TOOTH ABSCESS

General Information

DEFINITION--An abscess (pus-filled sac) around a tooth root, which is imbedded in bone of the upper or lower jaw.

BODY PARTS INVOLVED--Teeth, gums; jawbone.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Persistent toothache or throbbing, extreme pain upon biting or chewing.
• Swelling and tenderness in the neck glands and on the side of the face.
• Earache.
• Fever.
• General ill feeling.
• Foul taste and bad breath (if the abscess opens spontaneously).

CAUSES--The pulp (nerves and blood vessels that fill the central cavity of a tooth) is invaded by bacteria, usually as a result of dental caries that destroy a tooth's enamel and dentin, or when a tooth is injured. Abscesses also develop from periodontal disease when bacteria invades the pockets between the teeth and gums.

RISK INCREASES WITH

• Tartar beneath the gum.
• Poor nutrition.
• Improper diet.
• Inadequate fluoride in drinking water.

HOW TO PREVENT

> Prevent decay with good brushing and flossing:

Use a soft-bristle toothbrush to remove plaque from the teeth's front and back surfaces, especially at the gum line. Learn to use dental floss correctly. Ask your dentist or hygienist to demonstrate the technique.

• Use fluoride mouthwash, toothpaste, tablets or liquid supplements if your dentist recommends them.
• Reduce sugar consumption. Tooth decay increases as sugar consumption increases.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a dentist.
• X-rays of the mouth.

APPROPRIATE HEALTH CARE--

Tooth abscesses can be drained in one of 3 ways:

• If the tooth has poor bone and gum support, the tooth can be extracted, allowing the abscess to drain through the socket and heal.
• A hole can be drilled through the top of the tooth, and a tiny metal or plastic wick inserted into the narrow nerve canal through the center of the tooth. This allows the abscess to drain.
• An incision can be made in the gum at the site of infection, which dramatically relieves pain and pressure. Your dentist may place a small rubber wick in the incision for a few days. When the infection improves, your dentist can perform root-canal therapy (see Root Canal in Surgery section).

POSSIBLE COMPLICATIONS

• If untreated, the abscess erodes a small channel through the jawbone to the gums surface where it forms a gumboil (swelling). If the gumboil bursts, it lets foul-tasting pus into the mouth.
• Loss of the tooth.
• Spread of infection through the bloodstream to other body parts.

PROBABLE OUTCOME--Curable with treatment.

How To Treat

GENERAL MEASURES--

• Rinse your mouth with warm water to draw infection from the abscess. Repeat each hour or as often as feels good.
• Don't chew on the affected side of your mouth for at least 2 days.
• If a tube has been used to drain the abscess, keep the small hole free of infection. Carefully remove impacted food.
• If a drain has been placed in gum tissue, return to your dentist in several days to have it removed.

MEDICATION--

• For minor pain, you may use non-prescription drugs such as acetaminophen.
• Your doctor or dentist may prescribe: Antibiotics to control infection. Pain relievers.

ACTIVITY--Resume your normal activities as soon as possible.

DIET--A liquid diet may be necessary for 1 or 2 days until pain subsides.

Call Your Doctor If

• You have symptoms of a tooth abscess.
• The following occurs during treatment: Fever spikes to 101F (38.3C) or higher. Pain becomes unbearable.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.