Tooth abscess

A tooth abscess is an infection of the mouth, upper or lower jaw, face or neck that originates from a dental infection or tooth decay.

When caries is neglected (not treated), it reaches the tooth pulp (pulp).
The nerve and blood vessel in the center of the tooth become infected and die.

The bacteria spread beyond the tooth and form an abscess.
This can also happen with milk teeth of children or a reconstructed or crowned tooth that has undergone root canal treatment.
A tooth abscess is not contagious.
It can affect any tooth: canines, incisors, premolars and molars.


Types of tooth abscesses

  • A “periapical abscess” has its origin in the tooth pulp. It occurs mainly in children.
  • A “periodontal abscess” develops in the bone and tooth tissue. It is mainly found in adults.

Causes of a tooth abscess

The main cause is the complication of caries.
It may also be due to trauma to the tooth that causes a fracture (the tooth breaks) through which bacteria can enter.

Risk factors for a tooth abscess are:

  • poor oral hygiene,
  • incorrect dental treatment.

Symptoms of tooth abscess

The main symptoms of a tooth abscess are toothache, which is often described as stabbing, strong and throbbing.
Other symptoms of a tooth abscess include a nodule on the gums that feels like a pimple on the side of the cheek or tongue.

  • Pain when chewing.
  • Bad taste in the mouth.
  • The teeth are sensitive to hot or cold food.
  • Upper or lower jaw swell.
  • Redness and swelling of the gums.
  • The feeling that the tooth is detaching from its cavity and you can no longer close the teeth correctly.
  • Fever.
  • Enlarged cervical lymph nodes.
  • Pus or yellowish blood leaking from the swollen area.

The symptoms of an abscess on the wisdom tooth are identical to symptoms of other tooth abscesses. They occur mainly in wisdom teeth, the eruption of which has only partially occurred.

If the infection continues to progress, the person may also suffer from systemic symptoms such as fever, chills, nausea, and insomnia.

Possible complications

If symptoms of a tooth abscess are ignored, an untreated abscess can worsen and cause complications.
With timely and effective treatment, one can easily cure the infection and preserve the tooth.

Possible complications of a tooth abscess include:

  • loss of the affected tooth,
  • infection that spreads to the jawbone,
  • Sepsis (blood poisoning) or septicaemia (can lead to death).

Diagnosis of a tooth abscess

If the pain intensifies when pressing on the tooth or chewing, there is a suspicion of a tooth abscess.
A dentist will perform an examination to determine if the tooth can be drained.

If you visit a dentist with severe toothache, he will perform a dental examination during which he gently taps the tooth.
Then he takes an X-ray to determine the severity of the infection.

What to do? Treatment for tooth abscess

The first step in treatment is to eliminate the infection with the help of oral medications.
Antibiotics are prescribed to destroy the bacteria that cause the infection.
The doctor may also prescribe nonsteroidal anti-inflammatory drugs that relieve pain and gingivitis.
If pain and inflammation subside, antibiotic treatment must not be interrupted.
The dosage of antibiotics must be continued as directed by the doctor, even if the signs of infection recede.

The dentist may choose other methods to treat a tooth abscess.
One of these procedures is drainage of the pus that has accumulated in the tooth with the abscess.
To do this, he cuts in the abscess so that the pus can escape.
An abscess that forms at the root of the tooth can affect the stability of the tooth and must be cured with root canal treatment.
The main goal of this treatment is to remove the infected pulp and reconstruct the tooth.
In this treatment, the dentist uses the drill to make small holes on the inside of the infected tooth and removes the dead tissue of the tooth pulp.
Then he cleans and seals the pulp chamber and root canals.
Finally, he covers the tooth with a crown of porcelain or gold.
In this way, the reconstructed tooth can be preserved for a lifetime.

In case of severe infection, the doctor must pull the tooth and remove the pus.
The tooth is lost as a result.

Amoxicillin (Augmentan) is used to treat and prevent infections caused by bacteria.
It does not kill the bacteria, but prevents them from multiplying by destroying their cell walls.
It is available in the form of tablets, juice or suspension.

Possible side effects

  • Diarrhoea
  • Vomit
  • Itch
  • Stomach ache

Amoxicillin can also be taken during pregnancy.
Pregnant women should talk to their doctor before taking any medication that could harm the child; however, no harm has been found for this drug in preliminary studies.

Penicillin is successfully used to treat dental abscesses. However, there is a possibility that the bacterial enzymes in the tooth destroy the penicillin before it can take effect.
To counter this problem, penicillin is sometimes used in combination with beta-lactamase inhibitors, which are designed to protect the penicillin.
Penicillin hinders the construction of bacterial walls and thus destroys the microbes.

This medication is used to treat infections caused by sensitive bacteria, such as anaerobic bacteria. It blocks some functions of the bacteria that cause the infection within the cells, resulting in the death of the bacteria.
It is available in the form of tablets, capsules and infusions.

Possible side effects

  • Nausea
  • Loss of appetite
  • Headache

How to treat a tooth abscess at home

In truth, home remedies do not really solve the problem with a tooth abscess.
Nevertheless, you can temporarily treat the symptoms until you get an appointment with the dentist.
Some options for treating a tooth abscess at home include:

Ice packs: Cold packs can stop the inflammation and prevent swelling from getting worse, but have no effect on the infection.
Some patients have asked me if heat or cold is better. In this case, cold can relieve the inflammation and pain in the short term, but it is not a cure.
In case of infection, the body reacts by increasing the temperature (fever). Therefore, you should not use the cold throughout the day, as this hinders the body’s defenses.

Salt water: This is an old therapy for tooth abscesses.
To do this, add half a teaspoon of sodium bicarbonate and the juice of a squeezed lemon to a glass of lukewarm water and gargle with this solution 2 or 3 times a day.
This is an antiseptic solution that kills the bacteria in the mouth and keeps the infection under control.
If the tooth breaks with the abscess, one should continue this salt water therapy, as it ensures faster healing of the tissues.

What is the prognosis?

If an abscess is not treated, it is dangerous and can even lead to death.
Through antibiotics and an intervention of the dentist, bacteria and pus are removed and the patient can recover.

Tooth abscess after extracting the wisdom tooth

After extracting a wisdom tooth, an abscess is a rather rare complication. One can completely avoid this possibility by following the doctor’s instructions for treatment and taking some precautions.

The wisdom teeth are molars that usually appear after the age of 16 and before the age of 25. Most people have 4 wisdom teeth, two in the upper and two in the lower jaw.
However, there have also been cases where people had less than 4 or even no wisdom teeth.
Since a wisdom tooth appears later than the other teeth, it can be blocked by the adjacent teeth. Then one speaks of an overgrown wisdom tooth.

Consequences can be:

  • Insensitivity
  • Ache
  • Facial swelling
  • Injuries to adjacent teeth and roots
  • Caries
  • Formation of cysts

To avoid all these complications, dentists and oral surgeons often recommend extraction.

Recommendations to avoid tooth abscess after extracting the wisdom tooth

Here are some recommendations that can help avoid tooth abscess:

  • Consistently complete the prescribed antibiotic cycle.
  • Every two hours and after eating, rinse your mouth with lukewarm salt water or a mouthwash (if prescribed by the dentist).
  • Absolutely avoid smoking and drinking alcohol for at least one month after surgery.
  • Perform proper oral care; Brush your teeth twice a day until there are no more food particles between your teeth.

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