Severe dental abscesses can be extremely painful, but did you know some stages of a tooth abscess are less painful than others and have different symptoms? Today, our Edmonton dentists explain the stages of an abscessed tooth, why they occur, and how we can treat them.
What is a tooth abscess?
Pockets of pus can accumulate as a result a bacterial tooth infection, leaving you at risk for a dental abscess or tooth abscess.
While a tooth abscess can cause problems, you may be surprised to learn that it is the body's natural defence mechanism in the battle against infection. By building up a layer of pus, the abscess prevents the infection from reaching other areas. While abscesses can develop at various locations throughout the body, an abscess of the gum or tooth is one of the most common forms.
Unfortunately, along with its natural defence properties a dental abscess poses further risk for the teeth and gums and can erode the periodontium - the tooth structure made of gum (gingiva), periodontal ligament (PDL), or hard compact alveolar bone - and cause irreparable damage. In some cases, the sole solution is to extract the affected tooth.
Tooth decay is a common cause of dental abscesses, which can also happen as a result of a fractured, cracked or chipped tooth. Either way, bacteria is the main culprit as it enters via a tooth cavity or through a chip or crack in the tooth.
In response to this invasion of bacteria, the body develops a protective barrier or shield in the form of pus. As we already know, this can cause more harm than good.
Types of Tooth Abscess
The types of dental abscesses are classified based on where they form in the mouth. They include:
- Gingival Abscess - This gum abscess forms on the surface of the gum tissue. For most people, it resembles a small but visible pimple. Detected early, a gingival dental abscess is easy to treat and recover from.
- Periodontal Tooth Abscess - This type of abscess happens deeper within the gum - mainly in the gum pockets. Since the pus does not have anywhere to drain, a periodontal tooth abscess can easily spread to surrounding bone and tissue.
- Periapical Abscess - Can erode a tooth's protective enamel and softer inner dentin. Once it reaches the dentin it can easily attack the soft inner pulp where the tooth's nerves are located. This is when severe pain occur. For this type of abscess the only solution is to have a root canal to save the tooth.
Tooth Abscess Stages
Now that we're clear on what a dental abscess is and where they can occur, we should also cover the various tooth abscess stages. Keep in mind that an abscessed tooth happens gradually and that a series of dental problems and clear stages need to happen. These are as follows:
- Enamel Decay
Plaque is what causes a buildup of bacteria in the mouth, which then leads to the development of pus and finally, a dental abscess. If we don't brush as frequently or thoroughly enough to eliminate plaque from our teeth and along the gum line, plaque can build up on gums and tooth surfaces. Acid can form and erode the tooth enamel. Once tooth decay occurs, a cavity forms.
- Dentin Decay
If you don't visit your dentist soon enough to have the cavity filled, bacteria continue to eat their way through the enamel and enter the dentin (sub-layer).
- Tooth Pulp Infection
After the bacteria has destroyed the dentin, it can then enter the inner pulp of the tooth. When this happens, the nerves within the tooth die and the body's immune system starts to attack the infection. Pus then develops around the dying roots, causing the dental abscess.
- Abscess Formation
In the later stages of tooth decay, after the bacteria has entered the pulp of the tooth or made its way deeper into the gums or jawbone, you may notice pain surrounding the tooth, along with gum redness and swelling. A severe abscess can also trigger a fever.
- Tooth Loss
By this stage, discomfort or throbbing pain would typically alert you that a dental abscess has happened and prompt you to see your dentist. The abscess has reached a critical point and should be treated before it worsens. If for some reason the tooth or dental abscess is still left untreated, the abscess can further erode the bone, leading to tooth loss.
In addition, people with weakened immune systems may find the infection spreads. It can easily become fatal as it reaches other parts of the body.
How quickly does a tooth abscess progress?
Abscesses can develop relatively quickly - as little as one or two days after the first signs of infection. They may progress undetected and therefore untreated, and develop for months or even years. Since early detection is key, we recommend seeing a dentist regularly for dental exams and checkups and contacting us at the first sign of any infection or problem.
How do I know if my tooth abscess is spreading?
It's relatively rare for a tooth infection to spread to other areas of the body. However, because consequences can be severe if this does occur this would be considered a dental emergency. Below is a list of symptoms that could point to a tooth infection spreading to another part of the body.
Anyone who suspects they have a tooth infection and notices any of these symptoms should make an appointment with our dentists right away:
- Severe headache
- Difficulty opening the mouth (trismus)
- Difficulty swallowing
- Difficulty breathing
- Swelling of the neck, cheeks or face
- Painful mouth and tongue
- Itching or burning sensation on the skin
- Nausea or vomiting
- Double vision or loss of vision
- Drooping eyelids
Without prompt treatment, you may be at risk for developing infections in the blood vessels in the sinuses, the bone surrounding the tooth, the skin, and infections in the blood that could cause sepsis. A parapharyngeal abscess (an infection at the back of the mouth) can also form.
Tooth Abscess Treatment at Azarko Dental Clinics
Similar to most other dental issues, the earlier you can contact your Edmonton dentist to have a tooth abscess treated, the more favourable outcomes for your smile - and your long-term health.
Treatment will depend on several factors, including:
- The initial location of the abscess
- Whether, and how much, the infection has spread
- The extent of the immune system's reaction to the infection
Your dentist may simply need to make a small incision into the abscess to drain it, then wash the area with a saline solution. If the dental abscess has reached the inner pulp chamber, root canal therapy is needed to clear bacteria from the tooth's pulp chamber. A dental crown would then be placed to protect the remaining tooth.
Alternatively, the tooth may need to be extracted and the abscess drained to prevent the infection from spreading further. Along with the steps above, your dentist may prescribe a course of antibiotics, especially if the infection has spread to nearby teeth.