When your tooth pains you continuously, causing you sleepless nights, it may be due to something more alarming than a mere toothache. It could be a dental abscess. If you develop a dental abscess, take note that it won’t heal on its own. You have to visit a dentist or endodontist and get treated. If you fail to address it, the abscess may spread beyond your jawbone to the head, neck, and other parts of the body.

At Northridge Emergency Dentist, we treat dental abscess as a health condition that needs urgent attention. We understand the pain and discomfort that this condition can cause, thus the urgency to have your life get back to normal. Many clients in Northridge, California, can attest to our successful treatment of dental abscess as well as other dental diseases thanks to our advanced technology. Therefore, if you experience any symptoms or any reason to believe you have a dental abscess, reach out to as soon as possible, so we can evaluate your case and commence treatment. This article focuses on all you have to know concerning dental abscesses, including its causes, treatment, and preventive measures.

Overview of Dental Abscess

A dental abscess is also known as a tooth abscess. It’s an accumulation of pus, which forms in the gums or teeth. Generally, the abscess occurs due to a bacterial infection caused by the bacteria that accumulate in the soft pulp of your tooth. Bacteria are found in plaque. Plaque refers to a by-product of saliva, food, and mouth bacteria that sticks to your teeth and destroys them plus your gums.

If this plaque isn’t removed by proper and regular brushing & flossing, these bacteria might spread to the soft tissues of your gums or teeth. This may eventually lead to an abscess. The abscess may develop in different areas of your tooth for various reasons. As a result, we have different types of abscesses depending on the location at which they form, as we shall discuss later in the article.

Dentists treat tooth abscesses by emptying it and eliminating the infection. Also, they might be capable of saving your tooth through a root canal treatment. However, in particular cases, the tooth might have to be extracted. Leaving tooth abscesses untreated may result in severe, life-threatening problems.

Symptoms of an Abscess

Symptoms and signs of a tooth abscess include:

  • Fever

  • Sensitivity to hot or cold liquids and foods

  • Feeling generally unwell

  • Pain around the affected place when you touch the area or when biting

  • Difficulty opening your mouth

  • Insomnia

  • Difficulty when swallowing or breathing

  • A foul taste and a foul smell in your mouth

  • Swelling in the cheek or face

  • Being sensitive to the force of biting or chewing

  • Tender, swollen lymph nodes in the neck or under your jawbone

  • Severe and persistent toothache that may spread to the neck, jawbone, or ear

  • A feeling of pain relief and salty fluid in your mouth in case the tooth abscess ruptures

  • The affected tooth turns dark compared to the neighboring teeth. This discoloration is caused by the necrotic pulp by-products that leak into the porous tooth layer. In most cases, you may not experience any tooth pain

  • There’s a raised swelling on the particular gum tissue that’s filled with pus. This swelling resembles a pimple close to the infected tooth. If the pimple opens, it means it has ruptured to let the pus out. An open pimple is known as a draining fistula. This swelling is an evident sign that you have an infection

It’s critical to keep in mind that an abscessed tooth may not show any signs or symptoms whatsoever. Since the tooth would have lost vitality (ability to feel any stimuli), there might be no pain linked with it. But, the abscess will still be present and could be spreading the tooth infection further. Occasionally, where you haven’t experienced any revealing symptoms or signs of an abscess, the abscess is discovered during regular x-ray exams.

The primary symptom of an abscess is feeling pain. You may experience throbbing pain, which is usually intense. Often, the pain starts suddenly then develops to be more intense as hours or even days pass by. In particular situations, the pain might spread to the jawbone, neck, and ears.

When You Should See a Doctor

Visit your dentist immediately if you experience any symptoms or signs of a dental abscess. In case you are experiencing swelling in the face and a fever, and you cannot reach the dentist, visit an emergency room. Additionally, visit the emergency room should you have difficulty when swallowing or breathing. These symptoms might be an indication that the abscess has spread deep into your jawbone and the surrounding tissues, or to other areas in your body.

Types of Abscess

There are three kinds of tooth abscess. They are classified based on the location they occur. They include:

  • Periodontal abscess - Periodontal abscess begins in the supporting bone tissue structures of your teeth. It may also spread to the adjacent bone and tissue.

  • Gingival abscess - This type of abscess occurs only in your gum tissues and doesn’t affect your periodontal ligament or the tooth

  • Periapical abscess - Periapical abscess starts in the soft pulp of your tooth

The abscess type will dictate how severe it is and the location of signs.

Causes of a Dental Abscess

In many cases, a tooth abscess is usually a complication of a tooth infection. Bacteria, often the ones found in plaque, usually infect then penetrate a given tooth.

  1. Periodontal Abscess

The moment the bacteria in the plaque affects the gums, you will develop periodontitis. That is, your gums will become inflamed. When this happens, it could make the tissues that surround the tooth root to separate from the tooth’s base.

A small gap (periodontal pocket) forms when the periodontal ligament detaches from the tooth root. This gap becomes dirty easily, and it’s difficult to keep it clean. As the bacteria build up in this periodontal pocket, it forms a periodontal abscess.

Periodontal abscesses may also occur in patients due to a dental procedure that accidentally leads to the formation of periodontal pockets. Additionally, using antibiotics for untreated periodontitis may mask the signs and symptoms of an abscess. This may, in turn, lead to a periodontal abscess. In other cases, gum damage may result in periodontal abscesses, whether or not you have periodontitis.

  1. Periapical Abscess

In this type of tooth abscess, bacteria enter your tooth through small holes that occur due to caries or decay, which develop in the harder outer layer of your tooth. Eventually, caries breaks down the soft layer of tissues below the enamel, known as dentin. In case the decaying continues, the hole ultimately penetrates the softer inner tooth pulp making it infected.

This condition is called pulpitis. If the pulpitis advances the bacteria penetrates to the alveolar bone (the bone surrounding and supporting the tooth). When this happens, it results in the formation of a periapical abscess.

Risk Factors

The following factors can increase the risk of developing a dental abscess:

  • Dry mouth - If you have a dry mouth, it could elevate the risk of your teeth decaying. Often, dry mouth occurs because of aging issues or the side effects of particular medications.

  • A diet that’s high in sugar - A frequent drinking and eating foods that contain much sugar, like sodas and sweets, can cause dental cavities, which may later transform into a dental abscess.

  • Poor dental hygiene - Failure to properly care for your gums and teeth, for instance, failure to brush your teeth two times a day and failing to floss may increase the risk of gum disease, dental abscess, tooth decay, and other mouth and dental complications.

Diagnosis

Apart from examining your teeth and the neighboring area, the dentist may also:

  • Tap on the teeth - Generally, a tooth that has developed an abscess at the root is sensitive to pressure or touch.

  • Suggest a Computed tomography (CT) scan - In case the abscess spreads to other places within your neck, a computed tomography scan might be recommended to evaluate the degree of your infection.

  • Recommend an x-ray - Conducting an x-ray of the aching tooth may assist you in identifying an abscess. Also, the dentist may use these x-rays in determining whether your infection has advanced, leading to abscesses in more areas.

Treating Dental Abscess

Any person experiencing symptoms associated with a tooth abscess has to visit a dentist as soon as possible. A certified dentist can easily diagnose a dental abscess. A person that has breathing and swallowing problems has to visit the emergency room of his/her local hospital straight away. If you can’t get to the dentist immediately, you should see a family physician.

A doctor can’t treat abscesses. However, they could prescribe drugs and advise you on pain management as well as self-care. Also, the doctor will most likely know the quickest way to get emergency treatment in case you need it. The aim of treating an abscess is to remove the infection. For the dentist to achieve this, he/she may:

  • Incise and empty the abscess - The abscesses have to be cut out then the pus containing bacteria emptied. The dentist makes a slight cut in the abscess, permitting the pus to come out. After that, he/she washes the area using saline (saltwater). Often, a tiny rubber drain will be placed in the cut area to keep it open for drainage as the swelling reduces.

  • Treatment of periapical abscess- A root canal treatment is used to get rid of the abscess. In this treatment, a drill will be used to make a hole in the dead teeth/tooth for the pus to come out. Also, any damaged tissues are removed from the pulp. After that, your dentist inserts a root filling in the left space. This is done to prevent further infections. The tooth can be capped using a crown to make it stronger, mainly if it’s the back tooth that’s affected. If you take proper care of your restored tooth, it could last a long time.

  • Treatment of periodontal abscess- Here, the dentist drains the abscess and then cleans the periodontal pocket. The surfaces of the tooth root are then smoothed out through planing and scaling below your gum line. Doing this helps with the healing of the tooth and prevents subsequent infections from arising.

  • Extract the infected tooth- In case the infected tooth cannot be successfully treated, your dentist may pull it out and empty the abscess to eliminate the infection.

  • Prescribe antibiotics- In case your infection is restricted to the area with an abscess, antibiotics may not be necessary. However, if your infection has progressed to the neighboring teeth, your jawbone, or other parts, the dentist will most likely prescribe antibiotics that can help to prevent it from spreading to other areas. Also, he/she may recommend antibiotics in case you have a weak immune system.

  • Treatment through surgery- People that have periapical abscesses and a frequent infection might need to get the diseased tissues surgically extracted. An oral surgeon performs this surgical procedure. Additionally, these kinds of people might need to get their gum tissues reshaped and their periodontal pockets removed. An oral surgeon will also conduct this procedure. Should a tooth abscess reoccur even after undergoing surgery, your tooth might be extracted.

Managing Pain from Dental Abscess

Over-the-counter painkillers might help relieve the pain as you wait for treatment. It’s critical to follow all the instructions on the medication packet carefully. Note that painkillers only reduce pain, and you can’t substitute them with visiting a dentist.

Ibuprofen, paracetamol (Tylenol), or aspirin are the most common effective painkillers to relieve abscess pain. However, others are ineffective for particular kinds of patients. For instance:

  • Ibuprofen & stomach ulcers- Don’t take ibuprofen in case you have stomach ulcers, or have ever had them before

  • Aspirin & children- Don’t give aspirin medication to minors that are below the age of sixteen years old

  • Ibuprofen & asthma- If you’re asthmatic, don’t take ibuprofen to reduce abscess pain

  • Aspirin & pregnancy or breastfeeding- Don’t take aspirin in case you are breastfeeding or pregnant.

Antibiotics

Your dentist may prescribe antibiotics to you to help stop the infection you have from spreading. You may take these antibiotics together with the painkillers. The antibiotics that you can take include metronidazole or amoxicillin. Just like painkillers, you shouldn’t see antibiotics as a means of substituting abscess treatment with your dentist, or a way to postpone treatment.

Home Remedies and Lifestyle

We have various actions a patient could take at the comfort of their homes to relieve dental abscess pain. These are:

  • Avoiding drinks and foods that are either too cold or too hot

  • Avoid flossing around the infected area

  • Chewing on the side of the mouth where there is no abscess. This is less painful

  • Using a soft toothbrush

  • Taking over-the-counter painkillers like ibuprofen, as required

  • Rinsing your mouth using warm, saltwater

Whereas home remedies may help you feel more comfortable as you await treatment, it’s critical to see a healthcare expert and get treated to prevent any further complications due to the infection.

Complications

Dental abscesses will not go away if it is not treated. In most situations, complications only arise in case the dental abscess doesn’t get treated on time. However, in other cases, complications may occur even after what appears like effective treatment, though in very area cases. Should the abscess rupture, the pain can decrease significantly. However, you still have to get dental treatment. In case the abscess does not drain, it could spread to the jawbone and other parts of your neck and head. You may also develop sepsis. This is a life-threatening condition that spreads all over your body. Other possible complications are:

  • Osteomyelitis- This is a situation where the bacteria that’s in the tooth abscess go into your bloodstream and end up infecting the bones. When this happens, you will experience increased body temperature, possible nausea, and severe pain around the infected bone. Generally, the bone that’s affected nears the abscess location. However, since the abscess might have spread up to your bloodstream, any given bone in your body might be affected. Treating this condition involves either intravenous or oral antibiotics.

  • Dental cysts- This is a case where a cavity filled with fluid may form underneath the tooth root in case the abscess isn’t treated. This cavity is known as a dental cyst. There’s a significant danger that this cyst will be infected. If it gets infected, you will need to take antibiotics, and most probably undergo surgery.

  • Ludwig’s angina- Ludwig’s angina refers to an infection of the mouth’s floor when the tooth abscess bacteria spread. When this happens, you will experience intense pain and swelling in your neck and beneath the tongue. In acute situations, you could find it difficult to breathe. This is a possibly fatal condition. If you develop it, treatment involves taking antibiotics. Patients in severe conditions may need to undergo a procedure for opening the airway in case they have breathing problems.

  • Cavernous sinus thrombosis- If the bacteria spread, it causes the formation of a blood clot in the cavernous sinus. The cavernous sinus is a large vein found beneath your brain. This condition is treated using antibiotics and other times, surgery to remove the sinus. The condition could be fatal in other cases. However, this complication is rare among patients with abscesses.

  • Maxillary sinusitis- Here, the bacteria spreads into tiny spaces behind your cheekbones known as maxillary sinuses. The condition is not as severe, but it could be painful. If you have this condition, the symptoms include having tender cheeks and developing a fever. Sometimes, maxillary sinusitis heals by itself. Based on its severity, your doctor might prescribe antibiotics.

If your immune system is weak and then leave a dental abscess untreated, you will have an even more increased risk of the infection spreading to other areas.

Preventing a Tooth Abscess

Prevention contributes a great deal in maintaining excellent dental health. Preventing tooth decay is an essential way to prevent a dental abscess. And, to prevent your teeth from decaying, you need to take proper care of them. Here are the various ways you can avoid tooth decay:

  • Brushing your teeth two times a day at the minimum, using fluoride toothpaste

  • Using fluoridated drinking water

  • Using an interdental cleaner or dental floss to clean in-between the teeth daily

  • Replacing your toothbrush after every four or three months, or when the bristles get frayed

  • Visiting your dentist regularly for checkups or professional cleanings

  • Eating healthy foods, limiting the items rich in sugar, and having snacks between meals

  • Consider using a fluoride or an antiseptic mouth rinse. These add a layer of protection against tooth decay

  • If you discover tooth decay early enough and have it treated immediately, cavities that may develop into abscesses are usually contained

  • Avoiding tobacco (chewing and smoking) use may also help prevent abscesses

Any person who suffers from recurring tooth abscesses has to be assessed by a healthcare expert to determine whether a particular medical condition could be the cause.

What You Can Do

The following information will help you prepare for an appointment with your dentist:

  • List any symptoms you are experiencing, including those that may appear to be unrelated to mouth or tooth pain.

  • List all medications, herbs, vitamins, and any other supplements that you are taking and their dosages

  • Prepare the questions you will ask your dentist

The Prognosis for Tooth Abscesses

The prognosis is ideal for resolving a slight dental abscess after it has been drained or raptured. In case your symptoms and signs are improving, then it’s most unlikely that your infection is worsening. Larger abscesses require immediate medical treatment, which often involves antibiotics and drainage. Also, it’s mandatory to do proper follow-up care with your dentist for the reevaluation of your infection. Follow-up care is also critical as it helps in caring for the affected tooth.

Contact an Emergency Dentist Near Me Specializing in Dental Abscesses

Any pain in your teeth will suggest that they are not okay. While you can contain the pain with painkillers, don’t assume that it would go away. Instead, it could be an indication of something serious like a tooth abscess. What you should do if you experience any tooth pain is to see a dentist who will find out the underlying cause of that pain.

If you are in Northridge, California, visit the Northridge Emergency Dentist offices for quality services. Our dentists will evaluate your situation and begin treatment right away. Our treatment procedures are as comfortable as possible. Additionally, we will advise on preventive measures so you won’t have to develop a tooth abscess again. Call us at 818-928-5854 for high-quality, advanced dental services.