What is a Dental Abscess?

The term ‘dental abscess’ is used to describe a pus-filled swelling that can develop either outside the tissue – on the gums, or inside the structure of the teeth – in the central pulp chamber, they are sometimes referred to as boils or cysts. The two different types of abscesses are called peripapical and periodontal, and both of them are a symptom of bacterial infection entering the system, either through holes in the enamel or damage to the soft tissue. This kind of problem needs to be dealt with promptly, before the infection spreads to the supporting bone and subsequently the rest of the circulatory system.

Where does a dental abscess come from?

Periapical abscesses (those that form at the centre of the teeth) are the result of dental decay, which is a big problem among adults and children in the UK at the moment. The decay starts with cavities that eventually leave a pathway right through the hard minerals of the teeth, to allow bacteria and food particles to infect the inner pulp – where the blood vessels and nerve endings are housed. Once the decay has deteriorated to this level, the pulp will become diseased and probably die as a result, in which case it has to be removed completely as part of a root canal filling procedure. Without this treatment, the infection travels down the root and into the alveolar (supporting) bone, where it has access to the rest of the teeth. It is at this stage that periapical abscesses begin to form in the canal, as the body tries to flush out the bacteria; the infected fluid that makes up the swelling has to be drained and the area thoroughly cleaned to make sure that no harmful bacteria remains. Periapical abscesses are not immediately noticeable to the naked eye because they affect the inner workings of the tooth; they normally make themselves known by painful toothache and have to be identified using an x-ray.

Periodontal abscesses are less common than the periapical variety, but they are still fairly widespread as the health of the nation’s teeth deteriorates, perhaps due to poor diets or lack of education on the issue. Abscesses of this kind are slightly harder to deal with because they are the result of aggressive bacteria found in patients suffering the early stages of gum disease; there are several very specific bacteria that cause this problem, and they can sometimes be hard to get rid of. Gum disease begins with painless bleeding when brushing, so most people won’t even notice that there is a problem until the soft tissue becomes inflamed and tender; without treatment, the gums begin to pull away from the roots of the teeth, leaving a space for bacteria to gather in, known as the periodontal pocket. As gum disease progresses to the more troublesome periodontitis, abscesses begin to develop around the infected area, putting all the teeth at risk.

Unlike periapical abscesses, periodontal ones are not as simple to avoid either; it’s not just a question of brushing and flossing on a regular basis, and eating a healthy diet. Periodontal pockets can form after some type of dental surgery or trauma, if the gums have been pulled away from the teeth for some reason – this can affect patients who don’t even have the early signs of gum disease. This is why it’s a good idea to get your teeth checked over after an accident, even if there are no obvious signs of infection right away.

How are dental abscesses treated at the dentist?

The best way to properly cure an abscess is to seek treatment right away, before the infection spreads to the surrounding teeth and puts the rest of your body at risk. If you see swelling or inflammation around your gums, or feel toothache that doesn’t appear to have any noticeable cause, speak to your dentist as soon as possible. If you are worried about some dental problems that could be related to infection, the Pearl Dental Clinic offers a twenty-four hour emergency service, so give them a call and they should be able to fit you in within a day.

When you arrive at the surgery, your dentist will begin by examining your mouth externally, and then they will take some x-rays to pinpoint the root of the problem – as mentioned earlier, this is the only way to locate periapical abscesses. The key to successfully treating both types of abscess is disinfection; the first stage of which is to remove the diseased fluid or flesh, then clean out the infected area with strong anti-septic solution. Different techniques are employed to treat periodontal and periapical cysts.

Periapical swellings have to be treated with a root canal; there is no other way to deal with the infected tissue effectively. The fluid is drained away, the pulp removed, and then the empty chamber cleaned to remove any infected particles that may still be present. In order to keep the tooth functional, the dentist will place a filling in the cavity and probably a crown over the top of it, to strengthen the structure.

Periodontal abscesses are principally dealt with in the same way, except that there is no need to drill into the tooth to drain the fluid. The periodontal pocket has to be drained and cleaned, after which the dentist will normally shave away sections of the diseased tissue and smooth out the surface of the roots, to allow healthy tissue to grow through – it is important that all infected areas are removed, otherwise the infection will return and the treatment is back at square one.

If the bacteria have penetrated deep into your system, your dentist might prescribe you some antibiotics to help fight the infection. With any luck, this should be enough to get rid of the problem and return your mouth to a healthy state, but it’s best to return to the surgery for follow-up appointments, so that your dentist can carefully monitor your recovery.