What it looks like and how it manifests itself
Usually it all starts with a feeling of fullness and pain in the area of one tooth, which intensifies when biting. A convex, painful area appears on the gum, and the skin above it turns red and becomes tense. The cheek often swells, the pain radiates to the ear or temple, and an unpleasant taste appears. The tooth may feel “grown” and mobile. Sometimes the abscess opens spontaneously, forming a fistula: the pain subsides, but the infection remains, and the process becomes chronic with periodic exacerbations.
- Painful swelling on the gum
- Pain when biting and touching
- Swelling of the cheek and redness of the mucous membrane
- Feeling of a “grown” mobile tooth
- Unpleasant taste and odor from the mouth
- Fistula with periodic discharge of pus
Reasons
Most often, an abscess develops in two scenarios. The first is periodontal: with periodontitis, a deep pocket is formed around the tooth, in which plaque and food debris accumulate; if the outflow is disrupted, the contents fester. The second is periapical: infection from advanced caries affects the pulp, descends along the canal to the apex of the root and forms an abscess that emerges under the mucosa. Less commonly, the cause is injury to the gums by a fish bone or a hard brush, the entry of a foreign body, a complication after tooth extraction, or the eruption of a wisdom tooth. The risk is higher with smoking, diabetes and reduced immunity.
- Periodontitis with deep pocket
- Advanced caries and pulp inflammation
- Periodontitis at the root apex
- Gum trauma and foreign body
- Complications after tooth extraction
- Difficulty erupting wisdom teeth
- Diabetes and smoking
Why is it dangerous?
The main danger is the spread of pus beyond a limited focus. The infection can spread to the periosteum with the formation of periostitis, to the bone with the development of osteomyelitis, and then to the cellular spaces of the face and neck with the formation of phlegmon. This condition occurs with high fever, severe swelling, difficulty opening the mouth, swallowing and breathing and is treated in a hospital. Swelling in the upper jaw extending to the eye and any situations with numbness of the lip require special attention. A chronic lesion also harms the tooth: it destroys the bone around the root and often ends in tooth loss.
- Periostitis and osteomyelitis of the jaw
- Cellulitis of the face and neck
- Spread of infection to the eye socket
- General intoxication and sepsis in severe cases
- Bone destruction and tooth loss
- Transition to a chronic process with fistula
What not to do
You should absolutely not warm your cheek with a heating pad, a warm compress or a scarf: heat dilates the blood vessels and accelerates the spread of pus. You should not try to open or squeeze out the abscess yourself - this will make the infection deeper. Rinsing with alcohol, soda with iodine and kerosene does not heal, but burns the mucous membrane. Self-medication with antibiotics is also dangerous: without opening the lesion, they provide a temporary lull, mask symptoms and contribute to bacterial resistance. You can take painkillers, but this is only a measure while waiting for a doctor’s appointment, and not treatment.
- Do not heat your cheek or apply compresses
- Do not open or squeeze out the abscess
- Do not rinse your mouth with alcohol or aggressive solutions.
- Do not take antibiotics unless prescribed
- Do not postpone the visit after spontaneous breakthrough of pus
- Do not chew on the affected side
How to treat
The first and mandatory step is to ensure the drainage of pus: the doctor, under local anesthesia, opens the abscess and rinses the cavity, leaving drainage if necessary. Then the fate of the causative tooth is decided: in case of periodontal abscess, the pocket is treated and periodontitis is treated, in case of infection from the canal - endodontic treatment, and in case of significant destruction, the tooth is removed. An x-ray is needed to see the lesion at the root apex and the condition of the bone. Antibiotics are prescribed for spreading edema, fever, and associated illnesses, but they complement, rather than replace, autopsy. After the inflammation subsides, professional hygiene is carried out and care is taught.
- Opening and draining the lesion
- Spot X-ray
- Root canal treatment or tooth extraction
- Periodontal pocket treatment
- Antibiotics according to indications, prescribed by a doctor
- Professional hygiene after inflammation subsides
- Controlling diabetes and quitting smoking