Infections can develop anywhere in your mouth – in the gums (periodontal), lips, palate, cheeks, and tongue, or within and below teeth (endodontic). Paying attention to dental health is important in preventing dental infections. A tooth infection occurs when bacteria enters your teeth or gums, and your body sends white blood cells to fight the infection. The mixture of bacteria, white blood cells and dead tissue constitutes pus, which fills a cavity and produces swelling and sensitivity.
This pus-filled cavity is the abscess, which contains the infection and must be drained and treated by a dental professional. Simply put, the infection is the root of the problem and the abscess is the most visible symptom of the infection. It’s important to see your dentist as soon as possible because infections don’t go away on their own. They can spread to the other parts of your body and make you sick.
What is a tooth abscess?
Dental infections are caused by bacteria getting into the tooth and gum. A tooth abscess is a pocket of pus that develops on or around a tooth. It is formed as the result of a bacterial infection.
There are three main types of dental abscess:
- Periapical abscess: This type of infection is when bacteria get inside the tooth through small holes. The bacteria cause the pulp in the centre of the tooth to die and the cavity left gets infected. The infection will eventually make its way to the bone that supports the tooth and an abscess filled with pus will form around that bone.
- Periodontal abscess: This type of infection is much rarer than the periapical abscess. These types of abscesses form when the gums get infected by the bacteria in plaque. The gums will become inflamed and a void can appear between the tooth and the gum that is very difficult to clean. An abscess will then form. The inflamed gums are known as periodontitis.
If you have a dental abscess, you may be suffering from some of the following symptoms:
- Persistent and severe toothache
- Pain radiating to your ear, jaw or neck
- Increased pain when lying down
- Swelling and sensitivity around a tooth or gums
- Persistent bad breath or a foul taste in your mouth
- Sensitivity to pressure from chewing
- Sensitivity to hot and/or cold temperatures
- Tender lymph nodes under your jaw or in your neck
- Fever and general unwellness
- Difficulty opening your mouth, swallowing or sleeping.
An abscess is caused by a dental infection, usually bacterial. These infections typically occur as a result of poor dental hygiene.
When tooth decay develops, a hole in the enamel of your teeth (a cavity) can allow bacteria to enter the tooth and an abscess to form. Bacteria may also enter the tooth through a dental injury or prior dental work.
Similarly, if gingivitis (gum disease) is left untreated, bacteria may accumulate in periodontal pockets or abrasions on the surface of the gums.
Other factors that can contribute to dental infection include:
- Impacted wisdom teeth
- High sugar diet
- Dry mouth.
Infection after dental work
Dental work, from cleaning to root canals, may cause bleeding and an opening where bacteria can enter the body. While dentists, hygienists, and dental assistants work to keep everything as clean as possible as they do their work, sometimes infections do develop, just as sometimes they do after surgery on another part of the body.
dentists recommend that certain people receive prophylactic or preventative antibiotics before they have dental work done. These are people who have certain heart conditions that could make them more prone to developing a condition called infective endocarditis. As well, it may be recommended that some people with artificial joints (like a knee or hip) take prophylactic antibiotics before dental work. If you have an artificial joint, speak with your doctor before you need dental work to see if this is recommended for you.
Here are some of the most common dental procedures.
Dentists try to avoid pulling teeth (tooth extractions), but sometimes it is the only option. Endodontic (root canal) procedures are preferable to extraction when possible.
Some reasons for to have a tooth extracted are:
- Too much damage to the pulp (within the tooth) from infection or decay.
- Infection that has not been cured with antibiotics.
- Gum disease that results in loose teeth that can’t be stabilized.
- Crowded mouth, before orthodontics (braces).
- Teeth that cannot be restored with a dental crown or restoration.
Another part of good dental health is getting dental repairs as quickly as possible. Tooth fillings are done when a cavity or hole in the tooth needs to be fixed. After cleaning out debris and dirt, the dentist inserts the filling material, which will then protect the tooth.
If you have an infection or have had a root canal, the dentist may put in a temporary filling. A temporary filling protects the pulp from bacteria reaching it and usually helps relieve any pain that you may be feeling. Temporary fillings must be replaced with permanent fillings as they are not made to last.
Root canals (Endodontics)
If your tooth is badly decayed or infected, your dentist may suggest that you have a root canal done before going to the more drastic step of extracting (pulling) the tooth.
When a root canal is done, the nerve and the pulp are removed from inside of the tooth. That inner space is then replaced with a sterile inert (chemically inactive) material.
Don’t try to treat a tooth abscess at home
If you’re struggling with the pain of a tooth abscess, it’s important to see a dentist as soon as possible. A dentist will safely drain and treat the abscess, and a root canal procedure may be necessary.
While waiting to see the dentist, you may find temporary pain relief at home, with some of the following methods:
- Ibuprofen: Over-the-counter ibuprofen is an anti-inflammatory and may help to reduce pain related to swelling.
- Clove oil: Clove oil has both anaesthetic and antibacterial properties. It can be gently applied to the abscess with a cloth or cotton swab.
- Salt water rinse: Rinsing your mouth with salt water can help to wash away bacteria and offer some short-term relief.
When to see a dentist?
The longer you let pain go untreated, the more damage may be done. See a dentist as soon as possible if you suspect you’ve developed a dental abscess.
Signs you should see a dentist include:
- you are feeling unwell with a high temperature, a rapid pulse rate or low blood pressure and rapid breathing
- you are in severe pain despite using painkillers
- you have a spreading facial infection
- you have a weakened immune system (for example, because you are having chemotherapy)
- Pain that lasts longer than a day.
- Dental pain accompanied by fever, ear or jaw pain.
- Swelling in or around the face.
- Previous cases of dental infection.
The sooner you book an appointment with dentist, the sooner he can treat your pain.
Dental infection treatment
It’s normal to be anxious about seeing the dentist, but it can help to calm your nerves by knowing what to expect.
When you come to dental clinic for a dental abscess or severe dental pain, we’ll start by asking you a few questions about your pain. Consider:
- When did the pain start?
- How do you think the abscess occurred?
- What is your usual dental routine?
- Have you made any changes recently?
Dentist will then perform a full examination and may require an X-ray to see what’s going on under the hood. A dental X-ray is very simple and quick, and can be done in the same appointment.
Depending on the severity and type of infection, dentist may suggest a number of treatments including antibiotics, root canal or extraction of the infected tooth if the infection has proceeded too far. possible treatments include:
- Root Canal Therapy– this procedure removes the abscess from the root of an affected tooth, before filling and sealing it.
- Tooth Extraction– this may be required if root canal treatment isn’t possible.
- Incision and Drainage– a small cut is made in the gum to drain the abscess.
Local anaesthesia will be administered to numb your mouth for these procedures. More advanced operations may be carried out under general anaesthesia.
Antibiotics aren’t routinely recommended for dental abscesses but may be taken if the infection spreads further or is particularly serious.
Preventing dental infections with good dental health
Preventing infections from occurring in your mouth will help you reduce your risk of developing sepsis. Regular twice-a-year visits are usually recommended for up-to-date x-rays, exams, and dental cleanings.
Good oral hygiene is the first basic step in promoting good dental health and preventing infections. These habits should be taught to children from early on to help them keep healthy mouths and teeth.
- Brush your teeth thoroughly at least twice a day.
- Floss your teeth at least once a day.
- Don’t over brush – brushing too hard or with too hard a brush can damage your teeth. Ask your dental hygienist for the best way for you to brush your teeth.
- Don’t use your teeth to open packaging, break string, etc. Your teeth are strong, but they are meant for chewing food, not hard objects, which can cause teeth to crack, chip, or break.
- Visit your dental office at least twice a year for a thorough cleaning and check up.
- If you have had dental work, watch for any signs of infection and contact your dentist if you experience any of the signs listed above.