What is an oral abscess. How does it form. What are the common symptoms of an oral abscess. What are the different types of oral abscesses. How can you manage an oral abscess at home. What treatments will a dentist provide for an oral abscess.

Understanding Oral Abscesses: Formation and Causes

An oral abscess is a painful condition that occurs when bacteria enter and infect the mouth, leading to a pus-filled swelling. This infection typically develops as a result of injury or irritation to the oral tissues. The body’s natural defense mechanism attempts to contain the bacterial infection by forming a barrier around it, resulting in the characteristic abscess formation.

Oral abscesses can develop rapidly, sometimes within just one or two days of the initial infection. They require prompt medical attention, as they do not resolve on their own and can lead to more severe health complications if left untreated.

How does an oral abscess form?

The formation of an oral abscess involves several steps:

1. Bacterial entry: Bacteria enter through a wound or irritated area in the mouth.
2. Infection: The bacteria multiply, causing an infection.
3. Immune response: The body’s immune system responds by sending white blood cells to fight the infection.
4. Pus formation: As white blood cells die, they mix with tissue debris and bacteria, forming pus.
5. Swelling: The accumulation of pus leads to swelling and pain in the affected area.

Recognizing the Symptoms of an Oral Abscess

Identifying the symptoms of an oral abscess is crucial for seeking timely treatment. While the primary indicator is often pain, several other signs can help you recognize this condition:

• Persistent, throbbing pain in the mouth
• Sensitivity to chewing and difficulty brushing teeth
• Swollen lymph nodes in the neck
• Pain when swallowing
• Fever
• Pressure in the sinuses

It’s important to note that in some cases, an abscess may cause little to no pain. However, this doesn’t mean it should be ignored, as untreated abscesses can lead to long-term complications.

Can an oral abscess cause other health problems?

Yes, an untreated oral abscess can potentially lead to more serious health issues. The infection can spread to surrounding bone and teeth, causing damage. In rare cases, it may even spread to other parts of the body, leading to systemic health problems. This is why prompt treatment is essential, even if the abscess isn’t causing significant pain.

Types of Oral Abscesses: Gingival, Periodontal, and Periapical

Oral abscesses are classified into three main types, each with distinct characteristics and origins:

1. Gingival Abscess

A gingival abscess forms in the gum tissue between the tooth and gum, near the “neck” of the tooth. This type of abscess typically occurs in teeth without preexisting periodontal pockets or bone loss. It’s often caused by the impact of food particles or foreign objects into the gum area around the tooth.

2. Periodontal Abscess

Periodontal abscesses are more advanced and associated with teeth that already have periodontal pockets and some degree of bone loss. Like gingival abscesses, they can be triggered by food or foreign objects becoming impacted in the pocket around the tooth. Interestingly, this type of abscess can sometimes develop after a dental cleaning, if bacteria overgrow in the treated area.

3. Periapical Abscess

A periapical abscess occurs inside the tooth, typically when the tooth’s nerve is dead or dying. This abscess begins at the tip of the tooth’s root and can spread to the surrounding bone. It’s often associated with severe tooth decay or trauma that has damaged the tooth’s pulp.

Complications of Untreated Oral Abscesses

When left untreated, oral abscesses can lead to several complications:

What is a fistula or sinus tract?

A fistula, also known as a sinus tract, is a hollow tunnel that can form through the bone and skin to allow pus to drain from an untreated abscess. It may appear as a pimple-like opening inside the mouth and can cause a strange taste due to the draining pus. While the formation of a fistula can reduce pain by relieving pressure, it doesn’t eliminate the need for treatment of the underlying infection.

Can an abscess lead to cyst formation?

Yes, an untreated abscess can sometimes lead to the formation of a fluid-filled cyst in the jawbone. If the affected tooth is beyond saving, the cyst may come out when the tooth is extracted. However, if the tooth can be saved, a root canal procedure may be necessary to remove the infected nerve. In some cases, surgery might be required to remove the cyst if it doesn’t heal after the root canal treatment.

Home Care for Oral Abscesses: Temporary Relief Measures

While professional dental care is crucial for treating an oral abscess, there are some steps you can take at home to manage the condition temporarily:

How can salt water rinses help with an oral abscess?

Salt water rinses can provide temporary relief for an oral abscess. If you notice a pimple-like swelling on your gum, rinse your mouth several times a day with a mild salt-water solution. Use half a teaspoon of salt in 8 ounces of water. This can help draw out pus and relieve pressure, potentially providing some comfort. However, it’s important to remember that this is not a substitute for professional dental care.

Remember: Even if salt water rinses seem to help, you still need to see your dentist as soon as possible. Abscesses are serious conditions that require professional treatment to prevent the spread of infection.

Professional Treatment of Oral Abscesses: Dental Interventions

When you visit your dentist for an oral abscess, they will typically focus on three main goals:

1. Thoroughly cleaning the affected area
2. Allowing trapped pus to escape
3. Treating the underlying infection

What procedures might a dentist use to treat an oral abscess?

The specific treatment approach will depend on the type and severity of the abscess, but may include:

• Draining the abscess: The dentist may make a small incision to allow the pus to drain.
• Root canal treatment: For abscesses caused by tooth decay reaching the pulp, a root canal may be necessary to remove infected tissue and save the tooth.
• Tooth extraction: In severe cases where the tooth cannot be saved, extraction may be the best option.
• Antibiotic therapy: Oral or topical antibiotics may be prescribed to fight the infection.

If a fistula has formed, your dentist will trace it back to the source of the infection to ensure comprehensive treatment.

Prevention Strategies: Maintaining Oral Health to Avoid Abscesses

While not all oral abscesses can be prevented, maintaining good oral hygiene can significantly reduce your risk:

How can you prevent oral abscesses?

Here are some strategies to help prevent oral abscesses:

• Brush your teeth twice daily with fluoride toothpaste
• Floss daily to remove food particles and plaque between teeth
• Use an antiseptic mouthwash to reduce bacteria in the mouth
• Avoid sugary foods and drinks that can contribute to tooth decay
• Visit your dentist regularly for check-ups and professional cleanings
• Address any dental issues promptly to prevent them from worsening

By following these preventive measures, you can maintain better oral health and reduce your risk of developing painful and potentially serious oral abscesses.

When to Seek Emergency Care for an Oral Abscess

While all oral abscesses require prompt dental attention, certain symptoms may indicate a need for emergency care:

What are the signs that an oral abscess requires immediate medical attention?

Seek emergency care if you experience any of the following:

• Severe, uncontrolled pain that doesn’t respond to over-the-counter pain relievers
• Difficulty breathing or swallowing
• High fever (over 101°F or 38.3°C)
• Swelling that extends to the eye or neck
• Rapid heart rate
• Confusion or disorientation

These symptoms could indicate that the infection is spreading and may require immediate medical intervention to prevent serious complications.

Understanding oral abscesses, their symptoms, and treatment options is crucial for maintaining good oral health. By recognizing the signs early and seeking prompt professional care, you can prevent potential complications and ensure a speedy recovery. Remember, while home remedies may provide temporary relief, they are not substitutes for professional dental treatment. Always consult with your dentist if you suspect you have an oral abscess or any other dental concern.

What is an oral abscess?

When the inside of your mouth gets hurt or irritated, bacteria may enter and cause an infection. Sometimes you will see a painful swelling filled with pus (a thick, yellowish fluid). If the pus can’t drain out, the area will become more swollen and painful. This is known as an abscess. Your body tries to keep a bacterial infection from spreading by forming a barrier around the infection.Since most abscesses, regardless of being gum or tooth, are painful, the majority of people will seek medical help immediately. Abscesses will not go away by themselves, so it is critical that you get help from a medical professional as soon as possible. However, it can be tricky to decipher whether what youre experiencing is actually an abscess. Here are the common symptoms of a gum or tooth abscess.

What are the symptoms of an oral abscess?

The main symptom of an oral abscess is a throbbing or stabbing pain in the mouth that wont subside. If you have atoothache, it may be the result of an abscess. Usually, the area of the mouth that has the abscess will be sensitive to chewing, and it will be difficult and painful to brush your teeth. Another symptom is swelling of the lymph nodes in your neck, which may cause pain when swallowing and is sometimes accompanied by a fever. Pressure in the sinuses can be another symptom of a gum or tooth related abscess. If you are experiencing symptoms like the ones described, seek professional medical help immediately. In rare cases, the infection caused by an abscess can lead to more serious health problems if left untreated.

What are the types of Abscesses and what should I expect?

Abscesses can form very quickly. Sometimes they form only one or two days after the infection starts. There are three types of abscesses:

• Gingival Abscess:The first type is called a gingival abscess because it is contained in the area of the gum between the tooth and gum that is closest to the “neck” of the tooth. The tooth usually doesn’t have preexisting pockets or bone loss, and often catches inflammation caused by food or foreign-body impact into the gum area around this particular tooth.
• Periodontal Abscess:The second and more advanced form of gum abscess is the periodontal abscess. This is associated with a tooth that already has a periodontal pocket and degree of bone loss. Like the gingival abscess, however, it can be caused by food or a foreign object impacted into the pocket around the tooth. This condition can develop after a dental cleaning where bacteria still overgrows despite having recently received treatment in the area.
• Periapical Abscess:The third oral abscess usually occurs inside the tooth. This happens when the tooth’s nerve is dead or dying. This type of abscess shows up at the tip of the tooth’s root, then spreads to the surrounding bone.

Most abscesses are painful, so people usually seek treatment right away. Sometimes the infection causes little or no pain. If an abscess is not treated, the infection can last for months or even years, so it’s important to not ignore the symptoms.

An untreated infection can damage the surrounding bone and teeth. A hollow tunnel sometimes forms through the bone and skin to allow pus to drain. This tunnel is called a fistula or “sinus tract.” You might see or feel this opening inside your mouth. It looks like a pimple. If you have pus draining through a fistula, you might notice a strange taste in your mouth. The buildup of pressure causes the pain of an abscess. Draining the abscess through a fistula reduces the pressure. The pain will disappear; however, the infection still needs to be treated.

Sometimes, an abscess that isn’t treated can form a fluid-filled bubble (cyst) in the jawbone. If the tooth is severely broken down and can’t be saved, the cyst may come out when the tooth is extracted. If the tooth can be saved, you will need a root canal to remove the infected nerve. If this treatment does not heal the cyst, you may need surgery to remove it. In rare cases, the infection that causes an abscess may spread and lead to serious health problems.

What can you do at home?

Abscesses are always serious because the infection may spread to other parts of the body. Call your dentist for an appointment. If you can see or feel a pimple-like swelling on your gum, rinse your mouth several times a day with a mild salt-water solution. Use half a teaspoon of salt in 8 ounces of water. This may help draw the pus out and relieve pressure. Even if the rinse seems to help, you still need to see your dentist as soon as possible.

What will your dentist do for your abscess?

Most gum abscesses will heal quickly after three things happen:

• The area is cleaned thoroughly.
• The trapped pus is allowed to escape.
• The infection is treated.

If a fistula has formed, your dentist will trace it back to the source of the infection. Your dentist will insert a flexible, thin piece of material into the fistula. This will appear on an X-ray and show the dentist where the fistula leads. Once your dentist cleans out the infection, the fistula usually will close on its own.

If the infection started inside a tooth, your dentist will make a small hole in the tooth. This allows the abscess to drain. The tooth will need root canal treatment, followed by a filling or a crown.

If an abscess is very large or the tooth is badly damaged, you may need to have the tooth removed. A large abscess often will need to be drained. The dentist makes a hole in the gum through the bone that provides an exit path for any fluid or pus. This will reduce the risk of further spread of the infection.

People with severe periodontal disease may have abscesses. Draining them helps the immediate problem. However, the periodontal disease needs to be treated to prevent another infection. Your dentist may give you a prescription for antibiotics and painkillers. These drugs will help the abscess heal and keep the infection from spreading.

If you have any questions about oral abscesses, call Winning Smiles to schedule an appointment with your dentist 716-332-2444.

Signs of tooth abscess | Ada

What is a dental abscess?

An abscess is a pocket of pus that forms within body tissues. Abscesses are the result of an infection, generally bacterial, localized in the area where the abscess forms. They are almost always accompanied by swelling and inflammation. Dental abscesses are abscesses affecting the teeth and adjacent jaw tissue.

Each tooth is made up of several layers. The outermost layer is the enamel, which covers a softer layer, the dentin. The dentin and enamel are the tooth’s protective layers. Underneath the dentin is the pulp, where the tooth’s nerves and blood vessels are situated. The pulp runs down the center of the root of the tooth, which connects the tooth to the underlying bone of the upper or lower jaw. Infections in the pulp can therefore easily spread into the bone of the jaw. Likewise, if the gum around the tooth becomes infected, the tooth is at risk of damage as well. Some abscesses affect the pulp first and spread to the bone, while others affect the surrounding tissues of the gum and do not start in the pulp.

In abscesses, the presence of plaque and gingivitis are likely to make the situation worse. Antibiotics are sometimes necessary to control the infection. If treated correctly, dental abscesses are not life-threatening. Treatment of dental abscesses is usually carried out by dentists, and often involves taking an antibiotic and root canal treatment. In rare cases, however, the infection can spread, and the condition may become very severe and possibly life-threatening in extremely rare cases.

Treatment for dental abscesses involves draining the pus from the tooth and filling or removing the tooth to prevent re-infection.

There are two major subtypes of dental abscess: periapical and periodontal.

Good to know: A third type, pericoronitis, is much less common. In pericoronitis, the infection affects the gum flap, known as the operculum, which covers a tooth that has not yet erupted through the gum. This article deals with periapical and periodontal abscesses. For more information on pericoronitis, please see the FAQs.

Periapical abscesses: affecting the inside of the tooth

Periapical abscesses usually occur near the tip of the root of the tooth. They are more common among children than among adults. Children with poor dental hygiene are particularly at risk of periapical abscesses.

Poor dental hygiene, including inadequate brushing or flossing, can cause caries, also known as cavities, which erode the enamel and dentin, admitting bacteria to the pulp. As a result of this, the pulp becomes inflamed, and this can lead to the death of nerves in the tooth. Because dead tissue is more vulnerable to infection, this puts the tooth at high risk of an abscess.

In periapical abscesses, damage to the enamel and dentin, as in the case of later-stage cavities admits bacteria to the pulp, leading to an inflammatory condition known as pulpitis. Periapical abscesses are a common complication of severe, long-term pulpitis. They can cause swelling in the jaw, cheeks and the floor of the mouth.

Periodontal abscesses: affecting the gums

Periodontal abscesses are more common among adults than children and are often a complication of gum disease. They tend to originate in the alveolar bone and periodontium. Gum disease or injury can cause teeth to become loose and/or inflamed, including the surrounding area. The resulting pocket that forms between the tissue and the tooth is vulnerable to infection by bacteria which can then form a periodontal abscess.

Signs and symptoms of a dental abscess

Dental abscesses are usually painful. The pain may be situated in the tooth itself, the surrounding gum or be more generalized, including the jaw, cheeks, or even neck or face, depending on the location of the abscess. The affected tooth may:

• Feel tender
• Feel loose in the jaw
• Be sensitive to heat and/or cold in the mouth
• Be sensitive to pressure on the tooth, or to being tapped
• Be slightly raised

People with a dental abscess may experience pain in the affected area. If you are concerned that you may have a dental abscess, you can do a free symptom check with the Ada app or find out more about how it works.

Other symptoms of dental abscesses include:

• Swelling in the gums or face
• Redness of the skin over the affected part of the gum
• Bleeding in the gums
• Swollen lymph glands in the neck
• Generally feeling unwell (malaise)
• Loss of appetite or inability to eat
• Fever

Dental examination may also reveal swelling and redness around the tooth in the mouth and a fluctuant (movable/shiftable) mass in the area.Periodontal abscesses may also present with a gum boil. A gum boil, also known as a parulis, is a soft red papule that appears where a sinus or channel from an abscess reaches the outside of the gum, between the gum and the inside of the cheek. It is the result of an abscess, so it is a definite sign that an abscess is present, but it is not itself an abscess.

Rarely, in severe cases of dental abscess, the affected person may also experience:

• Cellulitis, a bacterial infection of skin and subcutaneous tissues
• Lockjaw (trismus)
• Difficulty swallowing, due to pain and swelling
• Difficulty breathing, due to swelling
• Difficulty speaking
• Dehydration

Generally, a spreading dental infection as a result of an abscess may cause the affected person to feel very unwell. They may have a fever (a body temperature of 38 C / 100.4 F or higher), swelling in the floor of the mouth, the face or the jaw and severe pain that does not respond to maximum doses of over-the-counter painkillers such as.

If any of these symptoms occur, the affected person should seek emergency dental care from a dentist or, if no dental care is available, visit a hospital emergency department or see another doctor as soon as possible. While doctors are not trained to handle dental procedures, they will be able to assist with antibiotics and painkillers to control the infection and pain until dental care is accessed.

Causes of dental abscesses

Dental abscesses are the result of bacterial infection. When the gum tissue surrounding a tooth becomes damaged or the tooth itself is damaged, bacteria that are already in the mouth and, under usual circumstances not harmful, may enter the area and cause infection.

One of the most common causes of damage to the teeth and gums is poor dental hygiene, such as inadequate brushing and flossing, high sugar or carbohydrate consumption, and lack of regular checkups at the dentist. These factors may lead to dental caries or cavities, gingivitis and periodontitis, which can admit bacteria to the inside of the tooth or the gum. Maintaining healthy teeth and gums is therefore one of the best ways of reducing the risk of developing dental abscesses, as it removes one of the main causes of abscesses.

Diagnosing dental abscesses

If a dental abscess is suspected, the affected person should visit the dentist as soon as possible. The dentist will perform an examination of the affected area. They may test the affected tooth by pressing on it or tapping it with an instrument. If the tooth is infected, it will usually be very sensitive to pressure or tapping (percussion), and may often be painful. Further, if the abscess is periapical, the swelling at the root will push the tooth upwards in its socket, and it will feel higher than the surrounding teeth.

While laboratory testing is not usually needed to establish whether or not an abscess is present, dentists will usually do an X-ray of the affected tooth and the mouth as a whole to establish the exact location and the size of the abscess.

The abscess may be aspirated and the pus cultured to determine which strains of bacteria are involved. This helps to guide antibiotic therapy if it is needed.

Treatment of dental abscesses

The usual treatment for a dental abscess is to drain pus as soon as it is possible to do so. This will be done surgically, either by a dentist or a maxillofacial surgeon, a surgeon that has trained as a dentist as well as a doctor and handles complex jaw, tooth and mouth conditions. They may make an incision in the gum or drill a hole in the tooth to allow the pus to drain.

Once the pus has drained away, the area will be cleaned. In periapical abscesses, all dead pulpal tissue will be removed to prevent infection recurring. In periodontal abscesses, a very deep cleaning of the teeth and specifically the gum and roots will be done. A root canal may also be necessary if the whole tooth is compromised. If the decay is severe, the tooth may be removed.

Root canal treatment

Root canal treatment is the standard treatment for the removal of pulpal tissue in cases where the tooth will be retained and not extracted, and it may also be an option in cases where pain is ongoing even after the abscess is resolved. The person undergoing a root canal will be given a local anesthetic injection to numb the parts of the jaw and mouth affected by the abscess. During the procedure, the dead or infected pulp is removed, the inside of the pulp canals are smoothed, and the pulp is replaced with a filling, often gutta percha. In a few months time, an X-ray and dental checkup will be done to check that the site is healing properly.

Pain management and antibiotics

As abscesses are painful, people may need acetaminophen or to control the pain. Essential oil of cloves has topical anesthetic properties and can be applied to the painful area, although it is very important to maintain strict hygiene while doing this. Home remedies like the above mentioned oil may provide some pain relief, but will not cure an abscess or prevent further infection.

In uncomplicated abscesses, antibiotics may not be necessary.

If the infection is severe or has spread, or if the abscess cannot be drained, antibiotics will be prescribed to help bring the infection under control. Antibiotics commonly prescribed for dental abscesses include:

• Penicillin
• Amoxicillin, alone or in combination with clavulanate
• Azithromycin
• Metronidazole
• Cefoxitin

If the patient is allergic to amoxicillin and/or penicillin, clindamycin may be prescribed. Penicillin is the usual antibiotic used to treat mild or moderate infections. Because antibiotics alone don’t always penetrate the abscess very well, the abscess may also be surgically drained.

Most dental abscesses are straightforward to treat and resolve completely after they are drained.

Home treatment of dental abscesses

Although essential oil of cloves can be used to manage the pain and sensitivity associated with dental abscesses, it will not cure the abscess. Abscesses will not go away on their own and cannot be treated at home. Untreated abscesses can develop secondary infections and other serious complications that are extremely hazardous to health (see below). It is possible for an untreated abscess to become a medical emergency requiring urgent care from a doctor or dentist. It may also lead to jaw bone loss.

Only a qualified medical or dental professional is properly equipped to administer treatment for an abscess safely and effectively. It is strongly advised that people affected by abscesses, or who suspect they may have a dental abscess, seek out the advice of a dentist as soon as they can. It is not safe to try to drain an abscess at home or to leave an abscess untreated.

When to seek emergency treatment for dental abscesses

Ideally, a person affected by a dental abscess, or who suspects that they may have a dental abscess, should visit the dentist as soon as possible. Because it is not always possible to see a dentist in time, some people may need to be treated for their abscesses in a hospital emergency department. Medical doctors are not specifically trained to handle dental issues, but will be able to stabilize the affected person, providing antibiotics and pain relief, until they can see the dentist.

Good to know: Dentists do not form part of the regular staff in most hospital emergency departments. Treatment by a doctor at a hospital will not replace seeing a dentist. Doctors are not trained to deal with dental problems but will be able to assist with managing infection and pain.

If a person with an abscess or a suspected abscess shows any of the signs listed below, they should seek urgent medical care as soon as possible. Danger signs for tooth abscesses include:

• An abscess of more than 1cm in diameter, or which feels large
• Severe swelling or hard lumps on the gums or the face
• Bleeding on the gums or in the mouth
• Fever or a body temperature of more than 38 C / 101.4 F
• Tender lymph nodes in the neck area

If a person shows the symptoms listed below, they should immediately be seen by a hospital emergency department:

• Severe pain that cannot be controlled with painkillers
• Shortness of breath or other difficulty breathing
• Difficulty swallowing due to swelling, or difficulty taking in liquids leading to dehydration
• Severe difficulty opening the mouth
• Swelling of the neck or around the eyes, or severe swelling of the face in general
• Secretions in the mouth they can’t handle due to difficulty swallowing, opening the mouth or others

Complications of dental abscess

In rare cases, complications do arise. These can include:

• Cellulitis, an infection of the skin and subcutaneous tissues.
• Ludwig’s angina, which occurs when cellulitis spreads into the tissues under the tongue, in the lower jaw and under the chin. It is also known as submandibular cellulitis/submandibular space infection.
• Osteomyelitis, an infection of underlying bone.
• Parapharyngeal abscess, an abscess at the back of the mouth, near the throat. It is caused by staphylococcal and/or streptococcal bacteria. It is most common in children aged five years or younger.
• Cavernous sinus thrombosis, which can occur when the infection spreads into the blood vessels in the sinuses of the head.
• Sepsis

These conditions require very urgent medical attention and are best evaluated via a hospital emergency department.

Cellulitis and facial cellulitis

Cellulitis is an infection of the skin. Facial cellulitis, for example, can be caused by infections of the upper respiratory tract, middle ear infections or tooth abscesses. Although these conditions can increase the risk of facial cellulitis, they do not directly cause it; the condition results when an infection spreads to the skin. Symptoms of facial cellulitis include:

• Swollen, red skin on the face, especially the cheek
• Itching and burning of the affected skin
• A painful, possibly swollen, tongue
• Fever

If you are concerned that you or a loved one may have cellulitis or a tooth abscess, you can start a free symptom assessment right now using the Ada app.

Parapharyngeal abscesses and Ludwig’s angina

Parapharyngeal abscesses and Ludwig’s angina can both cause swelling severe enough to obstruct the airways and cause difficulty breathing. Parapharyngeal abscesses require a and needle aspiration to diagnose. Ludwig’s angina is diagnosed by, needle aspiration and X-rays.

Treatment for Ludwig’s angina, parapharyngeal abscess, osteomyelitis, cellulitis and cavernous sinus thrombosis involves drainage of any pus that is present, possibly via surgery and antibiotics and possibly intravenous antibiotics. People affected by Ludwig’s angina, if untreated, may require a tracheostomy to open their airways and thereby help them breathe if the swelling obstructs the windpipe.

Spreading infection

A spreading untreated infection from a dental abscess can cause pain around the eyes, ear pain, nose pain and swelling in the eyes or face. Severe dental infections can spread to other parts of the body, causing potentially serious medical conditions such as bacterial meningitis and infective endocarditis.

An untreated dental abscess or one that does not respond to treatment can very rarely cause sepsis, which is potentially life-threatening.

Read more about Sepsis »

Dental abscess FAQs

Q: Can a dental abscess be dangerous?
A: Dental abscesses, especially if they are properly treated, typically do not cause severe or long-term problems. However, if it is left untreated or if improperly treated, a severe dental abscess can potentially cause complications, possibly even serious ones.

Q: Are dental abscesses contagious?
A: No, they are not. Dental abscesses cannot be spread from one person to another.

**Q: How can dental abscesses be prevented? **
A: As dental abscesses are most often the result of dental caries or gum disease admitting bacteria to the vulnerable pulp of the tooth or into a gum pocket, the first line of prevention is preventing caries and gum disease. This involves maintaining good dental hygiene, including:

• Regular, twice daily brushing
• Regular, daily flossing and use of mouthwash
• Eating a healthy diet with limited sugar, particularly limiting or avoiding sugary drinks
• Avoiding smoking

Q: Are there any factors which predispose people to dental abscesses?
A: Some medications, such as anticholinergics, protease inhibitors, SSRI antidepressants and SNRI antidepressants can cause xerostomia, meaning dry mouth. Dry mouth results from a decrease in the amount of saliva, which causes the amount of bacteria in the mouth to increase and can therefore worsen tooth decay. This can be prevented by taking especially good care of proper dental hygiene, drinking plenty of water and possibly talking to a doctor for further treatment options for the xerostomia itself.

People who are immunocompromised may be at higher risk of dental abscesses because their immune systems cannot always adequately handle bacterial invasions. People at risk include:

• People who are HIV positive or have AIDS
• People who are undergoing chemotherapy
• People who have sickle cell anemia
• People who use steroids
• People who have had a splenectomy
• People taking immunosuppressive medication after transplantation
• People with severe autoimmune diseases, taking immunosuppressive medication

It is recommended that most people have a dental checkup at least once a year. Children and people who are at risk, or who have a history of dental problems, should go more often, at least twice per year. If a dental abscess is suspected, dental help should be sought immediately.

Q: What foods are safe to eat and drink after treatment for a dental abscess?
A: Many people find it best to eat soft, bland foods after treatment for a dental abscess, as there may be some mouth pain. Foods such as milkshakes, bananas, applesauce, yogurt, cooked cereals, scrambled eggs, mashed potato and custard or soft pudding may be suitable. It is important to ensure that the affected person stays well hydrated.

Q: What is pericoronitis?
A: Pericoronitis is a condition involving infection in the gum that covers an unerupted tooth, the operculum. It is particularly associated with wisdom teeth, especially impacted wisdom teeth. Sometimes the gum above the unerupted tooth breaks, and bacteria lodge in the damaged tissue, causing infection.

Acute cases of pericoronitis can have symptoms such as pain in the jaw and pain when the affected person opens their mouth, as well as swelling and fever. Bad breath may also be a symptom. Abscesses can also occur. Chronic pericoronitis may present with mild inflammation that comes and goes.Pericoronitis will require the treatment and care of a dentist.

Pericoronitis can be treated with warm salt-water rinses and antibiotics such as metronidazole, phenoxymethylpenicillin, or erythromycin.

Q: Can dental abscesses affect wisdom teeth?
A: Wisdom teeth, also known as third molars, usually erupt into the mouth in late adolescence. Occasionally, due to the position of the other teeth in the mouth, there is not enough space for them and as a result impaction may occur. Impaction can occur at any age and means that the teeth cannot erupt properly and get stuck completely or partly below the surface of the gum. Although this does not always cause problems, it can cause pericoronitis, an inflammation (see above), which may then develop into an abscess.

Q: Can a dental abscess cause swelling but no pain?
A: Yes. However, this is a cause for concern: if an abscessed tooth that has been painful initially stops being painful, it generally means that the affected tooth has died. Pain may also lessen considerably if the abscess ruptures and drains. It does not mean that the abscess is gone, however. Infection can still spread and become very serious even if the tooth is not painful, and the affected person should see a dentist as soon as they can.

Q: Are all dental abscesses visible?
A: No. Those dental abscesses that develop a fistula or a gum-boil are visible, but it is possible for there to be no visible sign that an abscess has formed. If someone is experiencing mouth pain and/or any of the symptoms listed above, they should see a dentist to determine what is causing the pain, even if they cannot see anything obviously wrong in the mouth.

Q: Can a dental abscess be hard?
A: While most abscesses are usually soft and warm to the touch, occasionally they can feel firm or even hard to the touch. Anyone with a suspected abscess, jaw swelling, jaw pain or tooth pain who feels a hard lump in the mouth should see a dentist as soon as possible.

Q: Can dental abscesses develop next to or underneath a crown, dentures, dental implant or a dental bridge?
A: Yes. Dental work such as crowns or implants can cause dental abscesses, but only if they are improperly done, damaged or broken. Crowns are often used to help preserve a tooth after a root canal has been done, meaning that they are attached to a tooth that is already compromised. Although it is rare for abscesses to affect crowns, it is possible. Dentures can cause injury to the gums beneath them if they do not fit properly; an injured gum is vulnerable to infection. It is important to make sure that dentures fit properly, and it is necessary to replace any denture that does not fit properly to reduce the risk of infection, injury and poor dental hygiene. Dental implants are used to replace missing teeth and are not natural teeth. They are a little more susceptible to mechanical stress and therefore to colonization by bacteria that may lead to abscesses. However, most dental implants are successful. Dental bridges do not have roots and cannot themselves become abscessed, but it is possible for one of the supporting teeth on either side of the bridged tooth to become abscessed.

Q: Can trauma or an injury to the mouth cause a dental abscess?
A: Yes. A trauma like a blow to a tooth, or, over the longer term, increased wear and tear, such as might result from chronically grinding or clenching teeth, can damage structures of the tooth and therefore increase the risk of a dental abscess developing by bacteria having easier access to this tooth’s sensitive areas.

Q: Can dental abscesses appear under the tongue?
A: An abscess under the tongue is not a dental abscess, but it could possibly be the result of a dental abscess that has led to Ludwig’s angina, a form of cellulitis that affects the tissue below the tongue, below the lower jaw, and the floor of the mouth. Ludwig’s angina is a medical emergency, and the affected person should seek medical help in a hospital without delay.

Dental abscess – NHS

A dental abscess is a collection of pus that can form inside the teeth, in the gums or in the bone that holds the teeth in place. It’s caused by a bacterial infection.

An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess.

Dental abscesses are often painful, but not always. In either case, they should be looked at by a dentist.

It’s important to get help as soon as possible, as abscesses do not go away on their own.

They can sometimes spread to other parts of the body and make you ill.

Symptoms of a dental abscess

Symptoms of an abscess in your tooth or gum may include:

• an intense throbbing pain in the affected tooth or gum that may come on suddenly and gets gradually worse
• pain that spreads to your ear, jaw and neck on the same side as the affected tooth or gum
• pain that’s worse when lying down, which may disturb your sleep
• redness and swelling in your face
• a tender, discoloured or loose tooth
• shiny, red and swollen gums
• sensitivity to hot or cold food and drink
• bad breath or an unpleasant taste in your mouth

If the infection spreads, you may also develop a high temperature (fever) and feel generally unwell.

In severe cases, you may find it hard to fully open your mouth and have difficulty swallowing or breathing.

What to do if you have a dental abscess

You should see a dentist as soon as possible if you think you have a dental abscess.

Avoid visiting a GP, as there’s little they can do to help.

You can get help from:

You may have to pay for emergency NHS dental treatment, depending on your circumstances.

Find out about NHS dental charges

Relieving pain from a dental abscess

While you’re waiting to see a dentist, painkillers can help control your pain.

Ibuprofen is the preferred painkiller for dental abscesses, but if you’re unable to take it for medical reasons, you can take paracetamol instead.

Aspirin should not be given to children under 16.

If 1 painkiller does not relieve the pain, taking both paracetamol and ibuprofen at the doses shown in the medicine leaflet may help.

This is safe for adults, but not for children under 16.

It may also help to:

• avoid hot or cold food and drink if it makes the pain worse
• try eating cool, soft foods if possible, using the opposite side of your mouth
• use a soft toothbrush and temporarily avoid flossing around the affected tooth

These measures can help relieve your symptoms temporarily, but you should not use them to delay getting help from a dentist.

Treatments for a dental abscess

Dental abscesses are treated by removing the source of the infection and draining away the pus.

Depending on the location of the abscess and how severe the infection is, possible treatments include:

• root canal treatment – a procedure to remove the abscess from the root of an affected tooth before filling and sealing it
• removing the affected tooth (extraction) – this may be necessary if root canal treatment is not possible
• incision and drainage – where a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution and further treatment may be needed)

Local anaesthetic will usually be used to numb your mouth for these procedures.

More extensive operations may be carried out under general anaesthetic, where you’re asleep.

Antibiotics are not routinely prescribed for dental abscesses, but may be used if the infection spreads or is particularly severe.

What causes dental abscesses?

Your mouth is full of bacteria, which form a sticky film on your teeth called plaque.

If you do not keep your teeth clean, acids produced by the bacteria in plaque can damage your teeth and gums, leading to tooth decay or gum disease.

The following can increase your chances of developing a dental abscess:

• poor oral hygiene – plaque can build-up on your teeth if you do not floss and brush your teeth regularly
• consuming lots of sugary or starchy food and drink – these can encourage the growth of bacteria in plaque and may lead to decay that can result in an abscess
• an injury or previous surgery to your teeth or gums – bacteria can get into any damaged parts of the teeth or gums
• having a weakened immune system – this includes people with certain underlying health conditions, such as diabetes, and those having treatment, including steroid medication or chemotherapy

Preventing dental abscesses

You can reduce your risk of developing dental abscesses by keeping your teeth and gums as healthy as possible.

To do this, you should:

• use floss or an interdental brush at least once a day to clean between your teeth and under the gum line
• brush your teeth with a fluoride toothpaste twice a day – spending at least 2 minutes each time
• avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away – just spit out any excess toothpaste
• cut down on sugary and starchy food and drinks – particularly between meals or shortly before going to bed
• visit your dentist regularly – your dentist can suggest how often you should have a check-up, based on your oral health

Read more on how to keep your teeth clean and dental check-ups.

Page last reviewed: 05 February 2019
Next review due: 05 February 2022

Mouth sores

Mouth sores can be caused by infection, injury or oral cancer. This fact sheet explains some common mouth sores, their symptoms and treatment.

Mouth infections and ulcerations

Primary herpetic gingivostomatitis
Primary herpetic gingivostomatitis is a highly contagious viral infection. It causes fever, irritability, headache, pain on swallowing and swelling of the lymph glands. Within a few days, the mouth and gums become painful and very inflamed. The lips, tongue, inside the cheeks, palate, and throat may become sore. Yellow fluid-filled sores then develop, burst and form shallow, ragged and extremely painful ulcers covered by a greyish skin. Consult your dental or medical professional for advice and treatment.

Cold sores
Cold sores, or herpes simplex, usually occur on the lips and tongue, although they can also occur on the eyes, nose and hands. Take care not to infect another person while the sores are open and weeping. Cold sore ointments available over the counter from pharmacies may relieve some discomfort.

Thrush
Thrush, or candidiasis, is a fungal infection that initially presents as red areas of tissue in the mouth. As thrush progresses, a white flaky layer may appear on the tongue, gums or inside the cheeks. Although the white flaky layer can be easily wiped away, the tissues underneath often look ‘raw’. To avoid transmitting the infection, practice good hygiene by washing your hands and not sharing utensils. Consult your dental or medical professional for advice and treatment.

Hand foot and mouth disease
Hand foot and mouth disease is highly contagious, but not serious. It is relatively common in children, and is unrelated to the animal diseases with similar names. Symptoms include blisters inside the cheeks, gums and on the side of the tongue, as well as hands and feet. Children with hand foot and mouth disease may have a fever, be listless and may not eat well for a day or two. The blisters usually persist for seven to 10 days, and are contagious while they contain fluid. Consult your dental or medical professional for advice and treatment.

The best form of protection is good hygiene:

• wash hands with soap and water for at least 15 seconds and dry thoroughly before handling food, after going to the toilet and changing nappies
• implement good cleaning procedures
• allow blisters to dry naturally and do not deliberately pierce blisters as the fluid is infectious.

Practical Advice

Abscesses
Dental abscesses are pus-filled swellings caused by infection inside a tooth, infection of the gum and/or injury to the tooth. Abscesses are often painful, but not always. Dental abscesses can cause facial swelling and/or enlarged lymph glands. In rare cases, dental abscesses can cause more widespread infection and may be life threatening.

To treat dental abscesses:

• Control moderate pain using over the counter pain medication.
• Use cold compresses to help control swelling.
• Take antibiotics if prescribed to reduce infection.
• Seek prompt dental treatment – an abscess will not heal itself, and antibiotics will not fix the problem.

Angular chelitis
Angular chelitis can be caused by fungal and/or bacterial infection, poor nutrition or immune deficiencies. Angular chelitis appears as cracked, red crusting at the corners of the mouth, which often bleeds when the mouth is opened. To prevent the infection, keep lips moist with lip balm, practice good oral hygiene and keep hydrated by drinking lots of water. Consult your dental or medical professional for advice and treatment.

Trench mouth
Trench mouth, or acute necrotising ulcerative gingivitis, is extremely painful. It appears as yellow-white ulcers that bleed easily. The infection is caused by poor oral hygiene, but stress and smoking often contribute. Patients often report a metallic taste in their mouth and the sensation of their teeth being wedged apart. In some cases, patients also have swollen lymph glands, fever and fatigue. Consult your dental or medical professional for advice and treatment.

Mouth injuries

Mouth injuries can cause bleeding, ulcers and sore spots. If you injure your mouth:

• Apply a clean bandage or folded handkerchief to the wound and apply firm pressure.
• Sit down and maintain the pressure for at least ten minutes. Don’t lie down flat.
• If the bleeding cannot be controlled, seek immediate medical attention.
• Apply a cold compress to relieve swelling and pain.
• Seek dental or medical advice so your teeth and mouth can be checked for serious injury.

The mouth cannot be sterilised so there is always a risk of infection to a mouth wound. Warm saltwater used as a mouth rinse may aid healing.

Bitten lip or cheek
A bitten lip or cheek can occur during eating or as a result of a fall. More serious bites are sometimes seen after a patient has a local anaesthetic. If the patient sucks, bites or rubs the numb area, they can damage the tissue without realising it. The traumatised area often looks like a chemical burn. When feeling returns, this injury may be very sore and look unsightly. Swelling and infection may also occur. Warm salt water used as a mouth rinse may aid healing. If an infection occurs, consult your dental professional.

Traumatic ulcers and sore spots
Ulcers and sore spots can be caused by damage to skin, and can occur anywhere in the mouth. Dentures, braces, plates, toothbrushes, chemicals, allergies, poor nutrition, infection and hormones can all cause ulcers. Ulcers can be very painful. Warm saltwater used as mouth rinse may aid healing and provide relief. Over the counter products from the pharmacy may provide temporary relief. If ulcers are persistent, consult a dental professional for advice and treatment.

Oral cancer

The majority of ulcers and swelling in the mouth and neck are not cancer, and early examination and treatment will heal most conditions. In the early stages, most oral cancers are not painful. The first symptom is usually discomfort produced by the mass of tumour tissue. If you experience any of the following warning signs, seek urgent medical advice:

• any sore or ulcer on the tongue, cheek or gums that does not heal within two weeks
• red or white patches in the mouth or on the lips
• a swelling or lump anywhere in the mouth or neck
• difficulty swallowing and speaking
• repeated bleeding in the mouth, and/or
• numbness or loss of feeling in any area of the mouth.

Other Resources

For more information:

Related Content

Dental emergencies
Dentures
Wearing braces or a plate

What is a Tooth Abscess? (Updated)

Tooth Abscess Before Dental Treatment

Tooth abscess is actually a leading reason that people seek emergency dental treatment, and without immediate treatment, this condition can have serious repercussions for both oral and whole body health. Understanding the warning signs of infection and tooth abscess can help you avoid severe, long-term oral health issues. Keep reading to learn a little more about what causes tooth abscess, the common symptoms to look out for, and how your dentist can treat tooth abscess and restore your smile.

What is a Tooth Abscess?

A tooth abscess is a painful and serious dental emergency. An abscess is a pus producing bacterial infection that causes pain and swelling, which needs immediate attention. The infection occurs in or around the root of a tooth that contains blood vessels, nerves and connective tissue. The abscess can also occur between the gum and tooth.

Tooth abscess is most commonly caused by advanced tooth decay or damage, which may originate from a chipped or broken tooth that becomes infected, worn enamel that allows bacteria to enter the tooth, or an untreated dental cavity. Long-term, untreated periodontal (gum) disease can also cause an abscess, especially in the advanced form of this oral health condition called periodontitis. In very serious cases, the infection from the tooth abscess spreads out from the root of the tooth to the bones in the jaw supporting the teeth, which can lead to tooth loss or allow the infection to spread throughout the body.

Signs & Symptoms of Tooth Abscess

You should seek treatment for a tooth abscess as soon as possible to avoid the spread of this infection. Some of the warning signs that indicate you’re dealing with tooth abscess include the following:

• A severe toothache or tooth pain with dull pressure, aching, and throbbing or sharp pain
• Fever
• Pain with or without chewing
• Redness and swelling of the gums
• In advanced infections, swelling of the jaw
• Sensitivity of the teeth to temperature change – hot or cold
• An open, draining sore in the gums that may also cause a bitter taste in the mouth
• Bad breath

Treatment Options for a Tooth Abscess

Treatment for tooth abscess will be customized to address your specific needs, but in most cases, we will use some combination of the following treatments:

Drain the abscess

The most effective way to treat an abscessed or infected tooth is to drain off the infection. A small incision into the abscess will help the pus drain out. The dentist may also debride and irrigate or wash the area of infection with saline. Debridement is removal of dead or necrotic tissue that will never heal.

Antibiotic therapy

It is not always easy or even possible to drain the abscess. A serious dental infection can “neutralize” the effects of local anesthetics making it very difficult to numb the patient for treatment. Infected lower molars are especially difficult to numb in the presence of a serious infection. In these cases, a patient needs to be placed on an appropriate antibiotic to reduce the infection, so the local anesthetics can be effective for comfortable treatment.

Root canal

A root canal is a dental procedure to remove the nerve, arteries and vein in the center of the tooth root. In an infected tooth, a root canal can help remove infection and drain the abscess. When the infection heals, the tooth is restored with a crown to increase the strength and preserve the tooth.

Tooth extraction

If the infected tooth can’t be saved, it will be extracted to drain the abscess and promote healing of the infection.

Hospitalization

If there is increased swelling or fever despite antibiotic administration and other treatments, the dental patient may need to be seen in a hospital setting. We’ll need to partner with a local oral surgeon who has hospital privileges in these cases, but we will be your advocate every step of the way to ensure you don’t get “lost” in the hospital emergency room, dealing with physicians who may not have the expertise to handle the situation.

Is a Tooth Abscess Considered a Dental Emergency?

Tooth abscess is absolutely a dental emergency. If you have a tooth abscess, you need to seek treatment immediately. Left untreated, abscess can lead to infection that spreads through the body causing serious and even life-threatening effects. The sooner these issues are treated the better!

When Should I Visit the Dentist for Tooth Abscess?

If you notice any of the symptoms of tooth abscess listed above, you should come in to see us as soon as possible, and we will make every effort to set aside a same day appointment for you. Because of the dangers associated with tooth abscess, one of our dentists may even recommend coming into the office outside of regular hours. Don’t wait for the pain or infection to spread. Get help right away.

Meet McCarl Dental Group

The dentists at McCarl Dental Group take care of patients with dental emergencies every day at our Greenbelt, Maryland dental office. We provide same day emergency dental care to patients with pain from dental infections. Many patients who need emergency dentistry treatment are new to our dental office, and we are happy to help! If you’re in need of emergency dentistry services, call our dental office in Greenbelt, MD right way.

Jaw-Related Conditions | Division of Oral and Maxillofacial Surgery and Dentistry at Johns Hopkins

General dentists and specialized dental practitioners and physicians treat conditions that affect the jaw, as well as the head and neck. Our team typically works in a multidisciplinary manner so that different oral care specialists can discuss and collaborate on the best possible approach to treatment. 

Jaw-related Conditions We Treat:

• Jaw Trauma can be caused by any number of injuries and accidents. Reconstruction of the jaw is managed by several different types of doctors including dentists, otolaryngologists (ear, nose and throat specialists), oral surgeons and facial plastic surgeons. Our dentists understand the importance of the overall appearance of the mouth to a person’s cosmetic appearance, as well as their self-esteem, and work with surgeons to reconstruct function as well as cosmetic appearance. Learn more about jaw-related treatments.
• Jaw deformities are corrected using a variety of orthodontic and surgical techniques. Understanding the importance of the jaw to a person’s overall cosmetic appearance and self-confidence, our dentists work with other specialists, including facial plastic surgeons and otolaryngologists (ear, nose and throat doctors) to restore the jaw to full functionality, as well as a pleasing cosmetic result. Learn more about jaw-related treatments.
• Jawbone infections/dental abscesses are caused when a dental cavity remains untreated. Bacteria can form and cause an infection. If it is not treated immediately, the infection can travel into the jawbone and cause serious health issues. Symptoms of a jaw bone infection or dental abscess include:
  • Pain in the mouth or jaw
  • Redness or swelling
  • Drainage of pus from the area

You should seek immediate dental attention for an abscess. Your dentist will try to drain the infection and will probably prescribe antibiotics. In severe cases, the tooth may need to be pulled or surgery performed to stop the infection from spreading further into the bones. Learn more about jaw-related treatments, including oral surgery.

• Osteonecrosis /osteoradiodonecrosis of the jaw occurs when the bones lose their blood supply, or when they are damaged because of radiation during cancer treatment. Learn more about dental oncology.

Dental Abscess: Symptoms, Treatment and Healing

What is an Abscessed Tooth?
Tooth Abscess Symptoms
Dental Abscess Dangers
Tooth Abscess Treatments
Healing After Abscess Procedure

What is an Abscessed Tooth?

A dental abscess is a serious infection in the tooth’s pulp—the bundle of nerves and blood vessels in the center of each tooth. A dental abscess should be treated as soon as possible, because the infection from an untreated dental abscess could spread to other parts of your body.

Tooth Abscess Symptoms

If you have any of these symptoms, you might have a dental abscess, and you should see a dental professional as soon as possible: 

Gum Symptoms:

• Redness
• Pain
• Swelling
• Open sores on the gums 
• Presence of a small bump (gumboil) near the infected tooth on either the inside or outside of the gums

Tooth Symptoms:

• Pain while chewing
• Pus around the edge of the infected tooth
• Persistent tooth sensitivity to hot and cold foods

Other Symptoms:

• Swelling elsewhere on the face such as the jaw or in the glands of the neck
• A bitter taste in the mouth
• Extremely foul breath

Dental Abscess Dangers

If you experience any dental abscess symptoms, here are some things not to do:

• Don’t delay: See a dental professional as soon as possible. If treated promptly you may be able to avoid having the infected tooth removed.
• Don’t stop your oral hygiene routine: Continue to brush and floss.
• Don’t be fooled if your dental abscess stops hurting: Pain associated with a dental abscess may go away if the tooth root has died. But a dead tooth root doesn’t mean the infection is gone. In fact, the infection from a dental abscess can still spread.

Tooth Abscess Treatments

Proper treatment of a tooth abscess will cure the infection as well as your severe toothache. Your dentist may treat the abscess in any of several ways, including a root canal or incision into the gums to allow the infection to drain. In extreme cases, the tooth may need to be removed and replaced. Three common methods for treating a dental abscess are:

• Root Canal: If the abscess is not severe, the infected material can be scraped out, and the tooth can be repaired with a crown.
• Extraction: If the abscess is more severe, the infected tooth will be removed and replaced.
• Gum Incision: In some cases, an incision is made in the gum to allow the infected tissue to drain out.

Healing After Abscess Procedure

No matter how your dental abscess is treated, you can protect your mouth as it heals, and help prevent future tooth decay by following a regular oral hygiene routine that includes twice-daily tooth brushing and daily flossing. The Crest Pro-Health Sensitive + Enamel Shield Bundle includes products that are appropriate to help keep your mouth healthy. The product line includes:

Sources:
http://www.webmd.com/oral-health/guide/toothaches
http://www.webmd.com/oral-health/guide/abscessed-tooth
http://www.medicinenet.com/abscessed_tooth_guide/article.htm

90,000 Oral abscess, treatment, diagnosis and prosthetics

What is an oral abscess?

Oral abscess is an acute inflammatory disease characterized by the formation and accumulation of pus in the tissues of the gums, tongue or cheeks. The abscess is accompanied by local swelling and compaction of soft tissues, severe pain on palpation, fever and general weakness. The disease is diagnosed by a dentist after a visual examination of the tissues, after which urgent surgical intervention is required: opening the abscess, followed by cleaning and taking anti-inflammatory drugs.

Oral abscess is one of the most common complications in the practice of surgical dentistry. It can be observed in patients of different ages. Untimely treatment can lead to the transition of inflammation to the chronic stage. Against her background, sepsis and phlegmon may develop. That is why, if the slightest symptoms of an abscess occur, you must immediately visit the dentist.

Varieties of abscess by localization

An abscess is classified based on the site of the inflammation.The following types of pathology are distinguished:

Gum abscess

The most common type, inflammation forms around a particular tooth. If untreated, an abscess can provoke: leakage of pus from the formed fistula, putrid breath and intoxication of the body.

Abscess of the floor of the mouth

Formed under the tongue, which causes severe pain and discomfort during communication or eating. With a spontaneous opening of the abscess, the infected fluid is poured into the oral cavity and can provoke a new focus in the pharynx and neck.

Abscess of the sky

Occurs against the background of not completely cured or transferred periodontitis of the teeth of the upper jaw. In the future, inflammation can spread to the peritonsillar area and other tissues of the palate, which will lead to osteomyelitis of the palatal plate.

Cheek abscess

The depth of the lesion in this area of ​​the mucosa determines the localization of inflammation, which can sit inside the cheek or go to the outer surface. Such abscesses are extremely dangerous because the infection can affect nearby facial organs and tissues.

Language abscess

Obvious signs include swelling of the tongue, pain with meals, and difficulty speaking and breathing. This type of abscess, according to doctors, is the most dangerous and requires immediate treatment.

Diagnostics

Diagnosis of an oral cavity abscess is carried out by a visual examination by a dentist of the patient’s mucous tissues. Arbitrary opening or application of antibacterial drugs is strictly prohibited! This can aggravate and complicate the course of the disease.Before contacting a specialist, the patient can only rinse the mouth with an antiseptic solution and take analgesics. To relieve swelling of the cheek, you can apply cold to its outer surface.

Reasons for the development of an abscess in the oral cavity

An abscess in the oral cavity occurs as a complication of advanced periodontitis and periodontitis. These diseases are characterized by damage to the teeth and gums, followed by the formation of pockets in the periodontium. They accumulate pathogenic microorganisms that provoke inflammation.Among other things, an abscess can occur due to infection in the damaged area of ​​soft tissue (trauma, syringe needle, instrument). The cause of the disease is often staphylococcal and streptococcal tonsillitis, as well as boils on the face.

Inflammation in the oral cavity also appears as a complication after suffering from influenza or ARVI, which weaken the immune system, as a result of which the body is not able to fight the infection.

Symptoms

The abscess is characterized by rapid development.At first, the patient may be disturbed by only minor attacks of pain, similar to the sensations that arise with caries or periodontitis. Subsequently, the pain is localized in one place and gradually increases. In a specific place, there is a swelling, sometimes a neoplasm on the gums, sometimes reaching the size of a walnut. If the inflammation is localized closer to the outer surface, then the swelling and redness can be observed with the naked eye. When you find the first symptoms, we recommend that you consult a dentist.

An abscess of the tongue is characterized by an increase in organ volume, difficulty in swallowing, chewing and even suffocation. Any abscess is accompanied by fever, deterioration and general weakness, insomnia, and loss of appetite. The progression of the disease leads to a breakthrough of the abscess, which manifests itself in a decrease in temperature, a decrease in swelling and an improvement in general well-being. However, there is no reason to stop treatment, as the inflammation can continue and develop into a chronic form. This can lead to tooth loss, sepsis and cellulitis.

Treatment of an oral cavity abscess

Treatment of an abscess requires surgical intervention. In order to eliminate the infectious focus and stop the spread of inflammation, the dentist-surgeon in stages:

• opens the abscess;
• drains the cavity;
• cleans the pocket;
• rarely sutures if the incision is large.

After removal of pus, the patient’s well-being improves, the geometry of the face is restored.Taking antibiotics, antihistamines, immunostimulants and a vitamin complex significantly accelerates the healing process. Sometimes the doctor may prescribe physiotherapy procedures (UHF therapy and fluctuating).

For a while, the patient needs to exclude solid food from the diet and adhere to the rules of a healthy diet.

Forecast and prevention of oral cavity abscess

The success of the treatment of oral abscesses depends on at what stage of the disease the patient seeks help and how strong the body’s defense mechanism is.With timely treatment, the prognosis for eliminating inflammation is quite favorable. In the absence of complications, strong immunity and a well-performed opening of the focus, an abscess of the oral cavity can be cured in a couple of weeks.

Prevention of the disease consists in observing the following recommendations:

• regular teeth cleaning and professional oral hygiene at least once every six months;
• minimizing the risk of injury to the mucous membrane;
• timely treatment of caries and periodontal diseases;
• visit for a preventive examination of the dentist once every 6 months.

Oral cavity abscesses: causes, types, treatment

A sick tooth cannot be cured by rinsing with soda, using analgin and a wonderful paste for self-sealing teeth. Various dental drops, heating pads and so on are also ineffective and harmful. Sooner or later, you will “swell”. Believe me, it is better not to bring it to this.

Purulent inflammatory diseases of the maxillofacial region are most often complications of caries. Depending on the severity, they are arranged in the following order: periostitis, abscess, phlegmon.

Flux

The term “flux” is of German origin, it means “flow, flow”. Now you will not hear it from any professional dentist: the flux has been renamed once and for all to odontogenic periostitis . This is the most common “reward” of patient patients who have avoided the dentist for a long time.

Most often, the culprit of periostitis is a tooth affected by caries. However, it is possible that the whole point is in mechanical injury (bruise) or inflammation of the gum pocket – the space between the tooth and the gum.In any case, an infection is involved in the occurrence of the flux, which provokes the development of a purulent process.

As mentioned above, most often the cause of odontogenic periostitis lies in a diseased tooth. From the top of the tooth, pus makes a channel for itself in the bone tissue, trying to escape outward, and breaks through the bone, stopping under the periosteum of the upper or lower jaw (in Latin – periostum). It is from here that the name periostitis came from.

About periodontitis is said when:

• toothache is persistent,
• pain worsens when pressing on the tooth, chewing or trying to knock on the tooth with any object (fork, for example),
• tooth badly destroyed,
• previously this tooth was treated for pulpitis.

If the symptoms listed above are accompanied by edema of the tissues surrounding the tooth, swelling of the cheek from the side of the diseased tooth, this is already periostitis . Particularly severe cases of periostitis can be accompanied by an increase in body temperature.

Treatment

If you have such a nuisance, immediately run to the dentist. The treatment of periostitis looks like this: under anesthesia, an incision is made in the oral cavity, releasing pus. A rubber strip is inserted into the incision – drainage.After that, the patient is prescribed antibacterial and anti-inflammatory drugs.

Abscess

An abscess is a limited collection of pus in tissues. At its core, periostitis is also an abscess, but limited to the periosteum. Abscesses are also opened and drained, but the drainage (rubber strip) is kept longer.

Phlegmon

Phlegmon – diffuse purulent inflammation. Pus is not limited by anything and can penetrate into different parts of the face between the muscles, go to the neck and even go down into the mediastinum – the part of the chest cavity in which the heart, trachea and esophagus are located.

This disease is very dangerous and can cause death. Agree, it’s stupid to die because of a tooth that is not healed during.

How not to harm?

• Do not under any circumstances make warming compresses, this procedure promotes the spread of the process.
• Don’t give yourself any bandages. The “sick” ones with a bandaged cheek tied with a scarf are many times replicated in various drawings and cartoons – a very bad example. The bandage is not a remedy.
• Do not drink antibiotics without first talking to your doctor. Antibiotics are drunk according to a certain scheme, otherwise they are completely ineffective. Microbes adapt to the drug, and the antibiotic becomes useless in the future, along the way, you harm the liver and kidneys.
• Do not take pain relievers less than 3 hours before your doctor’s appointment. Otherwise, you will complicate the diagnosis.
• If you have an incision, do not drink aspirin. Aspirin can cause bleeding.Moreover, as an anesthetic in this case, it is absolutely unsuitable.
• If, despite the incision, you do not feel better within 12 hours, see your doctor again.
• Do not prescribe or discontinue medication for yourself.
• Do not listen to the opinion of your friends, even if they (according to their stories) had the same problem.

After treatment

Do not expect instantaneous disappearance of edema and infiltration, the edema may even increase slightly.However, on the 3rd day you should be on the mend dramatically. An infiltrate – an area of ​​soft tissue compaction in the affected area – can persist for a long time.

Within a few hours after opening the abscess or periostitis, the bursting pain in the area of ​​the focus should subside, and the temperature should begin to decrease. There may be slight discomfort along the incision line, but there should be no severe pain.

A rubber strip is usually inserted into the incision – drainage, which will not allow the wound to close prematurely.Do not pull, push or try to fix it. If the drainage has fallen out, see a doctor as soon as possible.

If something does not go as it is written here, consult your doctor.

I would like to emphasize that the widespread accusations of doctors that they “brought an infection” when they removed a tooth do not have the slightest rational basis. It is enough to remember how many bacteria of various species normally inhabit the human oral cavity to understand the absurdity of such statements.Yes, you may have developed an exacerbation after the treatment or extraction of a tooth, but this usually occurs despite the extraction or treatment of the tooth.

Dmitry Borisovich Konev

90,000 causes, symptoms and treatment in the article of the dentist-surgeon Kozlov P. Yu.

Date of publication March 3, 2020 Updated March 3, 2020

Definition of the disease.

Causes of the disease

Abscess of the oral cavity – inflammation of tissues with their melting (destruction, disruption) and the formation of a purulent cavity.

Most often, the cavity is located between the bone tissue and the periosteum (periostitis, subperiosteal abscess), less often – in the interfascial, intermuscular spaces and in the bone tissue (abscess of the floor of the oral cavity, abscess of the pterygoid-jaw space, abscess of the jaw-lingual groove). Separately, an abscess of the buccal region can be distinguished, which can be located between the mucous membrane and the muscle, in the intermuscular space and between the muscle and subcutaneous fat. In almost all cases, oral abscesses are odontogenic, in other words, the cause of their occurrence is a tooth, moreover, an affected, infected one.In an outpatient clinic, acute purulent periostitis occurs most often in comparison with other inflammatory diseases of the maxillofacial region ^{[1] [2] [3] [4]} .

An abscess of the oral cavity develops as a result of a reaction of local and general immunity in response to infection. The severity of the course of the disease depends on the joint interaction of all defense mechanisms of the body ^{[5] [6]} .

The most common cause of oral infection is acute or aggravated periodontitis.Periodontitis is a type of complicated caries, which can be clinically manifested by a carious cavity, or by a destroyed coronal part of the tooth with direct involvement in the pathological process of the tooth cavity and bone tissue behind the root apex. Radiographically, periodontitis is characterized by a change in the bone structure behind the apex of the tooth root, the degree and severity of the changes depends on the form of periodontitis.

The development of an oral cavity abscess from exacerbation of chronic periodontitis against the background of hypothermia clearly shows the dependence of the onset of the disease on systemic immunity. A patient can live for years with a large number of decayed teeth, which are foci of chronic infection, and only with a decrease in the general defenses of the body can an exacerbation develop with the appearance of an abscess.

The main role in the development of oral abscesses is played by streptococci and staphylococci of various types, gram-positive and gram-negative bacilli and putrefactive bacteria. Of these, about 75% are anaerobic bacteria (able to survive without oxygen) and 25% are aerobic (exist only in an oxygen environment).According to the literature, this ratio is variable, as is the resistance (resistance) of bacteria to antibacterial therapy, and depends on the region ^[7] .

In addition to periodontitis, abscesses of the oral cavity can be caused by suppuration of radicular cysts, which are hollow neoplasms in the apex of the tooth root filled with serous fluid. Also, abscesses can form as a result of infection of a bone wound with fractures of the bones of the facial skeleton, as well as difficult eruption of the lower wisdom tooth: in this case, the cause will be chronic inflammation, which is formed due to the multiplication of microorganisms between the wisdom tooth and the mucous membrane (hood) hanging over it.

Separately, an abscess of the pterygomandibular space can be removed, which can develop as a complication after performing local anesthesia on the lower jaw.

If you find similar symptoms, consult your doctor. Do not self-medicate – it is dangerous for your health!

Symptoms of an oral abscess

Symptoms of an oral abscess are variable and depend directly on the type and location of the abscess. In acute purulent periostitis, patients complain of pain in the area of ​​the causative tooth or jaw segment, swelling of soft tissues.The face of such a patient is asymmetrical.

When the causative tooth is localized in the anterior part of the upper jaw, the edema is located in the upper lip and infraorbital region, the nasolabial fold is smoothed. If the diseased tooth is located in the frontal part of the lower jaw, swelling of the soft tissues is noted in the area of ​​the lower lip and chin. When the causative tooth is located in the lateral part of the dentition, perifocal edema (near the infectious focus) is located in the buccal region.

Acute purulent periostitis is usually not accompanied by restriction of mouth opening.On palpation of regional lymph nodes, signs of acute lymphadenitis (enlarged lymph nodes) are often determined. Examination of the oral cavity reveals the causative tooth, which usually reacts sharply to tapping (percussion). This is due to the presence of a pathological process behind the apex of the root. When examining the vestibule of the oral cavity, a painful inflammatory infiltrate is determined, over which there is an edematous and hyperemic (red) mucous membrane. According to the literature, periostitis is more often located on the side of the cheek or lips, less often on the palatine and lingual side ^{[5] [8]} .

Often, abscesses of the jaw-lingual groove, buccal region, pterygo-maxillary space are considered as a complication of acute purulent periostitis. However, in some cases, these diseases develop on their own, so there is no reason not to consider them in this review.

Abscess of the maxillofacial groove is characterized by a more serious course. The patient complains of pain when swallowing, moving the tongue to the sides, limiting the opening of the mouth. A visual examination determines the swelling of the submandibular region, acute lymphadenitis.Examination of the oral cavity is often difficult and is possible only after blockade of the motor branches of the mandibular nerve. When examining the oral cavity, acute or aggravated periodontitis of the chewing tooth of the lower jaw or difficult eruption of the lower wisdom tooth is determined. When examining the jaw-lingual groove, its bulging is determined; on palpation, an inflammatory, sharply painful infiltrate can be detected.

With abscess of the pterygo-jaw space , the patient notes an increase in body temperature, pain in the pharynx, difficulty swallowing, mouth opening is limited, in some cases almost impossible.Perifocal edema is often absent visually. Examination of the oral cavity can be performed only after blockade of the motor branches of the mandibular nerve. In the oral cavity, difficult eruption of the lower wisdom tooth is usually determined, as well as a hyperemic and edematous pterygo-mandibular fold.

The clinical picture of the buccal region abscess largely depends on the depth of the abscess. With a superficial abscess, hyperemia (redness) of the skin is determined, a local increase in temperature, the skin is tense, does not collect in a fold.With an average and deep location, there is a pronounced swelling of the buccal region, the skin is not externally changed, it is difficult to fold into a fold. Local hyperthermia (fever) is usually not observed. With a deep location of the abscess on the mucous membrane of the cheek, teeth marks are determined.

The condition of patients with these abscesses is usually assessed as moderate. Treatment, as a rule, is carried out in a hospital of maxillofacial surgery under supervision in order to prevent the development of severe complications.Patients often have symptoms of general intoxication of the body (fever, headaches and muscle pains).

Pathogenesis of an oral abscess

Inflammatory fluid (pus) in the tissues around the apical third of the tooth root may not be emptied through the root canal, in which case it will spread from the periodontium towards the periosteum. In this case, the infection penetrates through the compact plate along the nutrient and osteon canals (structural units of the compact substance of bone tissue).An important role in this process is played by resorption (resorption) in the compact plate of the alveolar wall. Microorganisms can also spread under the periosteum by hematogenous (through blood) and lymphogenous (through lymph) pathways.

Violation of the integrity of periodontal tissues is the cause of functional failure of nonspecific and specific humoral and cellular reactions to suppress infection. Toxins of microorganisms enhance sensitization (sensitivity), disrupt hemodynamics (movement of blood through the vessels).Inflammation develops brightly, the body’s response to it can be normal (corresponding to the strength and nature of the stimulus) or hyperergic (exceeding the effect of the stimulus). Further, with an untimely visit to a doctor and an imbalance in the patient’s immune status, the infection spreads to nearby cellular spaces.

The abscess is separated from healthy tissues by an infiltrated shaft of leukocytes. At the same time, the vessels are full-blooded, from their lumens the liquid part of the blood passes into the tissues, forming perifocal edema.In the process of the development of a tissue reaction around the purulent focus and the multiplication of connective tissue cells, a granulation shaft is formed, which limits the purulent focus. With the long-term existence of a limited purulent process, it is possible to develop a dense connective tissue pyogenic membrane, which serves as a barrier for the further development of the inflammatory process.

Classification and stages of development of an oral abscess

By location:

1. Adjacent to the upper jaw.
2. Adjacent to the lower jaw.

For the reason:

1. Odontogenic (caused by an infected tooth)
2. Tonsilogenic (caused by inflammation of the pharyngeal tonsils).
3. Rhinogenic (caused by inflammation of the nasal mucosa).

By the type of inflammatory reaction:

1. Hypoergic (slow development of the disease, symptoms are weak).
2. Normal (the most typical course of the disease).
3. Hyperergic (rapid progression of the disease with pronounced symptoms) ^[11] .

Complications of oral abscess

Complications of oral abscesses are phlegmon of the face and neck, sepsis, mediastinitis, thrombophlebitis, meningitis ^[1] .

Due to good vascularization (blood supply) and an abundance of cellular spaces, purulent-inflammatory diseases of the maxillofacial region spread rather quickly to nearby areas.A prerequisite for this is the reduced immune status of the patient.

With the penetration of an inflammatory infiltrate through the diaphragm of the oral cavity, phlegmon of the floor of the mouth develops. This disease is characterized by a severe course and a rather unfavorable prognosis. Often the root of the tongue is involved, which can lead to closure of the airways. With phlegmon of the bottom of the mouth, the patient has difficulty breathing, it is almost impossible to close the mouth and make swallowing movements.The usual food intake for such patients causes a lot of problems, patients are often emaciated, are in serious condition due to pronounced symptoms of general intoxication of the body. Often, phlegmon of the floor of the mouth spreads to the neck, which aggravates the patient’s condition, especially if the neurovascular bundle of the neck is involved in the process. In some cases, putrefactive-necrotic phlegmon of the bottom of the oral cavity develops, which has a gangrenous character (Ludwig’s angina). This disease has an extremely severe course, with untimely treatment, a fatal outcome is possible.

Sepsis is a pathological condition caused by the entry of microorganisms into the systemic circulation from the focus of inflammation. Sepsis is characterized by severe general disorders and the formation of foci of purulent fusion in various organs and tissues. The most common causative agents of sepsis are staphylococcus, E. coli and Pseudomonas aeruginosa, anaerobes, however, theoretically, sepsis can be caused by any microorganism.

Mediastinitis – inflammation of the mediastinal tissue.It is one of the most severe complications of pyoinflammatory diseases of the maxillofacial region. Infection of the mediastinum occurs by contact (along the length of the neurovascular bundle of the neck in connection with the spread of pus from top to bottom) or hematogenous / lymphogenous. Mediastenitis is characterized by chest pain, impaired swallowing, hoarseness, and symptoms of a systemic inflammatory response. Symptoms of this disease can vary, they depend on the prevalence of the pathological process, the degree of involvement of the mediastinal organs and the severity of their damage ^[1] .

Thrombophlebitis of the facial veins – acute inflammation of the veins with the formation of a blood clot, which develops in pyoinflammatory diseases of the maxillofacial region. In some cases, thrombophlebitis of the sinuses of the brain develops.

Meningitis is a purulent or serous inflammation of the brain or spinal cord caused by bacteria, viruses or other agents.

The described diseases are quite dangerous, each of them is characterized by a serious condition of the patient.Cases of a combination of these complications are not uncommon, which affects the prognosis, terms of rehabilitation, as well as complete physical and mental recovery.

Any of the above diseases is an indication for immediate hospitalization in a specialized surgical department. In some cases, after surgery, the patient is admitted to the intensive care unit under constant supervision. Constant monitoring is required, in some cases – consultations or interventions of related specialists (neurosurgeons, thoracic surgeons).

Diagnostics of the oral cavity abscess

Basic and additional research methods are used for the diagnosis of oral cavity abscesses.

At the initial appointment, the doctor assesses the clinical situation and decides on the need for hospitalization of the patient with subsequent treatment in a hospital. The doctor listens to the patient’s complaints, learns the history of the development of this disease, asks about the presence of concomitant common pathologies. Then he conducts a clinical examination, which begins with a visual examination of the patient: in this case, the asymmetry of the face, the color of the skin, the degree of mouth opening are assessed.Particular attention is paid to the study of regional lymph nodes, since their enlargement is a clinical symptom of inflammatory diseases of the maxillofacial region. After a visual examination, the oral cavity is examined, during which it is necessary to identify the causative tooth and the focus of inflammation.

In a number of cases, especially in severe forms of inflammatory diseases of the maxillofacial region, it is necessary to measure body temperature and blood pressure. In the case of an oral abscess, the results of these examinations help determine changes in the general condition of the body, which can be expressed in the appearance of headaches, malaise, chills, etc.

In an outpatient setting, a sighting X-ray or radiovisiogram is carried out, it is possible to carry out electroodontodiagnostics (assessment of the state of the pulp by checking its response to an electric current). Orthopantomogram ^[5] is performed with special equipment. These research methods make it possible to establish the causal tooth, because in some cases the clinical picture does not allow this to be done due to the pronounced edema and a large number of decayed teeth.

Currently, more and more patients with pyoinflammatory diseases of the maxillofacial region, including acute purulent periostitis, are being treated in a maxillofacial surgery hospital. Only in the hospital, the patient is under round-the-clock supervision, which allows him to thoroughly examine him, as well as control and adjust the treatment and rehabilitation.

In inflammatory diseases of the maxillofacial region, a general blood test will be informative, in which special attention is paid to the number of leukocytes, the erythrocyte sedimentation rate (ESR) and the presence of a shift in the leukocyte formula. In addition to a general blood test, a general urine test, a biochemical blood test, a blood test for the presence of antibodies to infectious diseases, fluorography and electrocardiography, if necessary, are performed.

To clarify the localization and prevalence of the purulent process, as well as to select the optimal surgical access, an ultrasound scan of the inflammatory infiltrate and adjacent tissues is performed. After opening the abscess, material is taken to study the quantitative and qualitative composition of the flora, as well as its sensitivity to antibiotics.This study will allow prescribing the most effective antibacterial drug that will help the patient recover in the shortest possible time.

Treatment of an oral cavity abscess

Patients with oral cavity abscesses need urgent surgical treatment in the volume of opening the inflammation focus ^[8] . In case of acute purulent periostitis or deep buccal abscess under local anesthesia, the abscess is opened, then local antiseptic treatment of the postoperative wound with antiseptic solutions is performed, followed by drainage.

Patients with abscesses of the maxillofacial groove, pterygoid-jaw space, superficial and mid-buccal abscesses are increasingly being treated in a maxillofacial surgery hospital. Lancing of such abscesses is also performed under local anesthesia.

It is worth paying attention to the tactics of treating the causative tooth. After clinical and radiological examination, a decision is made to preserve or remove the causative tooth. With a relatively preserved crown part, the diseased tooth is usually preserved.If the tooth is destroyed, there is a pronounced pathological mobility, if an extensive focus of bone tissue destruction is revealed according to the X-ray data, the causative tooth is removed. Removal is also performed if the patient refuses to preserve and conservatively treat the causative tooth. In the absence of absolute indications for tooth extraction, a written refusal of the patient to save it is drawn up.

After opening the abscess, the patients are daily bandaged: antibacterial treatment of the postoperative wound and oral cavity, replacement of drainage.Also, the patient must independently observe oral hygiene.

In addition to surgical treatment, antibiotic therapy is prescribed. Its goal is to suppress the pathological microflora. Before the results of antibiotic susceptibility tests are available, empiric therapy is carried out, which involves the use of a broad-spectrum antibiotic. When the results are obtained, the pathogen or pathogens and an antibacterial drug are identified, which most effectively helps to fight the pathogenic flora ^[11] .

In connection with the presence of a pronounced pain syndrome in the area of ​​the postoperative wound, symptomatic therapy is carried out. The patient is prescribed non-steroidal anti-inflammatory drugs in injectable or tablet form.

detoxification therapy is being carried out, the essence of which is the intake of a large amount of liquid. Severe patients are shown intravenous infusion with isotonic solution. In some cases, multivitamins and physiotherapy are prescribed.

Forecast. Prevention

With timely treatment, correct treatment tactics and correctly selected drug therapy, the prognosis is favorable. In acute purulent periostitis, usually after 3 days, there is a decrease in collateral edema and a decrease in pain in the area of ​​the postoperative wound. Full recovery of working capacity is usually noted on days 3-7, depending on the severity of the disease, the presence of background diseases, compliance with the recommendations and prescriptions of the attending physician.

Often patients neglect the recommendations: they do not observe oral hygiene, do not come for repeated appointments, do not take medications, or take the wrong drug due to various reasons. In some cases, such a negligent attitude towards one’s own health does not bring negative consequences. But sometimes, especially against the background of a weakened general immunity, the presence of severe general diseases, including immunodeficiency, complications develop. In such cases, the patient is shown hospitalization in a maxillofacial surgery hospital under round-the-clock supervision.

Great attention is paid to the prevention of inflammatory diseases of the oral cavity. There are many daytime and nighttime dental clinics, weekends and holidays, both public and private. The Internet and other media sources of information talk about the need to brush your teeth twice a day, use various mouth rinses. Many dental clinics are organizing campaigns for professional cleaning of the oral cavity, but the number of patients with inflammatory diseases of the oral cavity is not decreasing.

It should be noted that with timely treatment of carious cavities and sanitation of the oral cavity as a whole, the risk of developing odontogenic abscesses of the oral cavity tends to zero. It is also important to maintain a high level of general immunity, lead a healthy lifestyle and observe a work and rest schedule ^[11] .

90,000 reasons, diagnostics, treatment methods – dentistry President

Phlegmon, abscess and periostitis (flux) are different degrees of purulent inflammatory diseases of the maxillofacial region.Most often they appear against the background of advanced caries.

Content

Flux

In modern medicine, the term “flux” as such no longer exists. The once popular word has now been replaced by “odontogenic periostitis.”

Periostitis is the first stage of jaw inflammation, which almost always occurs due to advanced caries. Rarely manifests itself as a result of a bruise, the entry of pathogenic bacteria into the pocket between the tooth and the gum.Previously treated pulpitis may be a prerequisite.

Symptoms:

• persistent toothache, aggravated by pressure or tapping on the tooth;
• severe tooth decay;

90,059 swelling of the tissues around the tooth;

• swelling of the cheek;
• in especially severe cases – an increase in body temperature.

Abscess – the second stage of inflammation

An abscess practically does not differ functionally from periostitis.The symptoms in this case are the same. Pus, as with flux, is limited to the periosteum, but it can penetrate deeper into the tissues.

Phlegmon – a dangerous omission

Phlegmon is the third, most severe stage of purulent inflammation in the tissues around the tooth. Pus in this case is not limited to the periosteum alone, but freely walks through the tissues, often penetrating into the facial muscles, cervical regions, and behind them into the trachea, esophagus, heart.

IMPORTANT! If phlegmon is not cured in time, it can be fatal!

Treatment of periostitis, abscess

The first and most important step in treating a flux is to visit a doctor.During the procedure, the dentist makes an incision in the mouth, releasing the accumulated pus, after which a so-called drainage – a rubber strip – is inserted into the wound. Further, the treatment continues at home with the prescribed anti-inflammatory drugs.

Treatment of an abscess differs from the elimination of periostitis only in the period of wearing drainage. Usually the rubber strip stays in the mouth for a little longer.

What happens after treatment?

Usually, the first 2 days, unpleasant sensations persist, although the body temperature gradually begins to decrease, and the pain is no longer so obvious.A sharp improvement in the condition and appearance occurs on the third day.

Infiltrate – tissue compaction in the focus of inflammation – can persist for quite a long time. Gradually, the “bump” should dissolve.

Drainage – rubber strip – should remain in the wound for some time after the procedure. It prevents the incision from tightening ahead of time, leaving an open path for pus to escape. It is strictly forbidden to loosen, push out, correct drainage in any way. If the strip falls out, see a doctor right away. Call a specialist even if you do not feel better 12 hours after opening the flux.

Prohibited for inflammation:

• to make warming compresses and dressings;
• self-prescribe antibiotics and other medications;
• take pain relievers before visiting a doctor;
• drink aspirin (before and after opening).

Finally, I would like to say one thing: please, do not be afraid to go to the doctor at the first symptoms of caries.Treating a tooth is still less painful than trying to cope with inflammation in the tissues later. Take care of yourself!

See also

90,000 Oral abscess – causes, symptoms, diagnosis and treatment

Oral abscess is an acute inflammatory disease of the oral cavity, which is characterized by focal accumulation of pus in the tissues. With an abscess in the oral cavity, there is a limited compaction and swelling of the mucous membrane, painful to touch, which is accompanied by a deterioration in general well-being and an increase in body temperature.An oral abscess is diagnosed by a dentist during an examination based on an assessment of the condition of the tissues. Treatment of an oral cavity abscess includes a surgical operation – opening the abscess, as well as anti-inflammatory drug therapy.

General information

An oral abscess is a local purulent inflammation of the tissues of the gums, tongue, palate or cheek. This disease is one of the most common problems in dental surgery and manifests itself regardless of the age and gender of the patient.Most often, an abscess of the oral cavity occurs as a result of complicated dentoalveolar pathology, but its development is also possible due to a violation of the integrity of the mucous membrane or in general infectious diseases.

In the absence of timely and correct therapy, an oral abscess can flow into a chronic form, as well as cause severe complications such as phlegmon and sepsis. Therefore, self-medication with an oral abscess is strictly prohibited. In order to prevent the consequences, it is necessary to urgently consult a specialist at the first symptoms of the disease.

Abscess of the oral cavity

Causes

Most often, an abscess of the oral cavity occurs as a complication of dental pathologies, for example, periodontitis or advanced periodontal disease. These diseases are characterized by the destruction of the periodontal joints and the formation of the so-called periodontal pockets, in which there is an intensive multiplication of pathogenic microorganisms that cause the inflammatory process.

An abscess of the oral cavity can form as a result of infection in the wound when the integrity of the mucous membrane is violated, for example, with a syringe needle during anesthesia or in case of mechanical injury.The reason that provokes the development of pathology can be boils in the face, streptococcal and staphylococcal sore throats. It is noticed that abscesses of the oral cavity often occur against the background of influenza or other common infectious diseases that weaken the immune system.

In most cases, an oral abscess is caused by an infection involving more than 3-5 microorganisms. The most common etiological agents are staphylococci, streptococci and gram-negative anaerobic flora (Eikenella corrodens, Porphyromonas gingivalis, Enterobacteriaceae spp.and etc.).

Classification

Depending on the location, there are several types of oral abscesses:

• Gum abscess appears next to a specific tooth. This is the most common type of abscess. In the absence of proper treatment, it can flow into a diffuse inflammation or into a chronic form, which is characterized by periodic exacerbations, the outflow of pus from the formed fistula, a bad smell from the oral cavity and intoxication of the body.
• Abscess of the floor of the mouth is located under the tongue, causing severe pain while talking and eating. With a spontaneous opening, pus leakage can cause secondary foci of inflammation in the pharynx and neck.
• Palate abscess most often occurs due to periodontitis of the teeth of the upper jaw. Threatens with the transition of infection to the adjacent tissues of the palate and peritonsillar area, as well as the development of osteomyelitis of the palatine plate.
• Cheek abscess , depending on the depth of the lesion, can be localized both inside – on the side of the mucous membrane, and out to the outer surface of the cheek. An abscess of this localization is extremely dangerous due to the possible spread to nearby facial tissues.
• Tongue abscess is characterized by swelling of the tongue, difficulty eating, speaking and even breathing. This type of abscess is the most dangerous; with the development of the first symptoms, urgent hospitalization is necessary.

Symptoms of an abscess

Formation of an abscess in the oral cavity, as a rule, occurs rather quickly. At first, painful sensations may appear that resemble the symptoms of periodontitis – the pain is localized in the area of ​​a particular tooth and intensifies when biting. Soon after that, a painful and dense swelling to the touch appears at the site of the development of the pathological process. Outwardly, it is a rounded formation on the gum, which in some cases can reach the size of a walnut.

Tongue abscess develops rapidly – rapidly growing pain appears in the thickness of the organ, it rapidly increases in volume; the patient has difficulty with the processes of chewing and swallowing, and in severe cases, suffocation occurs. When the inflammation is localized under the mucous membrane of the soft tissues of the oral cavity, as well as closer to the surface of the skin (face or submandibular region), on examination, redness and swelling can be observed at the site of the focus of infection.

Any abscess of the oral cavity, as a rule, proceeds against the background of a deterioration in general well-being, an increase in body temperature, sleep and appetite disorders.The progression of pathology can lead to a breakthrough of the abscess. The release of pus brings significant relief to the patient: pain decreases, swelling subsides, temperature decreases, general well-being improves, but this should not be a reason for calming down due to the possible development of complications.

Complications

The inflammatory process can continue, flow into a chronic form and spread to nearby tissues. An abscess of the oral cavity threatens with many serious consequences, for example, the loss of one or more teeth, the development of phlegmon and sepsis.In order to avoid complications, it is necessary to consult a doctor as soon as possible, who will prescribe the correct treatment.

Diagnostics

An oral abscess is diagnosed by a specialist based on a visual assessment of the condition of the mucous membrane during a dental examination. The expectation of spontaneous opening of an oral abscess or the independent use of antibacterial agents is completely unacceptable. To relieve symptoms, you can use pain relievers and rinse your mouth with warm antiseptic solutions before going to the doctor.

Treatment of an oral cavity abscess

An oral abscess is treated exclusively by surgery. In order to eliminate the focus of infection and prevent the spread of the inflammatory process, the dentist will open the abscess, drain and antiseptic the cavity. Suturing after such an operation is usually not required, as the size of the incision is small.

After removing the pus, as a rule, the patient feels better, the pain subsides, the swelling subsides, normal facial contours are restored, but if the oral abscess has developed significantly, then the final recovery may be somewhat delayed.

In the postoperative period, antibiotics, antihistamines, immunostimulants and vitamin-mineral complexes are prescribed. In some cases, physiotherapy, such as fluctuating or UHF therapy, is used for a speedy cure. It is also recommended to avoid solid foods after surgery and eat a good diet.

Forecast and prevention

In general, the success of treatment of oral abscesses depends on the timeliness of the visit to the doctor and the general condition of the patient’s body.It is very important to start treatment measures as early as possible – in this case, the prognosis is usually favorable. If the surgery is performed on time and there are no complications, the oral abscess will heal completely within 1–2 weeks.

To prevent an oral cavity abscess, it is necessary to observe the rules of hygiene, avoid injuries to the mucous membrane, and in the presence of periodontal diseases, timely treat them.

90,000 Tooth abscess. Tooth abscess treatment

Tooth abscess is a serious acute infectious disease that is usually localized in the area of ​​the tooth root.

Causes of tooth abscess:

• advanced caries;
• pulpitis;
• gingivitis;
• periodontitis;
• granuloma;
• tooth cyst;
• mechanical injuries that led to a tooth chipping or fracture;
• an infection that was transmitted by the bloodstream in general infectious diseases;

90,059 skin damage;

• damage to the oral mucosa;
• the formation of boils in the jaw area;
• infection by injection.

Symptoms of a tooth abscess:

• prolonged sharp aching or throbbing pain in the tooth;
• pain when pressing on the tooth;
• pain when chewing;
• increasing the sensitivity of the tooth to various temperature stimuli;
• Regular bitterness in the mouth;
• constant general malaise;
• feeling of discomfort;
• sleep disturbance;
• appetite disturbance;
• elevated temperature;
• unpleasant putrid odor from the mouth;
• enlargement of the cervical lymph nodes;
• redness and swelling of the gums.

Treatment of tooth abscess

A suspicion of a tooth abscess usually arises already at the first examination of the patient by external symptoms:

• Tooth pain that worsens with tapping;
• redness and swelling of the gums;

90,059 ulcers on the gums;

• discharge of pus.

These symptoms are the most obvious and if you have them, you should immediately contact the dentist.If necessary, an X-ray can be performed for you, which can finally confirm or deny the diagnosis.

Treatment of a tooth abscess is directed to eliminate the focus of infection. The purpose of this elimination is to preserve the tooth and prevent further complications from occurring.

In some cases, when the infection develops strongly enough, the risk of complications is very high, and the preservation of the tooth is problematic. Because of this, a tooth can be removed.

The most modern method of treating an abscess of a tooth is the use of a low-intensity laser, which allows opening the abscess and making its drainage less painful.

In order to relieve the pain caused by the abscess and reduce the feeling of discomfort, dentists recommend regular rinsing of the mouth. Rinse with warm water-salt solution. Alternatively, you can use analgesics that are sold at any pharmacy.

Prevention of tooth abscess

Preventive measures for tooth abscess are in many ways similar to the prevention of many other dental diseases.

First of all, prevention consists in thorough oral hygiene and in the timely treatment of any dental diseases in order to prevent their complications.

In addition, if there are mechanical injuries to the tooth, which lead to loosening or chipping of the tooth enamel, then you need to visit the dentist as soon as possible. This is necessary in order to prevent the possibility of developing an infection.

Source apolloniya-stom.ru

90,000 purulent inflammation of the gums, tongue, cheeks or palate

Painful sensations in the mouth can occur not only due to a carious process or other damage to the teeth.Often, pathogenic bacteria get into small cracks or wounds in soft tissues. What signs and symptoms to identify abscesses of the tongue, gums, cheeks, upper or lower palate is described in detail in this article. In addition, from it you will learn how dangerous it is to postpone a visit to the doctor, and what the consequences of a rupture of the focus of inflammation for the whole organism are fraught with.

There are many health problems that modern man constantly faces throughout his life. Purulent inflammation in this series is by no means a rare occurrence.And if suppuration on the skin can entail not so many negative consequences, then, for example, an abscess in the mouth that has not been cured in time threatens to turn into more complex diseases that carry serious complications.

An abscess of the oral cavity is a wound surface of soft tissues, into which an infection has entered. Over time, it begins to develop, the level of leukocytes rises in the body, aimed at fighting harmful bacteria, as a result of which the body’s immune system drives the infection into a limited space, where it begins to diligently destroy it.The result of this struggle is the formation of pus, consisting of dead tissue, bacteria and blood serum.

Thanks to this process, the abscess of the oral cavity takes on the final form of a pronounced inflammation of a rounded shape with clearly defined boundaries. Most often, an abscess in the mouth is formed when there are problems with the teeth, but the source of infection can be boils in the maxillofacial region, and mechanical damage to the oral mucosa, and streptococci with staphylococci that provoke angina.Let’s consider the most common cases of inflammation.

Language abscess

Perhaps one of the most dangerous is the abscess of the tongue, as it develops rapidly, causing a sharp increase in the size of the tongue, which can lead to a lack of oxygen and suffocation. When an infection gets into microcracks and an abscess forms in the thickness of the tongue, the patient begins to experience severe pain. The tongue swells, it becomes difficult to swallow and chew, these symptoms are especially pronounced in the presence of an abscess of the root of the tongue.The closer the source is to the nasopharynx, the sooner the patient is shown hospitalization and the doctor’s surgical intervention.

In addition to root dislocation, a sublingual abscess may develop. Although it is less dangerous for breathing, it is also subject to an early opening in order to avoid a breakthrough and purulent intoxication of the body.

When this type of inflammation occurs, the patient usually experiences painful sensations while eating and talking. In any case, an abscess of the tongue, in whatever area it is formed, is a very dangerous thing, since all nearby soft tissues, organs and, first of all, the brain are at risk.First signs of inflammation:

• painful sensations;

90,059 headaches;

• hyperemia;
• loss of sleep and appetite;
• general malaise.

Periodontal abscess

The causes of gum abscess (periodontal) are most often the gaps between the gums and the teeth, the so-called periodontal pockets, into which the infection gets. Outwardly, the focus of infection resembles a small, painful to touch, red ball.Pockets can form for various reasons, in particular due to diseases of the oral cavity, constant trauma from incorrectly installed dentures or fillings, mechanical damage (trauma, bruises, burns).

A gingival abscess that is not drained in a timely manner can damage one or even several teeth, which will subsequently lead to their loss. Among other things, periodontal inflammation grows quickly enough, and can increase to the size of a walnut, which not only deforms the jaw and oval of the face, but also leads to severe intoxication of the body.

Treatment for this type of inflammation is standard: the abscess is opened with a scalpel, pus is removed, the cavity is drained and cleaned. Sutures during such operations are extremely rare, since usually the size of the incision is quite small. However, if the tumor has reached an impressive size before the operation, the process of drainage and further recovery may be delayed. In some cases, doctors prescribe a number of physiotherapy procedures to help the patient recover as soon as possible.

Cheek abscess

The main danger of a cheek abscess is that it can spread to adjacent organs and parts of the face. Such an abscess can appear on both the outer and inner side of the cheek. In addition to redness and hyperemia of the inflamed area, the swelling can be expressed by moderate soreness, which increases when the mouth is opened.

When formed on the inner mucous membrane of the cheek, such inflammation, in the case of spontaneous opening, can infect the oral cavity in the presence of microcracks.In any case, contacting a doctor should not be postponed, since even an opened abscess can entail many negative consequences.

Self-medication in such cases is dangerous, but before a visit to a specialist, rinsing with antiseptic solutions, herbal decoctions at room temperature, as well as applying a cold bandage to the inflamed area will help relieve pain and stop the development of inflammation. It is important not to overheat the source of the infection in order to avoid further spread of the infection.

Abscess of the sky

Another type of inflammation in the oral cavity is a palatine abscess. Most often it is a consequence of periodontitis of the maxillary teeth (premolars, canines and incisors). This type of inflammation begins with redness and pain in the area of ​​the hard palate. With an increase in the focus of inflammation, the pain also increases, making it difficult to chew food. If the abscess spontaneously opens, the risk of spreading the infection to the entire area of ​​the hard palate increases, as well as the development of osteomyelitis.

According to the focus of education, this type of tumor can be divided into two subspecies: inflammation of the hard palate and soft palate:

Abscess of the hard palate

• patient complaints of palpable throbbing pain in the palate (upper jaw), which is aggravated by talking and trying to chew food;
• foci of infection – periodontal pockets of the maxillary teeth, wounds on the mucous membrane of the hard palate;
• is possible to spread in the absence of timely treatment to the soft palate and periopharyngeal space.

Soft palate abscess

• complaints of painful swallowing, sore throat, aggravated by talking. The affected area is greatly increased in size;
• sources of infection – damaged tonsil lacunae in chronic tonsillitis, microcracks in the mucous membrane of the soft palate, the site of local anesthesia;
• Further spread leads to damage to the peritonsillar and periopharyngeal space.

When faced with the above problems, it is important to remember that a timely visit to a doctor will not only keep you healthy, but also avoid a lot of complications.

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