symptoms, Diagnosis, Treatment, Prevention

Definition

A tooth abscess is a sac of pus (infected material) in a tooth or the gums that results from bacterial infection. There are two types of tooth abscesses:

• Abscess of the pulp (inside) of the tooth
• Abscess between the tooth and gum

Causes

A tooth abscess begins when bacteria invades and infects a tooth, resulting in the build up of pus. When the pus is unable to drain, an abscess results.
Conditions that allow bacteria to invade a tooth include:

• Severe tooth decay
• Break or crack in a tooth that allows bacteria to invade the pulp of the tooth

Food or other foreign matter that becomes trapped between the tooth and gum may lead to a bacterial infection in that location.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Build-up of tartar beneath the gum line
• Inadequate fluoride application to teeth, via fluoridated water, toothpaste, or mouthwash
• Poor dental hygiene leading to untreated caries and periodontal diseases
• Malnutrition, including severe vitamin and mineral deficiencies

Symptoms

Symptoms include:

• Throbbing/lingering pain in a tooth or gum area
• Pain when biting on a tooth
• Redness or swelling of the gums
• Swollen glands in the neck
• Discoloration of a tooth
• Bad breath or foul taste in mouth
• Open, draining sore on the gums

If left untreated, complications of tooth abscess can include:

• Loss of tooth
• Spread of infection to surrounding tissue or bone

Diagnosis

A dentist will ask about your symptoms and medical history and perform a detailed exam of your teeth and gums.
The examination will include testing the tooth for pain and sensitivity by:

• Lightly tapping on the tooth
• Placing ice on the tooth
• Stimulating the tooth nerve with a low electrical current
• Sliding a probe between the tooth and gum

Your dentist will also take an x-ray of the tooth and surrounding bone.

Treatment

Treatment includes:

Removal of Abscess Via Root Canal

• If abscess results from tooth decay or a break or crack in the tooth:

1. The tooth is numbed and a hole is drilled through top of the tooth.
2. Pus and dead tissue are removed from the tooth.
3. The interior of the tooth and the root (nerve) canals are cleaned and filled with a permanent filling.
4. A crown is placed on the tooth to protect it.

• If abscess results from infection between the tooth and gum:

1.  The abscess is drained and thoroughly cleaned.
2. The surface of tooth is smoothed.
3. In some cases, surgery to reshape the gum is performed to prevent recurrence of infection.

Tooth Extraction (Removal)

• Removal of the tooth may be required if:

1. Tooth decay and/or tooth infection is too extensive for filling or root canal.
2. The break or crack in the tooth is too severe to be repaired.
3. The infection between the tooth and gum is extensive.

• If the tooth is extracted, it will be replaced with:

1.  A partial bridge
2. A denture
3. A tooth implant

Medication

• Antibiotics to fight residual infection of the tooth or gums
• Non-prescription pain relief drugs (ibuprofen or acetaminophen) and warm salt water rinses

Prevention

Most tooth abscesses can be prevented with:

• Proper dental hygiene, including:

1. Brushing teeth with fluoride toothpaste after meals or at least twice per day
2. Daily flossing between teeth and gums
3. Regular dental check ups (every 6 months)
4. Regular professional teeth and gum cleaning (every 6 months)

• Limiting the amount of sugar you eat to prevent cavities