One of the most common dental emergencies that I treat at our Better Dental practice is a patient presenting with a dental abscess. Often, a patient will present with a large swelling or a “pimple” near an area that is inflamed and often extremely painful. In this article I will explain what an abscess is, what can cause it, and what a patient can do to best treat it in an emergency and non-emergency situation.
What is an abscess?
An abscess is a dental infection that can occupy a facial space inside or outside of the mouth (around the eyes, cheeks, or neck). An abscess occurs because an infection has spread from the crown of a tooth, to the pulp space where the nerves and blood supply reside, to the space surrounding immediately surrounding the root of that tooth. Depending on where the tooth is located, the bacteria will try to migrate to the local blood supply and spread throughout the body. In an effort to block that spread, the body sends various types of cells to wall-off and starve the bacteria. This attempt is what causes the swelling, inflammation, and presence of puss that can be associated with an abscess. Other than soreness, the most common observation that leads a patient to notice that they have an abscess is what appears to be a “pimple” on the gumline -typically associated with a tooth that may be giving the patient some discomfort. That structure on the gumline is a fistula. A fistula is the body’s attempt to create a pressure release valve in the affected area. Often, patients ask if they should pop, squeeze, or massage a fistula if they see it. The answer is no, you should not. It functions as a value to relieve pressure in the area through drainage which, in turn, will decrease pain and swelling. Manipulating a fistula only provides temporary sensation of relief but can cause more damage than benefit.
There are several treatment options for a tooth that presents with an abscess. These options include, but are not limited to, a root canal in the affected tooth, incision and drainage of the abscess and surrounding spaces, or extraction of the affected tooth and replacement of that space.
Many of our Better Dental patients often ask, “How do I know if an abscess is an emergency or not?” The presence of an abscess is always a sign that dental treatment is necessary. If swelling with an abscess increases in size to decrease one’s sight, makes breathing or swallowing difficult, or causes a fever of 100.5 ºF or higher, proceed to your local physician or urgent care immediately. If you notice that an abscess is present, but none of the previously mentioned symptoms are present, give our Better Dental office a call. We will schedule you as soon as possible to get you treated and taken care of.