About all

Abyss infection. Understanding Tooth Abscesses: Causes, Symptoms, and Prevention

What are the main causes of tooth abscesses. How can you recognize the symptoms of a tooth abscess. What preventive measures can help avoid tooth abscesses. When should you seek immediate medical attention for a tooth abscess. How are tooth abscesses typically treated by dentists.

Содержание

What is a Tooth Abscess?

A tooth abscess is a pocket of pus caused by a bacterial infection. It can occur in different areas near the tooth, with two main types:

  • Periapical abscess: Forms at the tip of the tooth root
  • Periodontal abscess: Develops in the gums at the side of a tooth root

This article primarily focuses on periapical abscesses, which are often the result of untreated dental cavities, injuries, or complications from previous dental work.

Common Causes of Tooth Abscesses

Tooth abscesses typically develop when bacteria enter the innermost part of the tooth, known as the dental pulp. This can happen through:

  • Deep cavities
  • Chips or cracks in the tooth
  • Trauma to the tooth

Once bacteria infiltrate the pulp, they can cause infection and inflammation, leading to the formation of an abscess at the root tip.

How does poor dental hygiene contribute to tooth abscesses?

Poor dental hygiene is a significant risk factor for tooth abscesses. When you don’t brush and floss regularly, bacteria can accumulate on your teeth, leading to plaque buildup and eventual tooth decay. This decay can create openings in your tooth enamel, allowing bacteria to reach the sensitive inner layers and potentially cause an abscess.

Recognizing the Symptoms of a Tooth Abscess

Identifying a tooth abscess early is crucial for prompt treatment. Common signs and symptoms include:

  • Severe, persistent toothache that may radiate to the jaw, neck, or ear
  • Sensitivity to hot and cold temperatures
  • Pain when chewing or biting
  • Fever
  • Facial swelling
  • Swollen lymph nodes
  • Bad breath or foul taste in the mouth
  • Sudden release of foul-tasting fluid in the mouth (if the abscess ruptures)

Can a tooth abscess cause difficulty in breathing or swallowing?

Yes, in severe cases, the swelling from a tooth abscess can spread to the face and neck, potentially causing difficulty in breathing or swallowing. This is a serious complication that requires immediate medical attention.

When to Seek Medical Attention for a Tooth Abscess

While any signs of a tooth abscess warrant a visit to the dentist, certain symptoms require urgent medical care:

  • Fever accompanied by facial swelling
  • Difficulty breathing or swallowing
  • Severe pain that doesn’t respond to over-the-counter pain relievers

These symptoms may indicate that the infection has spread beyond the initial site and could potentially become life-threatening if left untreated.

Risk Factors for Developing Tooth Abscesses

Several factors can increase your likelihood of developing a tooth abscess:

  1. Poor dental hygiene habits
  2. A diet high in sugar
  3. Dry mouth conditions
  4. Weakened immune system
  5. Previous dental work or tooth injuries

How does a high-sugar diet contribute to tooth abscess formation?

A diet high in sugar provides ample food for bacteria in your mouth. These bacteria produce acid as they consume sugar, which can erode tooth enamel over time. This erosion can lead to cavities, which, if left untreated, may eventually result in a tooth abscess.

Potential Complications of Untreated Tooth Abscesses

Leaving a tooth abscess untreated can lead to serious complications, including:

  • Spread of infection to surrounding tissues
  • Development of a sinus infection (if the abscess is near the maxillary sinus)
  • Sepsis (a life-threatening systemic infection)
  • Tooth loss

People with weakened immune systems are at higher risk for these complications, making prompt treatment even more crucial.

Can a tooth abscess lead to brain infection?

While rare, it is possible for a tooth abscess to lead to a brain infection if left untreated. The bacteria from the abscess can potentially spread through blood vessels or facial planes to reach the brain, causing a serious condition called cerebral abscess.

Treatment Options for Tooth Abscesses

Dentists typically treat tooth abscesses through a combination of approaches:

  1. Draining the abscess
  2. Eliminating the infection (usually with antibiotics)
  3. Addressing the root cause (often through root canal treatment)

In some cases, if the tooth is severely damaged, extraction may be necessary.

What is the process of draining a tooth abscess?

To drain a tooth abscess, the dentist will make a small incision in the abscess to allow the pus to drain out. This procedure is typically done under local anesthesia. After draining, the area is cleaned with saline solution. This process helps relieve pain and pressure while allowing for better antibiotic penetration to fight the infection.

Preventive Measures to Avoid Tooth Abscesses

Preventing tooth abscesses primarily involves maintaining good oral hygiene and addressing dental issues promptly. Here are some key preventive measures:

  • Brush teeth twice daily with fluoride toothpaste
  • Floss or use a water flosser daily
  • Drink fluoridated water
  • Limit sugary foods and drinks
  • Replace your toothbrush regularly
  • Visit your dentist for regular check-ups and cleanings
  • Consider using an antiseptic or fluoride mouth rinse

How often should you replace your toothbrush to maintain optimal oral hygiene?

Dentists generally recommend replacing your toothbrush every 3 to 4 months, or sooner if the bristles become frayed. Using a worn-out toothbrush can be less effective at removing plaque and bacteria, potentially increasing your risk of dental problems including tooth abscesses.

Understanding tooth abscesses and taking proactive steps to prevent them is crucial for maintaining good oral health. By recognizing the symptoms early and seeking prompt treatment, you can avoid potentially serious complications. Remember, good oral hygiene practices and regular dental check-ups are your best defense against tooth abscesses and other dental problems.

The Role of Diet in Preventing Tooth Abscesses

While maintaining good oral hygiene is crucial, your diet also plays a significant role in preventing tooth abscesses. Here’s how your food choices can impact your dental health:

  • Limit sugary and acidic foods: These can erode tooth enamel and feed harmful bacteria
  • Eat calcium-rich foods: Dairy products, leafy greens, and fortified foods help strengthen teeth
  • Consume crunchy fruits and vegetables: These can help clean teeth and stimulate saliva production
  • Stay hydrated: Drinking water helps wash away food particles and bacteria

Which foods are particularly beneficial for dental health?

Foods that are particularly beneficial for dental health include:
– Cheese and yogurt (high in calcium and protein)
– Leafy greens (rich in vitamins and minerals)
– Apples and carrots (help clean teeth and stimulate saliva)
– Almonds (high in calcium and low in sugar)
– Green and black teas (contain polyphenols that fight bacteria)

The Impact of Smoking on Tooth Abscess Risk

Smoking not only affects your overall health but also significantly increases your risk of developing tooth abscesses. Here’s how:

  • Weakens immune system: This makes it harder for your body to fight off infections
  • Reduces blood flow: Less blood flow to gums can slow healing and make infections more likely
  • Masks symptoms: Smoking can hide early signs of gum disease, allowing problems to worsen unnoticed
  • Increases dry mouth: This creates an environment where harmful bacteria can thrive

How quickly can quitting smoking improve oral health?

The benefits of quitting smoking on oral health can be seen relatively quickly. Within a few days to weeks, you may notice improved taste and smell. Gum health often improves within a few months, and your risk of oral infections, including tooth abscesses, begins to decrease. However, it may take several years for your risk of oral health problems to return to that of a non-smoker.

The Connection Between Stress and Tooth Abscesses

While stress doesn’t directly cause tooth abscesses, it can contribute to their development in several ways:

  1. Weakened immune system: Chronic stress can suppress your immune function, making you more susceptible to infections
  2. Teeth grinding (bruxism): Stress often leads to teeth grinding, which can damage teeth and create entry points for bacteria
  3. Neglected oral hygiene: During stressful periods, people may neglect their oral care routines
  4. Poor diet choices: Stress can lead to increased consumption of sugary, unhealthy foods

What are some effective stress management techniques for overall health, including oral health?

Effective stress management techniques that can benefit both overall and oral health include:
– Regular exercise
– Meditation or mindfulness practices
– Adequate sleep
– Balanced diet
– Time management skills
– Seeking support from friends, family, or professionals when needed
By managing stress, you can indirectly reduce your risk of tooth abscesses and other oral health issues.

The Importance of Early Dental Interventions

Early intervention is key in preventing tooth abscesses and other serious dental issues. Regular dental check-ups can help catch problems early, before they develop into abscesses. Here’s why early intervention is crucial:

  • Prevents small issues from becoming major problems
  • Reduces the risk of pain and discomfort
  • Saves money in the long run by avoiding costly treatments
  • Preserves natural teeth for longer
  • Maintains overall oral health and prevents systemic health issues

How often should adults visit the dentist for preventive care?

Most dental professionals recommend that adults visit the dentist for preventive care at least twice a year, or every six months. However, some individuals may need more frequent visits depending on their oral health status, risk factors, and any ongoing dental treatments. Your dentist can provide personalized recommendations based on your specific needs.

By understanding the causes, symptoms, and prevention strategies for tooth abscesses, you can take proactive steps to maintain your oral health. Remember, good oral hygiene, a balanced diet, stress management, and regular dental check-ups are all crucial components in preventing tooth abscesses and ensuring overall dental wellness. If you notice any signs of a potential tooth abscess, don’t hesitate to seek professional dental care promptly to prevent complications and preserve your oral health.

Tooth abscess – Symptoms & causes

Overview

A tooth abscess is a pocket of pus that’s caused by a bacterial infection. The abscess can occur at different areas near the tooth for different reasons. A periapical (per-e-AP-ih-kul) abscess occurs at the tip of the root. A periodontal (per-e-o-DON-tul) abscess occurs in the gums at the side of a tooth root. The information here is about periapical abscesses.

A periapical tooth abscess usually occurs as a result of an untreated dental cavity, an injury or prior dental work. The resulting infection with irritation and swelling (inflammation) can cause an abscess at the tip of the root.

Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with a root canal treatment. But in some cases the tooth may need to be pulled. Leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.

Periapical tooth abscess

Bacteria can enter the innermost part of the tooth through either a deep cavity or a chip or crack in your tooth. The resulting infection and inflammation can cause an abscess at the tip of the root.

Symptoms

Signs and symptoms of a tooth abscess include:

  • Severe, constant, throbbing toothache that can spread to your jawbone, neck or ear
  • Pain or discomfort with hot and cold temperatures
  • Pain or discomfort with the pressure of chewing or biting
  • Fever
  • Swelling in your face, cheek or neck that may lead to difficulty breathing or swallowing
  • Tender, swollen lymph nodes under your jaw or in your neck
  • Foul odor in your mouth
  • Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures

When to see a doctor

See your dentist promptly if you have any signs or symptoms of a tooth abscess.

If you have a fever and swelling in your face and you can’t reach your dentist, go to an emergency room. Also go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw, throat or neck or even to other areas of your body.

Causes

A periapical tooth abscess occurs when bacteria invade the dental pulp. The pulp is the innermost part of the tooth that contains blood vessels, nerves and connective tissue.

Bacteria enter through either a dental cavity or a chip or crack in the tooth and spread all the way down to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.

Risk factors

These factors may increase your risk of a tooth abscess:

  • Poor dental habits and care. Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of dental problems. Problems may include tooth decay, gum disease, tooth abscess, and other dental and mouth complications.
  • A diet high in sugar. Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.
  • Dry mouth. Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or issues related to aging.

Complications

A tooth abscess won’t go away without treatment. If the abscess ruptures, the pain may improve a lot, making you think that the problem has gone away — but you still need to get dental treatment.

If the abscess doesn’t drain, the infection may spread to your jaw and to other areas of your head and neck. If the tooth is located near the maxillary sinus — two large spaces under your eyes and behind your cheeks — you can also develop an opening between the tooth abscess and the sinus. This can cause an infection in the sinus cavity. You might even develop sepsis — a life-threatening infection that spreads throughout your body.

If you have a weakened immune system and you leave a tooth abscess untreated, your risk of a spreading infection increases even more.

Prevention

Avoiding tooth decay is essential to preventing a tooth abscess. Take good care of your teeth to avoid tooth decay:

  • Drink water that contains fluoride.
  • Brush your teeth for two minutes at least twice a day with a fluoride toothpaste.
  • Use dental floss or a water flosser to clean between your teeth on a daily basis.
  • Replace your toothbrush every 3 to 4 months, or whenever the bristles are frayed.
  • Eat healthy food, limiting sugary items and between-meal snacks.
  • Visit your dentist regularly for checkups and professional cleanings.
  • Consider using an antiseptic or a fluoride mouth rinse to add an extra layer of protection against tooth decay.

Skin Abscess: Causes, Diagnosis, and Treatment

A skin abscess is a bump within or below the skin’s surface. It is usually full of pus, painful, and may feel thick and swollen. This is typically caused by a bacterial infection.

A skin abscess may appear on any part of your body. It is similar to a pimple but typically larger and deeper under the skin. Abscesses most commonly develop on the:

  • back
  • face
  • chest
  • lower abdomen
  • buttocks

Skin abscesses can also appear in areas of hair growth, such as your underarms or groin.

Most skin abscesses are harmless and may go away without treatment. Over-the-counter (OTC) creams such as topical antibiotic creams and at-home care may decrease swelling and aid in healing in minor cases.

Sometimes, skin abscesses are more difficult to treat and may require laceration (cutting) or drainage. In other cases, oral antibiotics may be prescribed along with prescription washes in addition to draining.

There are cases in which an abscess can lead to serious, potentially life threatening complications if left untreated.

A skin abscess is usually the result of a cut or nick in your skin that allows typical bacteria found on your skin, such as Staphylococcus aureus and Streptococcus pyogenes, to enter the wound and cause inflammation.

You’re at an increased risk for this bacterial infection if you:

  • have close contact with an individual who has a Staphylococcus (staph) infection, which is why these infections are more common in hospitals
  • are living with a chronic skin disease, like acne or eczema
  • are living with diabetes
  • are living with metabolic syndrome
  • smoke
  • have a weakened immune system

Other, less common causes of skin abscesses include:

  • viruses
  • fungus
  • parasites
  • tuberculosis

The clinical term for a skin abscess is a cutaneous abscess.

When it comes to skin abscesses, a few common types are:

  • boils, which are painful bumps or nodules
  • furuncles, which are usually due to an infected hair follicle, are filled with pus, and can spread to the surrounding tissue
  • carbuncles, which are clusters of furuncles

In rare cases, an abscess can also form internally.

A few types of internal abscesses include:

  • abdominal abscesses
  • brain abscesses
  • tooth abscesses
  • spinal cord abscesses

A skin abscess often appears as a bump on your skin, similar to a pimple.

However, it can grow over time and become red and painful. The area on top of an abscess is usually inflamed, with the center of it feeling soft or “squishy.” The skin around the abscess may also be warm to the touch.

Depending on the cause of the abscess, other symptoms may also be present. These symptoms may include:

  • fever
  • chills
  • swelling
  • fluid drainage from the abscess

Share on PinterestAn abscess can occur anywhere in the body, including near the jaw, as seen here. Robert Lind / Alamy Stock Photo

Share on PinterestBoils can occur when hair follicles get bacteria trapped in them. They are usually filled with pus, which may leak out. Antoksena/Getty Images

Share on PinterestCarbuncles are a cluster of boils that are connected under the skin. Zay Nyi Nyi/Shuttertsock

A small, occasional skin abscess can usually be treated at home. However, if you think you have an infection or abscess and any of the following situations apply to you, it’s important to contact a doctor as soon as possible:

  • You have a weakened immune system or you were recently hospitalized.
  • You have received an organ transplant.
  • You’re currently receiving chemotherapy or you recently received chemotherapy.
  • The abscess is large, hasn’t healed within 2 weeks, and you also have a fever.
  • The abscess appears to be spreading to other parts of your body.
  • The abscess is becoming more painful or is throbbing.
  • Your skin around the abscess is swollen or extremely red.

Once you’ve made an appointment with your doctor, they will review your medical history and perform a physical examination to visually inspect the abscess.

A complete physical examination is the best way for your doctor to tell if an injury or ingrown hair is the cause of the abscess.

They will also most likely ask you about any associated symptoms, such as a fever.

Even if you’re not certain you have an abscess, it’s important to bring it up with your doctor, as an untreated abscess can lead to serious complications and can become life threatening.

Your doctor may take a culture or a small amount of fluid or pus from the abscess to test for the presence of bacteria. No other testing methods are necessary to diagnose an abscess.

However, your doctor may decide to do a blood test to rule out the possibility of sepsis.

You can book an appointment with a primary care doctor in your area using our Healthline FindCare tool.

In some cases, an abscess may cause serious complications. These may include:

  • fever and swollen lymph nodes
  • spread of the infection
  • blood poisoning, or sepsis
  • endocarditis, which is an infection of the inner lining of the heart
  • development of carbuncles or multiple abscesses
  • tissue death in the area of the abscess
  • acute bone infection, or osteomyelitis

Home treatment options

You can usually treat a skin abscess at home. Applying heat to the abscess can help it shrink and drain.

The most useful way of applying heat is to put a warm compress on the abscess. You can make a warm compress by running warm water on a face towel and folding it before placing it on the abscess several times a day for about 10 minutes at a time.

Drainage

Contact your doctor if the abscess doesn’t heal using home methods. They may want to drain it.

To drain the abscess, your doctor will apply a local numbing substance, such as lidocaine, and will then cut the abscess open to allow the fluid to come out. The open abscess is then washed out with saline.

After the abscess drains, your doctor will pack the wound with surgical material. This helps it to heal and prevents the abscess from reoccurring.

After the procedure is over, your doctor will likely prescribe antibiotics to prevent the wound from becoming infected.

Antibiotics

Your doctor might prescribe an oral antibiotic depending on the appearance and symptoms of the abscess. The antibiotics that are typically prescribed in this instance include:

  • clindamycin
  • cephalexin
  • dicloxacillin
  • doxycycline
  • trimethoprim-sulfamethoxazole (Bactrim)

In some cases, an individual with comorbid conditions (which occur at the same time) or severe infection may require hospitalization and will be given antibiotics through their vein.

After treatment, the abscess shouldn’t return.

You may not always be able to prevent a skin abscess. However, there are ways to minimize your chance of getting the staph infection that commonly leads to an abscess.

To minimize your risk of a staph infection:

  • Wash your hands regularly.
  • Clean all cuts and scrapes, even small ones, with soap and water and apply an OTC antibacterial ointment.
  • Keep your cuts and wounds bandaged.
  • Avoid smoking.
  • Eat a nutrient-rich diet.

It’s also best not to share personal items, such as:

  • towels
  • sheets
  • razors
  • athletic equipment
  • makeup
  • clothing

If you do have a cut or sore, wash your bedding and towels in hot water, detergent, and bleach regularly, and dry them on the hot setting if you can.

Read online “The Abyss for the Hero”, Octavia Kolotilina – Litres

Chapter 1.

Here it is, real happiness! The rubber bands of the respirator were rubbed behind the ears – to get rid of it, take off the sticky overalls of infectious protection, sweat-drenched T-shirt with underwear, step under the tight, tickling jets of the shower. Carefully cover yourself in a cloud of orange foam and almost physically feel how the hot water takes away the flu and chicken pox.

Two hours before the lecture. Inga got into a crisp, fresh surgical suit, twisted her straw strands into a bun and left the red zone.

Now comes the hard part: pronouncing the death sentence.

Went down to the floor. A pensioner in pajamas was shuffling along the corridor of the hospital with torn slippers, strongly raising her right shoulder. Inga immediately singled her out among the patients who staggered along the corridor with an expression of extreme employment on their faces and skirted the angry nurse on a long journey; grabbed by the sleeve.

– Darling! Grandma rejoiced. – Where is the bus stop?

She looked demandingly: well, what, in fact, is this – where could the stop have disappeared? You have to go. The blue-veined fingers trembled, crumpling the referral slip.

– Let’s go. – Inga grabbed a dry, weightless hand and with small steps led the old woman around the corner, through the recreation.

– Will he arrive soon? the passenger asked. – Me Tanya in the garden.

– You lie down on the couch, rest, and there you will arrive, – Inga reassured. – Does your head hurt?

– In the morning, a red-haired woman pricked, she pulls less, otherwise everything gnawed, gnawed.

Elderly people, quite sensible in a familiar to the touch apartment, are completely lost among the state walls.

Inga felt at ease with old people: no matter how old you look, for an eighty-year-old you will in any case be a “granddaughter”, everyone is equal here. She was terribly annoyed by her own appearance, short stature, naive brown eyes, as if she was still at school. Each new acquaintance decided at a glance: “Blonde teen, IQ at the level of a canary”, and come on, prove the opposite, get through for a condescending smile! And the old people do not need to prove anything, most importantly, ask about health – and make friends.

A nurse dyed with henna was rushing about in front of the iron doors with a sign “Tomography”. Seeing a couple approaching, she waved her diaper:

– Oh, where did you find it?!

– Lyudmila, so all the patients will run away from the hospital. – Inga grinned and adjusted her glasses in a black massive frame.

Hand over the granny to the clucking nurse, take a biopsy from the laboratory – and to yourself, to the infectious disease. An hour forty before the lecture, still on the subway to go.

I must tell him… I must tell him today.

The single room smelled of cologne, woody-musky, with cedar; even through the mask, the scent wafted through. Alexei looked out the window, leaning on the windowsill. His broad, muscular back was wrapped in a blue T-shirt.

I ran in the park and picked up a tick, they brought me with suspicion of borreliosis, and when the tests came … Inga checked everything a thousand times. She begged Professor Trushkin, the master of oncology, to come to them, in the “plague barracks”. But now there is no more doubt.

– Alexey, I need to inform you…

He turned abruptly, smiled embarrassedly, kindly. Because of the short beaver, his ears stick out more, and his look is as if he would grab him in his arms right now – and whirl him around, but he is afraid of a white coat.

Inga took a deep breath to calm her pounding heart. She said almost exactly:

– The results of the biopsy are ready, there …

– I know, – Alexey interrupted softly, covering one palm with the other. He has a St. Petersburg purring voice, and northern thin skin hugs his cheekbones. Yellowish skin: not surprising, with such and such a diagnosis.

– Examined in a private clinic, two weeks ago they also said that it was pancreatic cancer. And that he is not being operated on.

Inga exploded, threw the folder on the bedside table:

– So why the hell were you running around? You had to go to Kashirka to go to bed, and now, with borreliosis, they won’t accept you! I’ll talk to Trushkin tomorrow, maybe he…

– Don’t. Alexei shook his head, holding back a twisted smile with difficulty. Why do I need this chemistry, this violence against nature? All the same, after all, in vain, they only torture. You know what, Inga? Let’s go to the cinema. Right now, for the evening session? Can you ask the sisters for the key?

Inga backed away: she hadn’t been to the cinema for two years. No, she was invited, almost every week, either by colleagues, or students, or to the ballet, or to the bar … It’s just that all the hours in the day were scheduled: hospital, candidate, teaching. The world consisted of bright discoveries, diagnoses, the search for the reasons for the different susceptibility of people to viruses – why do some get seriously ill and even die, while others do not show symptoms, but they become carriers? Is it in the genes, in the general state of the body – or maybe the virus itself chooses its victims and carriers? Everything else seemed gray and insipid.

But blue eyes look like that… This twenty-year-old boy has four months left to live, and he will spend most of it in sickly green walls.

“Tomorrow,” Inga decided. – Now I have to run to the lecture, and tomorrow…

She didn’t even have time to move – Aleksey jumped forward, tore off the mask from her face and dug into his lips, cold and wet.

Inga thrashed, broke free and rushed out the door. She herself did not remember how she got to the internship, changed into a terracotta jacket with a skirt, jumped out of the hospital, went down to the subway.

I only thought about Alexei. Every minute she grabbed the phone, found his number and froze, not knowing whether to erase or call. Once again she moistened a napkin, put a bottle of alcohol gel into her skirt pocket and rubbed her lips: they were swollen and burning. Of course, neither cancer nor borreliosis is transmitted from person to person, but still … Strange. Wrong.

I wanted to try again and understand: what exactly is strange and wrong.

Brazen type. And he seemed so intelligent, shy. It is clear that from an excess of feelings he kissed, briefly, in a brotherly way – but still. And they know nothing at all, a week ago he entered, and Inga did not give reasons. Well, I ran three times a day, because the disease is rare, and then there is advanced oncology.

In fact, there is no point in sending him to the Blokhin Center: they won’t go there for an operation, only supportive therapy, pain relief…

Can such injustice be possible?! From the age of three, to rave about medicine, break into Sechenovka, complete the course in three years instead of six, overcome residency – and have no way to save a single person. Why, then, sit half the night over reference books, why spend all your vacations in the morgue and laboratory, refusing to look at the sea even once? Bruises under the eyes and after the weekend are visible, no matter how you cover it with foundation …

She was reading “Fundamentals of Infectology” from the pulpit in the large hall. Then she sat in the university library, tapping nervously on the lacquered table with a plastic human skull.

How stupid students sometimes come across! Then the same stupid interns come out of them, but how are they treated? That’s right, my mother does not want to go to cardiology. Inga sighed:

– Can you list me, Nikiforov, the pathologies of parietal bone development that this infection causes in the perinatal period?

The rack with anatomical atlases towering above them absorbed all sounds, they had to strain their voices. Vasya, the forward of the university hockey team, was asked by the dean himself, Pavel Sarkisovich, to pull him up. But is it really possible to put a three when there is no knowledge here and at the stake?

She covered her face with her hand so as not to see the strange, feline look: this is not at all the way a student should look at a teacher. Are you sure any girl will melt in front of his square chin? Decided to get an assessment not by cramming, but by irresistible charm?

But he is strong. If he starts pestering, then there is no one to call for help, the librarian left an hour ago – she had long resigned herself to the fact that Inga was staying up late, they had a cherished pot with dracaena, where they agreed to leave the key. The guard is downstairs, you won’t call.

Instead of answering, Vasya for some reason moved closer and put his powerful paw on the back of her chair. Well, it carries the same from him then! Inga nervously moved her shoulder, tried to move away … However, the student suddenly grabbed her waist.

She jumped up, clutching her skull; the chair fell with a bang. Seeing that Vasya was trying to grab it, she ran around the table, knocked it over on its side, dumping the textbooks on the floor, and hid behind this barricade.

– Stop it, Inga! The team captain kicked the tabletop. “I won’t do anything to you.

– Inga Valerievna! I’m your teacher, keep your distance.

Vasya smiled with all twenty-four teeth:

– Ooh, angry! And in appearance nyashka: black eyes, plump lips. Do you think people go to your lectures to hear about the “assessment of an epic situation”? That’s when you turn your back to the board, you have such a cool …

– Epidemiological! Nikiforov, if you don’t need any more help on the subject, you can be free.

Inga figured out the escape routes. She knew the library better than her own room. Vasya blocked the passage to the door, however…

– Yes, pretty girl, I need help. Only with something else.

Vasya playfully jumped over the tabletop; Inga threw her skull at him and rushed between the shelves.

The library of the Moscow Medical University was a labyrinth of obsolete literature. Tangled maze. But the long hours of preparing the list of works for the candidate’s thesis turned out to be not in vain: confidently turning between the bookshelves, Inga rushed to the emergency exit.

The pursuer would bump into everything, dropping it on his head. Some new shelving… Wait, where’s the exit?

The roar – and all sorts of expressions – were approaching.

Finding herself at a dead end, Inga feverishly searched the bookshelves with her eyes. “Non-surgical treatment of advanced pancreatic cancer” – there can be no such work here, I shoveled the catalogs! Will Alexei be able to help? Forgetting everything, she reached out her hand, took hold of the binding… Suddenly the rack bent like rubber, turned around and collapsed. The floor floated away from under my feet, Inga fell, glasses rattled nearby.

Vasya’s swearing stopped. Instead of the dusty library air, a draft filled his body, smelling of sage and snow.

Inga got up and put on her glasses. I took it off, washed it, and put it on again. She slapped one cheek, then the other: no, she doesn’t imagine.

A wooden corridor in which you feel as if you are in a huge hollow, only it continues forward and backward, and there is no end in sight; dim lanterns barely protrude from the walls. A breeze is blowing, which means it is coming in from the street somewhere. Fresh: so you dive into the hole, jump out, and the body pricks with needles.

Was there some kind of secret passage behind the bookcase in the library?

There were no corners here, the floor was smoothly rounded, turning into walls that closed overhead; either wires or creepers were woven along them. Inga felt the nearest one: wet, smooth. Nearby is a thin sprout, small glossy leaves stick out on it, pubescent, velvet from the inside.

Greenhouse? Of course, the librarian loves to plant flowers, but really – so much? The creepers are thick, intertwined, as if they have been growing here for two hundred years, try to move it – it doesn’t look like a passage. Maybe Inga failed here?

No, that would leave a hole in the ceiling.

They say secret government tunnels have been laid under Moscow in case of a zombie apocalypse or an “orange revolution”, which is almost the same thing. But how did you manage to get here? Magic-shmagiya, of course, is nonsense. Wormhole, dimensional hole?

They would put rails in the secret subway. People are building rectangular corridors, and then, like a giant worm crawling, the passage walks down, then up, then smoothly turns. A natural cave pierced by water?

Inga screamed. Then again, without any hope… And she wandered off to look for a way out.

Someone else’s appeasement was like a wave. It seemed deep, final, as if in an old, old cemetery, where the poplar trees stretched across the sky have already forgotten that they once ran to the office and prepared dinner…

What kind of thoughts come into your head? So the place is strange.

Roots covered the floor, walking on them on stilettos is just torture. Lanterns loomed at eye level, in desperation Inga took off her shoe and tried to break one with her heel, but he answered with a dull sound, like an oak board. The phone stubbornly did not catch: it only discharges the battery in vain, it is better to turn it off.

What a shame! The mother has a heart, she will begin to worry, call the hospital, and they will say, they say, your daughter is not on duty today. Maybe she’ll think she’s stuck in the library. But not as much?

Inga put the phone in her pocket… And then she noticed something strange.

On the floor stood a white oblong object the size of a fist, rounded in front and pointed at the far end, like a pulled out tooth. He bent two thin back legs, and put four front legs in front of him. And, it seems, he was studying a person: a gaze was felt, although the “tooth” did not have eyes.

Some kind of toy? Here is nonsense: a cave, idiotic jokes … Inga tried to turn the object over with the toe of her shoe, but he suddenly jumped and painfully clutched at the ankle.

She screamed. It turned out to be impossible to pull the creature off its leg – the creature released a lot of branched tentacles-needles and one after another drove them under the skin. From the left crept up three more of the same.

Despair washed over me like a red wave. Mom pestering with a bowl of soup, open on the candidate’s laptop, the hospital, Alexei – everything is gone, no way out …

There were more and more teeth around.

Chapter 2.

In London, at Coal Hill School, there was an old blue police box in the brush room. And inside it, near the control panel of the most powerful spaceship in the universe, the Doctor – the last Time Lord from the planet Gallifrey – and a middle school teacher exchanged barbs.

Suddenly the Doctor became serious, went down a couple of steps from the console platform, sat down and spread his arms:

– Clara, you have to tell me something. Only the truth.

Impossible girl landed next to the old Scot:

– Okay. What’s the matter, you say?

He licked his lips and closed his fingers.

Are you scared?

– I’m terrified!

– From what?

– The answer to my question must be honest, cool, measured, without pity or restraint. Clara, be a friend, tell me: am I a good person?

Clara looked somehow unusual. He had never noticed such a piercing, cold look on her pretty face.

– Does it matter, Doctor? Will you be good or bad, will you choose the evil path or the good one – what will change in the Multiple Universe? Look.

She jumped up, ran down the stairs, went to the blackboard, drew a line there and put a thick dot at the end.

– You come to the aid of the planet, save it, – a line went up from the point, – but then a parallel reality appears, – another line went straight from the starting point, – where the planet died. You are just wasting your energy.

– Clara, I don’t recognize you! Why such pessimism? In fact, everything is much more complicated. The Doctor winced. – But even according to this theory in one of the realities – and it is in mine! – the saved planet remains.

– Being attacked again and again because your reality tends to the original version with the lowest potential energy – the upper line collapsed down and connected with the straight line.

The doctor narrowed his eyes:

– Admit it, Clara, I told you: “Don’t read Hawking?”

– No, you said, “Don’t eat pears.”

– Damn.

The key turned in the lock, the TARDIS door clicked.

It just couldn’t happen, because everyone who had the keys to the ship was inside? The Doctor looked at Clara with the chalk in hand, then at the door.

The door has opened.

Smiling Clara came in with a pile of notebooks under her arm, threw back her brown hair, said “Hi”…

And looked at herself.

The one with the chalk in her hand rushed to the still open door. But the Doctor had already jumped to the console and flipped the switch.

The uninvited guest seemed to stumble upon an invisible wall, jerked back, and froze in a force field with her arms raised, as if suspended by her hands.

Door slammed shut. False Clara looked fearfully over her shoulder at the approaching Doctor.

– Good disguise. He pointed the sonic screwdriver at the prisoner. “Now let’s see what kind of creature you are.”

The real Clara put down her notebooks, came closer and looked at the numbers that the device gave out:

– How are you?

The doctor raised an eyebrow in disbelief, rubbed the screwdriver on his jacket, looked again:

– What?! Man, right?

The scout, caught by the ship’s defense, plaintively asked:

– Remove the field and I’ll leave right away. I didn’t do anything to you.

“I think she is scared,” the teacher concluded. “Why don’t you let her go?”

– Clara, stay away! The doctor raised his hand. This creature can be very dangerous!

– Just a man, besides, we are inside the ship. What can happen?!

The Gallifreyan stalked around the prisoner.

– Oh no, Clara, not “just a man.” The TARDIS didn’t recognize the deception, and neither did I, until I heard about the “Multiple Universe” from you. You don’t talk about things like that.

– Do you think I’m stupid?!

– It doesn’t spoil you at all.

Dodged the slap, pointed the screwdriver at the creature again:

– Answer me, who are you?

Caught looked up. They were bright green.

– Do you really want to know?

Emerald flames burst from her pupils and hit the Gallifrez in the face. For a few seconds he convulsed under the onslaught of lightning entering his brain, then collapsed to the floor.

– Doctor! Doctor! – Clara rushed to the limp body, shaking him by the shoulders, but she could not bring her friend back to consciousness.

The teeth were approaching from all sides. Inga pulled the sucking white creature with both hands, not paying attention to the pain, but it only dug deeper; two more climbed up the ankles.

Is that all, the end?..

Then something buzzed above the ear, a green “bunny” ran up the knee, and the creature fell off. A large confident hand clenched his fingers, someone shouted in his ear:

– Get up. Run, run, let’s go!

Inga obeyed, jumped up.

Stumbling, she tried to keep up with a tall, thin stranger who, putting a hefty laser pointer in front of him, confidently dived first into one branch of the wooden corridor, then into another. The “teeth” minced after them, then fell behind. That’s why at the university she excused herself from physical education? Sweat flows in a hail, and pricks under the ribs.

Finally, the hand unclenched. Inga thumped on the floor – just to catch her breath: you run, perhaps, in heels. Her savior was not even out of breath, although he looked clearly over fifty and was of an asthenic body type.

Oh, now it will start about “we, in the Soviet years”, “wouldn’t you have passed the TRP standards”, “the younger generation”… Suddenly, something completely different sounded:

– Don’t be afraid, they won’t catch up. Lost from sight – and forgotten, a rather primitive form of life.

Inga examined the dark crimson frock coat, noble posture, disheveled gray hair:

Are you a teacher? That is . .. From the university, also got lost in the library?

Bushy eyebrow movement, smile. It seems they once met, maybe in the dining room? How he looks like Grandpa Seryozha…

– I am the Doctor. And you?

– I don’t have it yet, I’m just doing my PhD. Inga Melantseva, infectious disease specialist. Do you lecture on surgery?

– Yes, even in agriculture! – The interlocutor laughed, warmly and sincerely, as if they were not stuck in a wooden labyrinth with terrible bloodsuckers. – I’m lucky for the doctors. Let’s get out of here.

It’s easy to say – get out. Corridors forked and passed into others, narrowed to the point that you could not get through, ended in dead ends.

She looked suspiciously at her ankle: the tights were intact, without puffs – the white tentacles were no thicker than a mosquito proboscis, and there were marks on the skin, as if from bites. Lubricated them with alcohol gel; It’s good that I put the bottle in my pocket, and not in my bag.

It’s easier with old people, old people don’t stare. Inga was embarrassed by excessive skating: the students paid too much attention to this, and all sorts of informal whistles were terribly embarrassing and could deprive the working mood for a whole day. In the comments under each picture on Instagram, someone was sure to joke about her lower part or suggest a diet.

What’s the point of them, these diets? No matter how you sit down, only your chest melts, well, once you managed to minimize the omentum in the lower abdomen, but your butt didn’t want to get out…

Butterflies the size of a tray were spinning around one of the lanterns. Their black, yellow-edged wings were covered with fluff, curled antennae and proboscises bristled.

Inga thought painfully. He introduced himself … What is his name? Pavel Vasilyevich? Mikhail Alekseevich? Oh, these names, they are simply impossible to remember! My memory kept all the articles on infectology of the Great Medical Encyclopedia, but the names and dates flew out of my head like the devil out of a church.

After coughing, she asked:

– I am very ashamed, but I forgot your name and patronymic.

– You didn’t ask him. For you it is much more important what kind of subject I read. Just call me Doctor.

– How convenient!

A pale pink bud crawled out of the ceiling, swelled up like an inflatable balloon and opened. Lotus flower, right? Wow – huge! Just in case, I turned on my phone and took a picture.

A tart and sweet smell with hints of cinnamon spread in waves. Immediately a flock of butterflies flew in, one of them crashed into Inga and got tangled in her hair with her paws. There was an explosion of panic, and she ripped out the insect, along with a couple of hairs, and threw it away.

The doctor moved his laser pointer in the right corridor, it buzzed, a green bunny ran along the walls.

Inga guessed:

– This is your weapon against monsters!

“Not a weapon, no,” the teacher grimaced. “Just a sonic screwdriver.

And what only the Chinese do not come up with! I’ll have to find out where I ordered it from. I remembered:

– The creature jumped off me when you shone it.

– I gave a false signal. I’m afraid this won’t work the second time: beings are connected telepathically, everyone learns at once.

Telepathy? He speaks so confidently, as if every day he deals with those who read other people’s minds. Maybe a psychic? Or a pseudoscientist? What difference does it make, the main thing is that he knows how to defend against these Whites.

– Are they hunting people? – cautiously asked Inga. – Can they find us?

– Yes. I think they pick up the radiation of your brain and come running. Like sharks that smell blood, – long fingers folded into the “jaws” and clicked.

– Look, there’s more!

Five teeth showed through the turn. The doctor turned his head, pressed himself against the wall, clapped beside him:

– Lively, stand up and think about the donut.

– Why – about a donut?

– I’ll tell you later! – He shook the screwdriver with all his might, finally hit it on the root, was delighted and put it in front of him.

Two very strange planets alarmed scientists

We are talking about planets in the constellation Lyra – in the system of the red dwarf Kepler-138, it is almost half the size of the Sun and is located at 219light years from us. On a galactic scale, it can be said to be in the neighborhood. A total of four worlds have been spotted near this star (one of which has not yet been confirmed), including the smallest of all that have been seen through telescopes to date – similar in size to Mars. With this, everything is more or less clear, at least scientists can quite confidently say that this planet has a solid surface. And as it turns out, this question alone can be a puzzle for astronomers, because the other two planets are something completely unseen.

The fact is that one of the surest ways to find a planet near a star is to notice how it passes over its disk, that is, the so-called transit method. And at the moment when the planet is in transit in front of its star, it is possible not only to fix the very fact of its existence, but also to determine the main properties. By how much a star temporarily dims because of this planet, one can understand its size. By the intensity of the star’s rotation around the center of mass common with the planet, one can judge the mass of the planet. Further, the mass is compared with the size, and thus an idea is created about the density of the celestial body. And the density allows you to guess what, in fact, the planet consists of.

Comparison of the size and composition of the Earth and one of the planets of the Kepler-138 system. Photo © NASA / University of Montreal / Benoit Gougeon

And scientists are used to seeing two main types of planets in space: gas and rocky. Gas, as a rule, very large, rocky relatively small. And now let’s see what is known about the mysterious Kepler-138c and Kepler-138d. Size: about one and a half times the size of the Earth. Mass: twice the size of the Earth, namely 2.3 and 2.1 masses of our planet, respectively. And from this, the density of both worlds is about 3.6 grams per cubic centimeter. For comparison, the Earth has 5.5 grams per cubic centimeter, Jupiter has 1.33 grams, and Saturn has 0.69.grams (it is lighter than water, by the way). Mars has 3.93 grams, but it is much smaller than Earth.

That is, the two planets of the Kepler-138 system look like they are clearly not gas and clearly not stone. What then? Scientists have only one version: they are aquatic. The density of water is approximately 1 gram per cubic centimeter. This means that these worlds do not consist entirely of water, but more than half. They should have solid, stone-metal cores inside, surrounded by a continuous global ocean with a depth of about two thousand kilometers. On Earth, by the way, the average depth of the oceans is 3.7 kilometers.

In principle, celestial bodies completely covered with water are well known even here, in the solar system: take, for example, Jupiter’s moon Europa or Saturn’s moon Enceladus.