Abscess (Dental)

Dental abscess: what is the difference between periapical abscess and periodontal abscess?

What Is a Dental Abscess?

An abscess is a localised collection of pus. Dental abscesses can be related to:
An infection of the pulp of the tooth (periapical abscess)
An infection of the gum and tissues surrounding the tooth (periodontal abscess)
A combination of both

Dental abscesses, if uncontrolled, can spread to become facial infections.

Causes of Dental Abscesses

A periapical abscess is a result of bacteria from dental plaque invading the pulp of the tooth. Bacteria enter the pulp through a cavity (decay) or tooth fracture. The pulpal infection spreads and reaches the bone surrounding the root tip, forming an abscess.

Meanwhile, periodontal abscess, commonly referred to as a gum abscess, occurs when bacteria in the form of dental plaque accumulates under the gums.

Symptoms of a Dental Abscess

You may experience some or all of the following symptoms when you have an abscess:
Tenderness of your tooth and surrounding area, especially to touch and on biting
Intense, throbbing pain that disturbs sleep
Sensitivity to food and drink that is very hot or very cold
Difficulty in opening your mouth (known as trismus)
Difficulty in swallowing (known as dysphagia)

Dental Abscess: Prevention

Regular check-ups with your dentist is the best mode of prevention. Decay can be detected and treated before it becomes a periapical abscess.

When to Seek Help for Dental Abscess

If you experience severe toothache, you should see a dentist immediately. If you also experience difficulty in breathing or swallowing, you should go to the nearest accident and emergency (A&E) department if you cannot find a dentist.

Dental Abscess Treatment

Your dentist will carry out immediate procedures to reduce pain and limit infection, which may include the following:
Drainage of pus either through a hole drilled into the pulp chamber, or an incision into the abscess or extraction of the involved tooth. This is done usually under local anaesthesia. More severe infections may need hospitalisation
Prescription of antibiotics and painkillers

Once the acute infection has subsided, if the tooth can be conserved, an endodontist will offer you the option of saving the tooth with root canal treatment.

Dental Abscess Complications

Complications can arise when an abscess is left untreated:
Infection may spread to the face and other structures
Osteomyelitis is an infection of the bone caused by bacteria from the abscess spreading through the bloodstream
Cysts can form around the root tip of a pulpally-infected tooth

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