Dental Abscess

What is a dental abscess?

A dental abscess (AB-sess), also called a dentoalveolar abscess, is a collection of pus (yellowish infected fluid) in or around a tooth. This may include pus in the pulp (inside center of the tooth), gums, or jaw bone. It may also be seen in an area where a tooth has not yet come out of the gums. Depending on its location, the abscess may spread to the throat, cheek, or face.

What causes a dental abscess?

A dental abscess may be caused by different bacteria (germs). The bacteria usually enter when the tooth enamel (outer cover of the tooth) is broken by tooth decay. Decay usually occurs with poor mouth care or hygiene. Bacteria may also enter after an injury to the tooth, such as when a tooth is broken or chipped. Procedures that are done on the tooth or gums may also cause a dental abscess. Food particles that are stuck between the teeth for a long time may also lead to an abscess. The following conditions may increase your risk of having a dental abscess:

• Diseases, such as diabetes, gastroesophageal reflux disease (GERD), or diseases that weaken the immune system. The immune system is the part of the body that fights infection.
  
  
• Dry mouth, decreased saliva (spit), smoking, or drinking alcohol. Alcohol may be found in beer, wine, liquor (such as vodka or whiskey), and other adult drinks.
  
  
• Having radiation therapy of the head and neck.
  
  
• Taking certain medicines, such as steroids or medicines for allergies and blood pressure.

What are the signs and symptoms of a dental abscess?

You may have any of the following:

• Toothache, a loose tooth, or a tooth that is very sensitive to pressure, temperature, or tapping.
  
  
• Bad breath, unpleasant taste, drooling, and trouble swallowing.
  
  
• Enlarged lymph nodes in the neck.
  
  
• Fever.
  
  
• Pain, redness, and swelling of the affected area. Sometimes, the face and neck may also be swollen.
  
  
• Trouble or pain with opening or closing the mouth.

How is a dental abscess diagnosed?

Your caregiver will closely look at your teeth and the area around them. He will check for the presence of pus, redness, swelling, or any enlargement. You may also have any of the following:

• Aspiration: Caregivers may do this test using a needle to check if there is pus under the inflamed area. A needle may be used to suck the pus out of the abscess. The sample is then sent to the lab for tests.
  
  
  • Culture: This is a test, which uses a sample from the infected area, to grow and identify the germ that is causing the abscess. It will also help your caregiver to know which medicine is best to treat your infection.
    
    
  • Smear exam: A sample is taken from the affected area and checked under the microscope to learn what is causing your abscess.
  
  
• X-rays: X-ray pictures will be taken of your mouth. Caregivers will carefully look at the x-rays for broken teeth, a jaw bone infection, and other problems.

How is a dental abscess treated?

• Medicines:
  
  
  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
    
    
  • Other medicines: Some medicines may be given to relieve your signs and symptoms. This may include medicines for pain and fever.
  
  
• Procedures:
  
  
  • Incision and drainage: Your caregiver may drain the pus that has collected by making an incision (cut) in the infected area.
    
    
  • Others: Your caregiver may also do surgical cleaning to remove the infected tissues. You may also need to have dental procedures, such as a root canal or tooth removal.

With treatment, such as medicine and a root canal, your abscess may be cured and more serious problems may be prevented.

What are the risks of having a dental abscess?

A dental abscess may cause more serious problems or become life-threatening if left untreated. Treatment for dental abscess may also have unpleasant side effects. You may have itching, nausea (upset stomach), vomiting (throwing up), or diarrhea (loose bowel movement). Sometimes, pus may need to be drained more than once. You may have nutrition and hydration (getting enough water) problems if you are not able to eat or drink. Your airway may become blocked and cause breathing problems. The abscess may burst and the infection may spread to the rest of the body. Even with successful treatment, the infection may come back. Ask your caregiver if you are worried or have questions about your condition, care, or treatment.

Where can I find more information?

Having a dental abscess may be hard. Contact the following for more information:

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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