There are several reasons why you would need an emergency dentist. One of these reasons is if you have a dental abscess. If your tooth is persistently throbbing and keeps you up the whole night, it could be something more serious than just a toothache— it may be an abscess. Therefore, you need to see a dentist as soon as possible for treatment before it worsens and causes complications.
The Downey Dentist understands that dental emergencies can happen at any time. That is why we are always on standby to attend to you. Our experienced dental professionals will accommodate your emergency appointment request, so you don’t have to continue struggling with dental pain. If you have a dental emergency like an abscess in Downey, California, don’t hesitate to contact us right away, and we will help restore your smile.
Dental Abscess Overview
A tooth or dental abscess refers to a pocket of pus that builds up inside the gums or teeth. This buildup is a result of bacterial infection. It can occur at different locations in a tooth for various reasons, which gives rise to different types of tooth abscesses, as we shall see later. A dental abscess causes moderate to severe pain that would sometimes spread to your neck and ear.
Every tooth consists of different layers. The outer layer is called the enamel, and it covers a soft layer known as dentin. The enamel and dentin are the protective layers of the tooth. Under the dentin, we have the pulp. This is where the blood vessels and nerves of a tooth are located. The pulp goes down the tooth’s root center that connects it to the lower or upper jawbone. Therefore, infections attacking the dental pulp can easily spread to the jawbone.
Similarly, in case the gum surrounding the tooth is affected, the tooth faces the danger of being damaged, too. Some abscesses will affect the dental pulp first then spread to the jawbone, whereas others will affect the tissues surrounding the gum. They don’t start in the dental pulp.
Types of Tooth Abscess
As earlier mentioned, there are different kinds of tooth abscesses named based on the place they are occurring. The three most common ones are:
A Periapical Abscess
A periapical abscess occurs near a tooth root’s tip. It’s more common in children than in adults. Minors with poor oral hygiene are especially at higher risk of this kind of abscess. For instance, poor oral hygiene like inadequate flossing or brushing can cause cavities, also called caries, that erode the dentin and enamel, allowing bacteria into the pulp. Consequently, the pulp will become inflamed, causing the nerves in the tooth to die. Since dead tissues are more susceptible to infection, they put the tooth at a higher risk of a dental abscess.
In a periapical abscess, damage to the dentin and enamel allows bacteria into the pulp, resulting in an inflammation called pulpitis. A periapical abscess is a prevalent complication of long-term, severe pulpitis. It could cause swelling of the cheeks and jaw.
A Periodontal Abscess
A periodontal abscess occurs in the gums at the supporting bone tissue structure of the tooth. This kind of abscess is more common in adults than in minors and is usually a complication arising due to periodontitis. It tends to start in the periodontium and alveolar bone. Injury or gum disease may cause your teeth to be inflamed or loose, including the neighboring area. The resultant pocket that develops between the tooth and the tissue is susceptible to bacterial infection, leading to a periodontal abscess.
A Gingival Abscess
A gingival abscess occurs only in the gum tissue and doesn’t affect the periodontal ligament or tooth. It occurs when mouth bacteria cause an infection in the space between the gums and the teeth. Some gum abscesses result from gum disease, which occurs due to poor oral hygiene.
There is also a rare type of abscess known as pericoronitis. Here, the infection attacks the gum flap (operculum) that covers a tooth that hasn’t yet erupted through the gum.
Dentists treat dental abscesses by incising them and draining the pus to eliminate the bacterial infection. They might be capable of saving your tooth by carrying out a root canal procedure. However, in given situations, they might have to extract the tooth. Leaving a dental abscess untreated could cause severe and even life-endangering complications.
Symptoms of a Dental Abscess
Dental abscess symptoms/signs are:
- Severe, throbbing, and persistent pain around the infected tooth or gum, which could spread to the neck, ear, or jawbone on the same side as the affected gum or tooth. This kind of pain could come on unexpectedly and increase to being worse.
- Sensitivity to cold and hot drinks or foods
- Swollen, tender lymph nodes in the neck or under the jaw
- Swelling in the cheek or face
- Sensitivity to the pressure of biting or chewing
- Difficulty swallowing or breathing because of swelling and pain
- An unexpected foul taste and foul smell in your mouth
- Redness in your face
- A discolored, loose, or tender tooth
- Difficulty speaking
- Pain that is worse when lying down, which could disturb your sleep
- Red, swollen, and shiny gums
- Trismus (lockjaw)
When You Ought to Visit a Dentist
Visit a dental professional as soon as you start experiencing any of the symptoms/signs of dental abscess. When you start swelling in the face and feeling feverish, and are cannot unable to reach your dental professional, visit an ER. Also, visit the ER if you are experiencing swallowing/breathing difficulty. These symptoms could mean that the bacterial infection has radiated deeper into your jaw and the tissues nearby or other body parts.
Causes of a Tooth Abscess
A tooth abscess arises when bacteria attack the pulp, i.e., the innermost part of the tooth containing blood vessels, connective tissue, and nerves. Bacteria enter through either a crack/chip or dental cavity in your tooth and spreads downward to the tooth root. This bacterial infection could lead to inflammation and swelling at the tip of the tooth root.
Tooth Abscess Risk Factors
The following factors might elevate the risk of developing a dental abscess:
Bad dental hygiene — failure to properly care for your gums and teeth, like, not flossing and brushing two times daily, could increase the risk and chances of gum disease, dental abscess, tooth decay, and other mouth and dental complications.
Dry mouth — If you have a dry mouth, your risk of having decayed teeth can go up. Dry mouth condition usually arises because of aging issues or the side effects of given mediations.
Eating a diet that’s rich in sugar — the frequent drinking and eating food high in sugar like sodas and sweets can cause dental cavities, which may develop into a dental abscess.
Complications Arising from Dental Abscess
An abscess will not heal by itself without treatment. Should it break, the pain might decrease significantly. However, you still have to undergo dental treatment. In case the abscess does not drain, the infection can spread to the jawbone and other parts of the neck and head, causing pain around the eyes, ears, nose, and swelling in the face or eyes. You may even develop sepsis. Sepsis is a life-endangering infection that spreads all through your body. In case your immune system is weak and you don’t treat a dental abscess, the risk of developing this spreading infection rises even more.
Other rare complications include:
- Cellulitis— cellulitis is a bacterial infection affecting the subcutaneous tissues and skin.
- Osteomyelitis— an infection affecting the underlying bone
- Ludwig’s angina— arises when cellulitis spreads to the tissues underneath the tongue, under the chin, and in the lower jawbone. It’s also called submandibular space/submandibular cellulitis infection.
- Cavernous sinus thrombosis— arises when the infection spreads to the blood vessels in the head’s sinuses.
- Parapharyngeal abscess — an abscess that develops at the back of the mouth, close to the throat. Streptococcal or staphylococcal bacteria cause it. It’s common among minors aged five years and younger.
- A severe tooth abscess may spread to other body parts, causing potentially severe health conditions like meningitis.
Ludwig’s Angina and Parapharyngeal Abscess
Ludwig’s angina and parapharyngeal abscess can both lead to swelling severe enough to block the windpipe and result in trouble breathing. Parapharyngeal abscess requires a needle aspiration to diagnose. On the other hand, Ludwig’s angina is diagnosed by x-rays and needle aspiration.
Cellulitis and Facial Cellulitis
As we mentioned, cellulitis is a skin infection. For instance, facial cellulitis can result from an infection in the middle ear, upper respiratory tract, or dental abscess. Even though these conditions may elevate the possibility of developing facial cellulitis, they don’t cause it directly. The condition occurs when an infection spreads to the skin. Facial cellulitis signs and symptoms include:
- A painful, probably swollen tongue
- Burning and itching of the infected skin
- Red, swollen face, particularly the cheek
These conditions need urgent medical treatment and are best assessed in a hospital. Their treatment involves draining any pus that’s present, possibly through antibiotics and surgery, and sometimes intravenous antibiotics. If you have Ludwig’s angina and are not treated, you may need to undergo a tracheostomy procedure to open your airway to help you breathe in case the swelling blocks the windpipe.
Preventing Dental Abscesses
Preventing tooth decay is crucial to avoiding dental abscess. You should properly care for your teeth and mouth to prevent tooth decay. The following are tips for caring for your teeth:
- Brush teeth at the minimum, two times daily with fluoride toothpaste
- Drink fluoridated water
- Use an interdental or dental cleaner or dental floss to clean in-between teeth daily.
- Eat healthy foods and limit between-meal snacks and sugary items.
- Replace your toothbrush every four or three months or when its bristles are frayed.
- See your dentist for professional cleanings and regular check-ups.
- Use a fluoride or an antiseptic mouth rinse to add a layer of protection against tooth decay.
Tooth Abscess Diagnosis
Apart from examining your teeth and the neighboring areas, your dentist might:
- Recommend that you do an x-ray— doing an x-ray for an aching tooth could help identify a dental abscess. The dentist might also use an x-ray to establish whether your tooth/gum infection has already spread, causing abscesses in different places.
- Tap on the teeth— any tooth with an abscess at the root is usually sensitive to pressure or touch
- Recommend that you do a Computerized Tomography (CT) scan— in case the bacterial infection has already spread to different other areas in the neck, your dentist can ask you to do a scan. They may use the scan to evaluate the degree of your infection.
Treating Dental Abscess
The reason for treating a dental abscess is eliminating the infection. And to accomplish this, the dentist might:
Incise (open up) the abscess and drain it— the dental profession makes a small incision into the abscess and lets the pus drain out. After the pus has drained out, the dentist will wash that place with saline (salty) water. A small rubber drain is sometimes put in place to have the area stay open so the draining can occur as the inflammation goes down.
Extract the infected tooth— in case the infected tooth cannot be saved, the dentist will extract (remove) it and drain the abscess, so they eliminate the infection.
Perform a root canal treatment— a root canal procedure can help eradicate the infection, thus saving your tooth. For your dentist to carry out this procedure, they will drill down into the affected tooth, remove the infected pulp (central tissue) and drain the abscess. They will then fill and seal the root canals and tooth pulp chamber. The dentist may cap the tooth with a crown, making it stronger, particularly if the tooth in question is a back tooth. Properly caring for the restored tooth, could make it last for an extended period.
Prescribe antibiotics— in case your infection only narrows to the abscesses place, that is, it hasn’t spread to other areas, antibiotics may not be necessary. However, if the bacterial infection has already spread to the surrounding teeth, jawbone, or other parts, your dentist may recommend antibiotics that will prevent its spread to other body parts. They could also prescribe antibiotics if your immune system has been weakened.
Hospitalization— if there’s increased fever or swelling despite taking antibiotics and being through other treatments, you may need to be examined in a hospital. Your dentist will need to partner with an oral surgeon who has hospital privileges in these cases. If this step ever comes when you are at our clinic, we’ll be your advocate each step of the way to make sure you are not lost in the hospital ER, dealing with doctors who might not have the experience to handle the situation.
Local anesthesia is usually used to numb your mouth for these procedures. More extensive treatment procedures might be conducted under general anesthesia, where you are asleep.
Home Remedies and Lifestyle
While the infected area is recuperating, your dentist might recommend the following measures to aid in easing discomfort:
- Rinsing your mouth using warm saline water
- Taking over-the-counter pain relievers like ibuprofen (Motrin IB, Advil, etc.) and acetaminophen (Tylenol, etc.) as required
Preparing for the Appointment for Your Dental Abscess Treatment
You are likely to begin the treatment journey by visiting your dentist. Here is the info that may help you prepare for the appointment with your dentist:
- List any symptoms you are experiencing, including those that may not be related to your mouth or tooth pain.
- List all medications, herbs, vitamins, or any other supplements you are taking together with their dosages.
- Prepare the questions that you will ask your dental professional. These questions may include:
- What could be causing my condition or signs and symptoms?
- What tests should I undergo?
- What are the appropriate steps to take?
- What alternatives do I have to the main approach you are recommending?
- Are there restrictions I must follow?
- Should I visit a specialist?
- Are there printed materials I can have? What website do you recommend?
- Is there any generic alternative to the medication you are prescribing?
Do not hesitate to ask any other questions you may have during the appointment.
What You Can Expect from Your Dentist
Your dentist will likely ask you several questions, including:
- When did you first start experiencing signs and symptoms?
- Have your signs or symptoms been occasional or continuous?
- Have you experienced any recent trauma to your dental work or teeth?
- How serious are your signs or symptoms?
- What seems to relieve the symptoms you are experiencing?
- What worsens the symptoms?
The dentist may ask further questions depending on your answers, needs, and symptoms. Anticipating and preparing questions helps you utilize your time maximally.
It is critical to pay attention to what is going on in your mouth and to your teeth. Any changes could be an indication of a more significant issue at hand. For instance, do not assume any severe and unexpected pain as it could be a sign of an abscess. What you should do is visit a dental clinic as quickly as possible.
At the Downey Dentist, we will examine your teeth and establish the problem before embarking on an effective treatment method. We don’t want you to continue experiencing oral pain and discomfort. Therefore, we will do our best to treat you right away, so you can restore your beautiful smile and comfort. Call us at 562-746-0350 to talk to us about any emergency dental issues.