Dental Abscesses: What you need to know

Dental abscesses are caused by infection, and often display with a swelling that contains pus, and may be very painful. The pain can be throbbing in nature, and may get worse the longer that the abscess is left untreated.

The pain from a dental abscess can spread to the jaw, ears and neck, as well as making it very uncomfortable to eat or drink. Some people with a dental abscess also experience a high temperature, have difficulty sleeping, problems opening their mouth, swallowing and feel generally unwell. In extreme cases, dental abscesses have been known to partially obstruct the airway, making it difficult for the sufferer to breathe.

If dental abscesses are left untreated, they can cause permanent damage to the bone around the affected area, making it vital to see a dentist as soon as possible if you think that you have one.

Different types of dental abscess

There are two main types of dental abscess that can develop, and both will require intervention by a dentist to treat them successfully.

Periapical abscesses are to be found at the ends of the roots of teeth and are caused by bacteria working their way into the tooth via a hole in the outer layers (enamel and dentine) and infecting the inside of the tooth (the dental pulp), which can cause an abscess to form at the root end. One reason for this could be decay or a cracked or broken tooth, allowing the bacteria inside. Another potential cause could be if a root canal procedure is not carried out to a good standard, leaving bacteria inside the tooth to cause an infection.

Periodontal abscesses are located with the support bone and soft tissue around teeth when there is a breakdown of these structures due to gum or periodontal disease. If the gums become inflamed, this can cause gaps around the teeth that can be difficult to keep clean. If bacteria build up here, a painful abscess in the mouth can be the result.

What to do if you think you have a dental abscess

It’s essential to see your dentist as soon as possible if you think that you have a dental abscess. You may need to get an emergency appointment if your usual dentist does not have an available appointment. Very severe dental abscesses may require treatment at Hospital A+E.

Dental abscesses do not go away on their own, and do require treatment in order to resolve the problem.

How are dental abscesses treated?

When you visit the dentist with an abscess, they will usually use local anaesthetic to numb the area around the abscess. They will often firstly drain away the pus, as this contains the infection. Then the cause of the abscess must be resolved, otherwise the abscess will just return. The specific treatment for this will depend on the type of dental abscess it is.

For a periapical abscess, this usually involves drilling into the infected tooth to make sure all pus and infected tissue is removed. The tooth will then need to be root filled to stop the infection from coming back. Alternatively extraction of the infected tooth may be a reasonable treatment option.

For a periodontal abscess, once the abscess has been drained and the area thoroughly cleaned, this may be the end of the necessary abscess treatment. However, if the gum has been permanently damaged through the inflammation and the abscess returns, it may require surgery to the affected area to treat the underlying condition.

Complications with dental abscesses

On rare occasions, even after treatment has been given, there can be some complications with dental abscesses. In some cases, this could be the result of dental negligence, if your dentist has failed in their duty of care to you when treating your abscess. These potential complications could include:

• The development of a dental cyst at the root of the infected tooth, which can get infected. These cysts will require additional treatment, which can include surgery to remove the cyst under local anaesthetic.
• Osteomyelitis, which is a rare but significant infection of the bone and can usually be treated with antibiotics, surgery or both.
• Ludwig’s Angina, which is a rare but significant infection on the floor of the mouth particularly under the tongue that causes pain and swelling and can usually be treated with antibiotics, airway management and drainage. This can be very serious if not treated quickly.
• Maxillary Sinusitis, which is an infection in the hollow spaces or sinuses within the bones of the face including the cheekbones. Whilst not a serious condition, it can cause pain, tenderness around the cheeks and fever. It may resolve itself with no further treatment, but can sometimes require antibiotics.

If you think that your dentist has been negligent in your care, you can contact the Dental Law Partnership for free initial advice to determine whether you may be able to claim for compensation. Call today on 0808 256 8989.

Sources

https://www.mentalhealth.org.uk/sites/default/files/dental-abscess-easy-read.pdf

https://cks.nice.org.uk/dental-abscess

https://www.nhs.uk/conditions/dental-abscess/