* Radiograph of abscessed molar tooth (UL6)
Why do dental abscesses form?
A dental abscess occurs when the NERVE (dental pulp) in a tooth die. Usually the tooth has a very large filling in it or a crown on it. Front teeth can sometimes die from a blow or severe trauma.
- Acute apical abscess (AAA)
- Low grade ‘dormant’ abscess: only noticed when deep x-rays are taken of the teeth.
The NERVE (or dental pulp) in a tooth can die very suddenly: EXTREME PAIN is felt and characteristically the pain wakens up the patient from sleep. A dull throbbing sensation that last for many minutes hours or is CONTINUOUS. Often the tooth is extremely painful to touch or when biting.
Treatment needed for Dental Abscesses (AAA)
There are 2 components of treatment needed:
1. DRAINING THE POISON
getting the pus get out of the tooth and the jawbone)
Drainage can achieve by either
- Root Canal Treatment (RCT)
- Extraction of the tooth allowing the pus to come out freely
- Rarely a small incision is made inside the mouth or under the jawline
2. SUPLEMENTARY ANTIBIOTICS
High doses of antibiotics are needed to help the body combat the infection. However, the prescribing of antibiotics alone is not recommended as a long-term strategy and is not a technique that will work for very long. Antibiotics treatment alone is NOT RECOMMENDED as it leads to BACTERIAL RESISTANCE to antibiotics.
IF you think you have a dental abscess, you should seek dental treatment IMMEDIATELY. Correct timely treatment can avoid serious complications from occurring.
Complications of Dental Abscesses
Facial Abscess (Cellulitis):
The infection spreads to the face and a substantial swelling occurs. The patient often gets a raised temperature. Difficulty in SWALLOWING or BREATHING may ensure which causes distress.
High levels of bacteria enter the blood stream and this can be life threatening due to multiple organ failure. Hospitalisation is required and intra-venous antibiotics are essential. In the UH in the region of 44 000 patients die from SEPSIS every year: prompt treatment prevents death.
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Dr P Young BDS PhD specialist in oral surgery
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