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What is a dental abscess? Symptoms and treatment

Dis Apsesi Nedir Belirtileri Ve Tedavisi

A dental abscess often results from tooth decay. This condition arises from infections that start at the root of the tooth and concentrate in areas called periapical regions. Typically, poor oral hygiene, trauma, or failed root canal treatments are the triggers. Moreover, these infections can cause severe pain if untreated. Additionally, they pose a risk of leading to serious health problems. Therefore, early diagnosis and proper treatment of a dental abscess are of great importance.

Causes of Dental Abscess: Risk Factors and Triggers

A dental abscess is a common oral health problem that requires urgent intervention. The main causes are usually tooth decay, dental trauma, and poor oral hygiene. The degradation of tooth enamel allows bacteria present in the mouth and throat to enter the inner part of the tooth, the pulp chamber. This leads to a local infection, and as the infection gets trapped inside the tooth, it causes severe pain.

As the infection progresses, it can spread along the root canal and move towards the lower or upper jaw, depending on the location of the tooth. The triggers for dental abscesses include:

  • Tooth decay and poor oral hygiene
  • Dental trauma
  • Failed root canal treatment

Additionally, some genetic and health conditions can also increase susceptibility to dental abscesses:

  • Genetic conditions such as amelogenesis imperfecta
  • Diseases like Sjögren’s syndrome that cause dry mouth
  • Teeth grinding and other mechanical factors

Exposure to chemicals or conditions and treatments that affect the immune system also increase the risk:

Each of these factors increases the risk of a dental abscess, highlighting the need for urgent and effective treatment. A dental abscess is not just a local issue; if it progresses, it can threaten overall health.

Prevalence and Impact of Dental Abscess

Dental health issues, particularly tooth decay, are a widespread public health problem. The National Health and Nutrition Examination Survey has shown that a large majority of adults have tooth decay. Untreated tooth decay, in particular, can lead to serious problems. Statistics can be specified as follows:

  • 27% of adults aged 20-64 have untreated tooth decay.
  • This rate rises to 36% among Hispanics and 42% among non-Hispanic blacks.
  • Among adults over 65, the rate of untreated tooth decay is 19%.

Dental infections, especially dental abscesses, are a significant cause of emergency room visits. In pediatric emergency room visits, the rate of dental abscesses is 47%. This shows not only the prevalence of dental health issues but also the need for urgent medical intervention. Having healthy teeth in people has a direct impact on health services in society.

Formation Process and Effects of Dental Abscess

A dental abscess is a severe infection that progresses to the deepest layers of the tooth. The infection usually starts due to tooth decay or gum disease. It first erodes the enamel and then reaches the underlying dentin layer. As the infection progresses, it reaches the pulp chamber of the tooth. This chamber contains nerves and blood vessels, which cause severe pain.

The infection has a high potential for spreading and can lead to the following effects:

  • Swelling and tenderness of the gums
  • Increased pain during swallowing or chewing
  • Difficulty opening the mouth

If such an infection is not treated, it can spread to the jawbone and even other parts of the neck. This spread can cause severe complications and, in rare cases, life-threatening health problems.

Symptoms and Clinical Findings of Dental Abscess

A dental abscess presents with some clear clinical findings. Patients usually report severe pain. This pain is localized around the tooth and may worsen with palpation. Infected teeth are associated with poor oral hygiene and a lack of regular dentist visits. Moreover, the patient may report having had untreated dental trauma in the past. During the dental examination, the following observations can be made:

  • Discolored tooth or teeth
  • Visible cracks on the enamel
  • Redness and swelling of the gums

On the other hand, signs such as facial redness, trismus, and dysphagia may also be observed. Fever and lymphadenopathy indicate the systemic effects of the infection. Changes in mental status and shortness of breath indicate more severe conditions and require urgent intervention.

How is Dental Abscess Diagnosed?

The first step in diagnosing a dental abscess is usually a head and neck x-ray. This x-ray shows whether the trachea is compressed or displaced. It can also detect subcutaneous air from necrotic tissue. Next, a complete blood count is performed to assess the presence and spread of the infection. This test examines the number and types of white blood cells, which are signs of an infectious condition. Especially neutrophils, which are white blood cells that fight bacterial infections. An increase in these cells indicates an infection.

If more detailed imaging is needed, the following techniques are used:

  • CT and MRI scans
  • These techniques are used to more clearly observe any ascending infections in the sinus cavities.

These detailed examinations help accurately diagnose a dental abscess.

Treatment Methods and Medications

The first step is to drain the pus that has accumulated at the root of the infected tooth. This procedure usually requires urgent intervention and quickly relieves the patient’s pain. Then, antibiotic treatment is initiated to prevent further spread of the infection. Antibiotics fight the bacteria causing the infection and help control the infection. Additionally, analgesics are prescribed for pain management, which speeds up the patient’s recovery process. The choice of antibiotics depends on the severity of the infection and the patient’s health condition.

Resistance to antibiotics can limit treatment options. Therefore, doctors need to evaluate alternative antibiotics that will be effective for the patient. Stronger antibiotics may be required for severe infections or patients with weakened immune systems. In such cases, broad-spectrum antibiotics are used.

Other Important Oral Health Issues

While dealing with dental abscess and its complications, other oral health issues should not be overlooked. These health issues can sometimes present similar symptoms and must be carefully examined for a correct diagnosis. Early detection of these issues allows for an effective treatment plan to be made.

  • Buccal bifurcation cyst
  • Eosinophilic granuloma
  • Gingival abscess
  • Langerhans cell histiocytosis
  • Lateral periodontal cyst
  • Osteomyelitis
  • Periapical abscess
  • Peritonsillar abscess
  • Periapical granuloma or cyst
  • Vertical root fracture

Each condition requires specific treatment methods, and therefore a detailed examination is essential. This prevents misdiagnoses and treatments.

Possible Outcomes of Dental Abscess

Timely and effective treatment of a dental abscess usually yields good results. However, untreated cases can lead to severe complications. Firstly, the infection can progress downward and cause mediastinitis. This condition can increase the mortality rate up to 40%. The infection can block the airways, requiring serious interventions. Moreover, infections that ascend through the sinuses or travel through the bloodstream to the brain further increase the risk of death. These dangerous outcomes include:

  • Mediastinitis
  • Airway blockage
  • Spread of the infection to the brain

Therefore, early diagnosis and appropriate treatment of a dental abscess are vital.