What to Know About A Tooth Abscess

By Premier Dental of Ohio

A tooth abscess can be painful

A Tooth Abscess: How It Occurs and How to Fix It

A tooth abscess will definitely ruin your day. These dangerous infections can quickly spread from a small bump on the gums to a large swelling that is at risk for cutting off your airway!  You should never ignore a dental abscess. Reading this article will help you to be prepared in the event that you or a loved one suffers from one.

How a Tooth Abscess Occurs

There are two types of dental abscesses, and the distinction results from the original site of infection.  Eventually the infection ends up in the bone and gums surrounding the tooth.  It can begin inside the tooth, called an endodontic infection.  Or it can begin around the tooth, called a periodontal infection.

Endodontic Infections

An infection that begins inside a tooth will spread to the surrounding bone and gums if left untreated.  This type of infection generally starts with a cavity in the tooth.  Cavities are bacterial penetration and infection of the hard tissues of a tooth (the enamel outer coating and underlying dentin).  When you don’t stop a cavity by having dental treatment, it continues to grow inward toward the hollow space in each tooth called the pulp chamber.  The pulp chamber is full of nerves and blood vessels.

Once bacteria reaches the pulp chamber in the center of a tooth, it continues to grow and spread out the tiny hole at the tip of each root.  This is how it infects the jawbone around a tooth.  Usually, the infection will destroy the bone until it makes an “opening” under the gums that allows for spreading and swelling of the gum tissues.  This is the source of the bump near the infected tooth.

Periodontal Infections

A periodontal infection begins with bacteria around the tooth.  Disease-causing bacteria collects on the teeth under the gums in the form of soft plaque and hard tartar buildup.  These collections of bacteria produce toxins that penetrate the gums.  The body responds to these toxins by producing inflammation, and over time, the inflammation actually destroys the tissues that should remain attached to the tooth.

The inflammatory destruction of a tooth’s supporting structures leads to deeper pockets and gaps around the teeth, which continue attract more bacterial buildup.  These infections can develop deep into the surrounding jawbone and then spread in the same way endodontic infections can.  The swelling around periodontal abscesses may be less painful as there is less pressure buildup.  They may also drain from the gums surrounding the teeth instead of from a small, pimple-like bump as an endodontic infection typically does.

How to Fix a Tooth Abscess

Unfortunately, there is no quick fix for a tooth abscess.  Because the source of the infections are either in or around the teeth, there is nothing you can do to actually cure the infection.  Only dental treatment is able to remove the original source of bacteria and prevent the infection from returning in full force.

Dental Treatment

In the case of endodontic infections, you must remove the bacterial infection from the pulp chamber of the tooth (which requires a root canal) or remove the entire tooth itself (a tooth extraction).  Antibiotic medication cannot penetrate into the internal pulp chamber of a tooth to kill the bacteria present there.  You cannot leave an infected or dead nerve inside a tooth.  If you do, it will be a constant source of infection and never heal.

If you have a dental abscess from an infection inside a tooth, your dentist will discuss your treatment options with you.  If you already know there is a large cavity in the tooth, you should expect to hear the words “root canal” and “extraction”.  In cases where a root canal would not have a high long-term success rate, you may only have the option of removing the entire tooth.

In the case of a periodontal abscess, the treatment depends on the state of the supporting structures of the teeth.  Your dentist may be able to provide specialized gum therapy to remove the bacterial buildup deep under the gums and promote healing around the tooth.  If the damage is severe, and the surrounding tissues are unlikely to reattach to the tooth, an extraction will be necessary.

How to Manage a Tooth Abscess

What if you are unable to seek dental treatment right away? 

If you have a tooth abscess and cannot seek urgent dental care, there are a few things you can do to manage it until the opportunity for dental treatment arises.

First, you need to reach out to a doctor for a prescription for antibiotics. As we mentioned earlier, the antibiotics cannot completely cure the infection.  However, they are an important tool in stopping the spread of the infection.  They can also relieve some of the pain by reducing the pressure of the infection inside the jawbone.  You can call your medical or dentist if you have a good relationship with him or her.  You can also go to a local urgent care facility.  One option that is gaining in popularity is telemedicine, so you may be able to have a virtual doctor consult and receive a prescription for the medication necessary to stop this abscess from worsening.

You can take over-the-counter pain relievers such as Tylenol and Advil in an alternating schedule to manage your pain.  We recommend warm salt-water rinses for one to two minutes of vigorous swishing.  You can do this four to five times per day, and it will flush out bacteria from the abscess, reducing inflammation and keeping the site clean.

What NOT to Do

It is extremely important that you know what NOT to do in addition to what you should do.

  • Do not take old, expired antibiotics. As antibiotics age, they weaken, making them less able to kill the bacteria in your infection.  What happens is that they could kill the weakest bacteria, allowing the stronger ones to take over and making your infection even worse.
  • Do not take someone else’s antibiotics. There are many different kinds of antibiotics, and they are specific to which bacteria they kill.  A dental abscess does not contain the same bacteria as a urinary tract infection.  Taking the wrong antibiotics will not fight the bacteria in your tooth infection.
  • Do not attempt to squeeze or pop the abscess. We know it is tempting to “deflate” the bump that develops on the gums when you have a tooth abscess.  The problem is that when you squeeze or pop the abscess, you actually introduce even more bacteria into the infection.  Leave it alone!
  • Do not ignore it! Some abscesses do not hurt, but they are all dangerous.  Ignoring a dental abscess allows it to spread, and in rare cases, it can spread to areas that will kill you like your airway, bloodstream or brain!

More Questions about Tooth Abscesses?

Call your nearest Premier Dental of Ohio location today to schedule a consultation with one of our skilled dentists.  We can answer any tooth abscess question you have and work with you to make sure you stay safe from the risks of the abscess spreading.

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