Symptoms and treatment of tooth abscess
The accumulation of pus in the inner or outer surface of the alveoli of the upper or lower jaw, resulting from the introduction of an infection, is called a tooth abscess. According to medical statistics, this pathology is most often recorded during the off-season, that is, in autumn and spring.
- Causes of the appearance of an abscess
- Symptoms and pathogenesis
- Complications of tooth abscess and disease prognosis
- Tooth abscess treatment
Causes of the appearance of an abscess
The disease develops as a result of the penetration of pathogenic bacteria through damaged enamel into the dental pulp.
The reasons for the development of purulent inflammation:
- Diseases of the teeth and gums - caries, pulpitis, periodontitis, cyst;
- Microtrauma to the gums and tongue;
- Boils on the face;
- Chipped or fractured tooth;
- Complications of infectious and viral diseases (tonsillitis, flu);
- The ingress of bacteria during manipulations performed by the dentist, and the doctor's violation of antiseptic rules.
Insufficient adherence to the rules of oral hygiene, excessive consumption of carbohydrates, the absence of a preventive examination by a doctor, and diabetes mellitus predispose to the development of an abscess.
Symptoms and pathogenesis
Through damaged enamel or gum tissue, pathogenic microbes enter the alveolar ridge. They multiply in the soft pulp of the tooth, stimulating the formation of pus. If there is no way out for it, the inflammation spreads to the surrounding tissues - periodontitis, jaw bones, adjacent teeth.
Manifestations of a developing abscess:
- Pain when pressing on the tooth, more often occurs during meals;
- Swelling of the tissues of the gums, cheeks;
- Throbbing pain outside meals;
- The appearance of a hyperemic seal in the affected area;
- Increased temperature sensitivity;
- Bad breath;
- Enlargement of regional lymph nodes;
- Hyperthermia, febrile condition;
- Violation of general well-being, restless sleep;
- On visual inspection, you can see an open wound with purulent discharge.
The onset of the disease is associated with the appearance of severe pain syndrome. With increasing pain, swelling and hyperemia of the gums develops, then the swelling spreads to the tissues of the cheeks.
By the stage of development of the inflammatory process:
- Acute stage, or purulent abscess - in rare cases ends with spontaneous opening of the focus of inflammation, release of pus into the oral cavity;
- Chronic stage - occurs after an independent resolution of the problem, is fraught with relapses, the formation of a purulent fistula.
By localization of the focus of inflammation:
- Gingival abscess (flux) - the inflammatory process does not affect the tooth tissue;
- Periapical abscess - occurs in a tooth with dead pulp;
- Periodontal abscess - develops in the periodontal canal in close proximity to the root.
The onset of a purulent abscess always proceeds with the development of gum swelling. The pain can join later, it is accompanied by swelling of the cheek tissues, swollen lymph nodes, headache. With the development of the inflammatory process, the tumor reaches the size of a walnut. At the same time, symptoms of intoxication are increasing - weakness, hyperthermia, deterioration in general well-being.
In the chronic form of an abscess that develops after spontaneous opening of the abscess, the pain becomes moderate, manifesting itself only during pressing on the tooth. The site of infection remains, exposing the body to the risk of new relapses.
If an abscess appears after a surgical extraction of a tooth, the reason for this may be a violation of aseptic rules by the doctor, improper care of an open wound of the hole. Normally, a blood clot protects the wound from infection, stimulates the formation of granulation tissue.
If the patient did not follow the rules of hygiene, he began to eat hot or rough food early, he may develop symptoms of inflammation:
- Persistent bleeding;
- Strong pain;
- Purulent plaque on the wound;
- Bad breath.
These manifestations are a reason for an urgent visit to a doctor.
A periapical abscess, which forms at the root of a tooth, results from the long-term existence of untreated carious teeth. The presence of an extensive network of blood vessels in the immediate vicinity of the focus of purulent inflammation increases the risk of infection spreading throughout the body. It is impossible to ignore the symptoms of this type of tooth abscess due to the sharp pain and the appearance of severe edema.
Often, an abscess occurs after the removal of a wisdom tooth, since sometimes it is necessary to divide it into fragments, while increasing the area of gum lesion. An extensive wound, abundant blood supply can provoke swelling, fever, and slow wound healing. If after 2-3 days there is no relief, and the pain intensifies, you should immediately consult a doctor.
Gumboil, or gum abscess, does not affect the tooth tissue, affecting only the gum. However, if it is not treated, the infection may spread to nearby structures, to the root of the tooth.
If an abscess occurs in a baby's milk teeth, the bud of a permanent tooth under the area of inflammation may become infected. If the infection develops and penetrates into the tissues of the jaw, the risk of frequent sore throats, inflammatory diseases of the nasopharynx, increases. A constant focus of infection contributes to the formation of asthma and allergies. The decision to remove an abscess affected tooth is made by the pediatric dentist.
Frequent occurrence of tooth abscesses can be a sign that there is an untreated focus of infection in the oral cavity. From there, it spreads to the tissues of the jaw and adjacent teeth.
Complications of tooth abscess and disease prognosis
The consequences of the pathology are very serious, a delay in treatment causes the development of severe complications:
- The appearance of a fistula;
- Development of phlegmon - diffuse purulent inflammation of the tissue of the oral cavity;
- Development of sepsis;
- Increased risk of developing osteomyelitis, meningitis, pneumonia, heart and vascular diseases.
Timely started treatment under the guidance of an experienced doctor leads to a complete recovery.
To make a diagnosis, the doctor only needs to conduct a visual examination, supplemented by the patient's complaints. The dentist records the hyperemia and swelling of the gums, pain during mechanical action on the tooth, its sensitivity to high and low temperatures.
Laboratory and instrumental research:
- General blood analysis;
- General urine analysis;
- Microscopic examination of the puncture of the purulent contents of the abscess;
- Bacteriological culture of discharge from the wound;
- X-ray of the affected area;
- Tomography of the maxillofacial area.
It is important to differentiate tooth abscess from diseases with similar symptoms - phlegmon, gum swelling, purulent periostitis, tooth cyst, gum tissue hematoma.
Tooth abscess treatment
To treat an abscess of a tooth, you need to contact a dentist-surgeon. After evaluating the data of diagnostic studies, he will determine the tactics of treatment.
Possible options for medical manipulations and procedures:
- Drainage of an abscess through an incision on the gum, performed in the absence of tooth damage;
- Drainage of the abscess through drilling the affected tooth, disinfection of the inflammation focus, filling the canal;
- Extraction of a tooth with the ineffectiveness of other methods, with an extensive abscess, curettage of a purulent wound, aseptic processing;
- The use of antibacterial drugs to relieve the inflammatory process and prevent relapse;
- Local treatment in the form of rinsing with saline and soda solution;
- The use of analgesics for pain relief.
Lancing of an abscess is performed under general or local anesthesia.
After performing medical procedures, a relapse of the disease may occur. Its symptoms are fever, hyperemia and swelling of the gum tissue, deterioration of the general condition. Relapse provokes alcohol abuse, smoking, excess weight, hypertension, and the use of thrombolytics. The forecast provides for a long recovery period. The course of treatment includes taking antibiotics.
If an abscess occurs in a pregnant woman, antibacterial agents are used only if absolutely necessary to avoid their teratogenic effects on the fetus. Preference is given to products for topical application. Anesthesia is performed with drugs with a minimum content of vasoconstrictor components that slow down their absorption into the blood.
For the treatment of tooth abscess, anesthetics, antibacterial drugs, solutions for local treatment, vitamins, immunomodulators are used.
To ease the patient's condition and anesthetize the manipulations, infiltration anesthesia is used when injections are performed in the gum tissue near the abscess.
Ultracaine can be used during pregnancy, is contraindicated in allergies, heart failure, arterial hypertension. Septanest is not used in patients with myocardial infarction.
Antibiotics to control inflammation:
The dosage of drugs, the frequency of their use is determined by the doctor. To strengthen the tooth enamel and prevent relapses, it is recommended to saturate the body with a sufficient amount of minerals and trace elements. It is better if the vitamin and mineral complexes contain calcium and fluoride.
The combination of therapeutic methods with physical therapy will accelerate tissue regeneration and shorten the recovery time.
- Hypothermia with UV rays;
- Fluctuorization (treatment with impulse currents);
- Antibiotic electrophoresis.
The author of the article: Muravitsky Boris Viktorovich, dentist, especially for the website ayzdorov.ru