Immediately check your teeth if you find symptoms that indicate a possible abscess. Do not do self-treatment without your dentist’s advice. Appropriate and prompt treatment of abscesses will prevent the possibility of other, worse conditions. It is much better if you immediately consult a dentist if you find a problem that could lead to an abscess in the future, such as tartar or cavities.
What is a Tooth Abscess?
A tooth abscess is a condition that always starts with a bacterial infection, which then triggers the appearance of a pus-filled lump in the gum area or tooth root [1,3,4,7,8,9].
Abscesses cannot be underestimated because it can not go away by itself, where if left without treatment immediately, the risk of spreading to other parts of the body will occur so quickly.
Dental abscess is the emergence of pockets / lumps / bubbles filled with pus in the area of the gums or tooth roots which was initially caused by a bacterial infection.
Facts About Tooth Abscess
In the United States, poor dental health conditions are quite common, this also includes the condition of dental caries.
National Center for Health Statistics conducted data collection from the National Health and Nutrition Examination Survey from 2011-2012 with results showing that there are 91% of older persons aged 20-64 years who have dental caries, tooth decay, to lose teeth [1,4].
The rates for these cases in older persons of non-Hispanic Asian descent, non-Hispanic blacks, Hispanic blacks, and non-Hispanic whites tend to be low.
There were 36% of untreated cases of tooth decay in Hispanics, 42% were found in non-Hispanic black Americans, and 19% of untreated cases of dental caries in older persons 65 years and over.
Meanwhile, in Indonesia, the prevalence of pulp and periapical disease as well as dental caries is relatively high, namely 85-99%, even among them are smokers with 67.4% cases.
Thus, the prevalence automatically shows the high number of patients with dental abscesses because tooth abscess is a condition resulting from the development of dental caries as well as pulp and periapical disease.
Types of Tooth Abscess
It is important to know that tooth abscess is divided into three types of conditions, namely:
Periapical abscess is an abscess that arises at the tip of the root of the tooth where at that location a lump or bubble appears that will be painful. [1,3,7].
This lump at the tip of the root of the tooth will cause a tingling sensation that when you press on the area you will see or feel the fluid contained in the lump.
Gingival abscess is a type of abscess condition that arises in the gums which is often caused by a bacterial infection .
If there are sores on the gums due to toothpicks, brushing too hard or other activities, this is an opportunity for bacteria to enter and infect.
Periodontal abscess is a type of infection that occurs in the periodontal tissue where the abscess appears on the gum but right on the side of the tooth root .
This type of abscess ca
Periodontal abscess is a type of infection that occurs in the periodontal tissue where the abscess appears on the gum, but right on the side of the tooth root .
This type of abscess can spread to the bone and surrounding tissue.
Generally, this type of abscess is also capable of causing loose teeth due to the damaged alveolar bone
Causes of Tooth Abscess
Dental abscesses occur on average starting from bacteria that fill the mouth and form plaque that sticks and is difficult to remove on the teeth.
The bacteria present in the plaques on the teeth can produce acid, which will increase the risk of gum and tooth decay if a person does not clean his teeth properly, regularly and cleanly.
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The following are a number of factors that can trigger a tooth abscess to form, so you need to be careful: [1,3,7,9]:
Weak Body Immune
One of the factors that increase the potential for a person to be more susceptible to infection and tooth abscess as a result.
Diabetics, steroid drug users, to cancer patients who are undergoing chemotherapy are people who have a low immune system.
Injury to the Gums or Teeth
The occurrence of injury to the teeth, such as the area of the gums or teeth that are impacted or other types of injuries that cause injuries in these areas will be an opportunity for bacteria to enter and invade.
After surgery on the gums or teeth there will be surgical scars, which will also be an opportunity for bacteria to enter if the oral condition is not kept clean.
Infection can also occur which can then develop into an abscess if the infection is not treated immediately.
Consumption of Sweet Food/Drink
Consuming foods and drinks with high sugar content, including foods containing high carbohydrates can increase the risk of the development of bacteria in the mouth.
Tooth decay can occur due to bacterial infection, which then results in the emergence of an abscess.
Poor Oral Hygiene
The level of poor oral hygiene such as plaque buildup on the teeth and gum area due to infrequent brushing or flossing can have an impact on the incidence of dental caries.
From dental caries, it can then increase the risk of tooth decay, infection to a tooth abscess.
The main cause of tooth abscess is the level of poor oral hygiene or even due to injury to the teeth or gums so that it becomes an opportunity for bacteria to enter.
Symptoms of Tooth Abscess
When an abscess occurs in the tooth and gum area, several conditions that can be a symptom include: [1,2,3,7,8]:
- Pain like a stabbing sensation in the affected gum or tooth.
- Pain will feel worse when the patient chooses to lie down.
- Sleep is disturbed because of the constant pain.
- Pain radiates to the jaw, neck, and ear areas.
- Swollen face
- The face is flushed, especially in areas where infection and abscesses occur.
- Sensitivity to foods and drinks that are too cold or hot will increase.
- Swollen gums are marked by redness and appear shiny.
- The mouth tastes bitter.
- Bad breath (bad smelling breath).
- Difficult to swallow, difficulty opening the mouth to difficulty breathing can occur when the condition is severe.
- Fever, if the spread of infection occurs.
Dental Abscess Examination
When the pain starts to approach and makes the mouth or jaw feel sore, especially when opening your mouth and chewing food, immediately consult a dentist.
Even when you find swelling of the gums, avoid ignoring it and immediately go to the dentist for an examination because there is a potential for a tooth abscess to occur.
When you go to the dentist for a symptom check, the examinations carried out are usually in the form of the following methods: [1,8]:
- Tooth Pressing: When an abscess occurs, the tooth that is touched and slightly pressed against the root will feel very sensitive.
- MRI or CT Scan: Scans such as CT scans are needed when the infection is known to have spread to other areas of the body, especially the neck.
- X-rays: Painful teeth need to be examined by X-ray methods to identify the presence of an abscess, but often dentists can detect the spread of infection that causes abscesses to other organs with this X-ray.
- Complete Blood Test : Checking white and red blood cell counts help doctors identify bacterial infections.
Before being treated by a dentist directly, often the pain in the teeth is unbearable.
If so, then painkillers can be used temporarily before getting proper medical treatment.
In the case of a tooth abscess, the most recommended pain reliever is: ibuprofen.
But for some people who have problems so they can’t use ibuprofen, paracetamol is a better alternative.
If the pain does not go away with the use of one type of pain reliever, ibuprofen and paracetamol can be used together (but avoid overuse, let alone overdose).
The use of aspirin is recommended, but not for children who have not reached the age of 16 years.
Dental Abscess Treatment
The main treatment for people with dental abscesses is to remove the pus as well as the infection that causes the abscess to occur.
Some of these treatments are generally recommended by dentists:
Pus Removal / Drainage Incision
This medical procedure is done through making a small incision by the doctor directly at the bubble or the abscess lump to be able to open and make the pus easier to remove. [1,7,8].
After the pus is drained and dry, the swelling in the area will usually subside.
Generally, this medical procedure is intended for patients with periapical type of dental abscess .
If it is not possible to drain the pus, then another medical step that needs to be taken by the patient is tooth extraction [1,3,7,8].
Teeth that have been affected by abscesses and are already severe must be removed immediately to remove pus and infection.
Root Treatment / Root Canal Treatment
Pus-filled lumps can usually be removed using root canal treatment by the doctor perforating the problematic tooth [1,2,3,7,8,9].
After removing the damaged tissue, the doctor will usually fill the cavities first so that infection does not occur.
Tooth abscess occurs as a result of a bacterial infection, so the administration of this type of drug (after one of the above medical procedures is applied) aims to prevent the spread of infection. [1,3,7,8].
However, patients are not recommended to take antibiotics on their own without a doctor’s prescription.
Consumption of antibiotics must be with a prescription and a doctor’s advice to be effective in overcoming the infection.
In the procedure for removing pus, the doctor will first give an anesthetic or anesthetic (local or general) to numb the mouth area so that you will not feel pain from the procedure that will be carried out by medical personnel.
Dental abscesses can be treated by removing the pus either by root treatment, drainage incisions, or even tooth extraction. But usually, doctors still prescribe antibiotics even though the pus has drained.
Complications of Tooth Abscess
Tooth abscess cannot heal by itself, so it always requires proper treatment.
Some of the complications that can occur due to late treatment or even abscesses that cannot drain (even after medical treatment) include: :
- Spread of infection to the jaw, neck and face.
- Palpitations or a condition when the heart rate is above normal.
- Erythema or reddened skin as a hypersensitivity reaction which is generally triggered by infection.
- Sepsis, or inflammatory conditions due to an infection that can occur throughout the body so that when there is a reaction by the body to infection, this can threaten the life of the sufferer.
Tooth Abscess Prevention
Dental abscess is a type of disease that can be prevented by maintaining the health and hygiene of the teeth, gums, and mouth as a whole. Here are some things you can do to avoid tooth abscess :
- Use fluoride toothpaste every time you brush your teeth.
- Brush your teeth 2 times a day properly and all parts of the teeth are cleaned.
- Brush your teeth for about 2 minutes to reach all parts of your teeth.
- Routinely do flossing once a day.
- Avoid smo**king habits.
- Reduce consumption of high-sugar foods and drinks (immediately brush your teeth after consuming sugary foods and drinks).
- Check your dental health regularly to the dentist.
Prevention of dental abscesses can be done simply, namely maintaining dental hygiene by taking proper care, such as flossing and brushing regularly so that the teeth are always healthy.
- Justin L. Sanders & Richard C. Houck. 2019. National Center for Biotechnology Information. Dental Abscess.
- Anonymous. American Association of Endodontists. Abscessed Teeth.
- Shweta & S Krishna Prakash. 2013. Dental Research Journal. Dental abscess: A microbiological review.
- Anthony W Chow, MD, FRCPC, FACP, Marlene L Durand, MD & Meg Sullivan, MD. UpToDate. Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections.
- Image: Coronation Dental Specialty Group, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons
- Video: Medical Centric
- Anonymous. National Health Service. 2019. Dental abscess.
- José F. Siqueira Jr., & Isabela N. Rôças. 2013. American Society for Microbiology – Clinical Microbiology Reviews.
- A Kumarswamy. 2016. Contemporary Clinical Dentistry. Multimodal management of dental pain with focus on alternative medicine: A novel herbal dental gel.
1) Justin L. Sanders & Richard C. Houck. 2019. National Center for Biotechnology Information. Dental Abscess.
2) Anonymous. American Association of Endodontists. Abscessed Teeth.
3) Shweta & S Krishna Prakash. 2013. Dental Research Journal. Dental abscess: A microbiological review.
4) Anthony W Chow, MD, FRCPC, FACP, Marlene L Durand, MD & Meg Sullivan, MD. UpToDate. Epidemiology, pathogenesis, and clinical manifestations of odontogenic infections.
5) Wasis Sumartono, Hasbullah Thabrany, & Ratna Meidyawati. 2016. Figshare. Sumartono, W., Thabrany, H., & Meidyawati, R. (2016). Heavy smoking and severe dental caries in Indonesian men.
6) Ministry of Health of the Republic of Indonesia. 2011. Center for Indonesian Health Profile Data and Information 2010.
7) Anonymous. National Health Service. 2019. Dental abscess.
8) José F. Siqueira Jr., & Isabela N. Rôças. 2013. American Society for Microbiology – Clinical Microbiology Reviews.
9) A Kumarswamy. 2016. Contemporary Clinical Dentistry. Multimodal management of dental pain with focus on alternative medicine: A novel herbal dental gel.