What is a Dental Abscess?

A dental abscess is a painful pus-filled swelling that forms either inside the teeth or on the outside of the gums, as a result of infection caused by harmful bacteria. There are two types of abscess; periapical and periodontal, periapical abscesses are the most common kind, as they develop from dental decay, which allows bacteria to enter the delicate inner workings of the tooth, via cavities (holes in the mineral layers). Millions of people in the UK suffer from dental decay, some even allow their condition to deteriorate to a life-threatening degree, but if a periapical abscess forms, it means that the problem has gone beyond a simple drill and repair procedure. Periodontal abscesses are more obvious, though usually just as painful as the periapical variety; they form around the gum line, identifiable as soft pockets of inflamed skin, filled with infected fluid (pus). They are generally the result of some kind of injury or disease that has allowed bacteria to gather underneath the soft tissue in the mouth. Abscesses are normally very painful and need immediate treatment, possibly along with a course of antibiotics, otherwise they can escalate to a very dangerous degree, some cases can be fatal.

What causes dental abscesses to form?

As mentioned above, this problem concerns bacterial infection, but there are several different ways the bacteria can enter the system, and the treatment process differs somewhat from periodontal to periapical.

Periodontal abscesses usually form at a later stage of periodontitis (gum disease), as the gums begin to pull away from the bones holding the teeth in place, this allows bacteria from plaque deposits to enter the body. The space between the gum line and the teeth is called a periodontal pocket, and it is the perfect environment for bacteria to multiply and begin attacking the system from within. These pockets are very difficult to clean; eventually infected fluid starts to build up around the exposed area, as the body attempts to fight the bacteria. However, periodontal abscesses are not always related to bad oral hygiene, they can sometimes occur after a dental procedure, when periodontal pockets are accidentally created. Furthermore, accidents or injuries can cause the gum line to break away from the teeth, leaving an available space for harmful bacteria to gather; this is nothing to do with cleaning or gum disease, it’s simply bad luck.

Periapical abscesses are much more common, due to the fact that dental decay is rife among adults in the UK. Dental caries (cavities) break down the protective layers of the teeth, allowing bacteria to attack the central pulp, which is where the delicate nerve endings and blood vessels are housed. When the pulp becomes infected, there is nothing left to do but remove the dead tissue and fill the excavated hole, but if this is not carried out in a timely fashion, an abscess can form inside the tooth, making the problem much harder to deal with. Without treatment, the infection can spread to the bone that holds the teeth upright, putting the patient at risk of tooth loss, or even in danger of more serious health problems, particularly if the infection spreads to the central nervous system and begins to affect the major organs.

How can I get rid of a dental abscess?

There’s nothing you can do at home that will get rid of infected tissue, you might be able to alleviate the pain with various pills and other remedies, but when it comes down to it, you need to speak to a medical professional. Make an appointment with your dentist as soon as you notice the symptoms of a dental abscess, or any small swellings developing around a suspect area, if you are in a lot of pain or you think your condition is becoming more serious, give your nearest emergency clinic a call. The Pearl Dental Clinic offers twenty-four hour emergency service for patients who are registered and those who are in need of immediate care, keep their number handy, so that you won’t be scrambling around for contact details in the event of an emergency. It’s also worth noting that you should go to the hospital, not the dentists, if you notice your health deteriorating to a worrying degree, if you feel dizzy or nauseous, or you develop a high fever – these are signs of blood poisoning, and you need to see a doctor.

What kinds of dental treatments are available?

To properly deal with a dental abscess, your dentist will need to cut out the infected area and clean it thoroughly, to get rid of both the dead flesh and the bacteria causing the problem. At the start of your treatment, the dentist will administer local anaesthetic, so that you will remain awake during the procedure, but won’t feel any pain.

For a periodontal abscess, the periodontal pockets have to be drained of infected fluid, and then cleaned with an anti-bacterial agent, to prevent the problem from occurring again. It will then be necessary to smooth out the exposed tooth root and cut away the infected tissue around the gum line, this process is called scaling and planing, and it is designed to remove all areas of infection, to allow healthy tissue to grow in its place. This is often quite a difficult procedure, particularly if the patient is reluctant to change their previous bad habits.

For a periapical abscess, the only way to remove the septic area is to perform a root canal treatment; this involves drilling into the tooth and pulling out the infected pulp, then washing out the empty root canal to get rid of any remaining bacteria. When the area has been prepared, the dentist will use some filler material to block the hole, this allows the patient to keep their tooth intact and also helps create a barrier between the root and the moist oral environment. If the tooth is in a particularly bad way, the dentist may decide to fit a crown over the top; this not only makes it appear more aesthetically pleasing, it also keeps the remaining fragments together and allows it to remain functional.