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Dental Abscesses

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An abscess is a localized collection of pus in a cavity formed by the disintegration of tissue. Abscesses are usually caused by specific microorganisms that invade the tissues, often by way of small wounds or breaks in the skin. An abscess is a natural defense mechanism in which the body attempts to localize an infection and "wall off" the microorganisms so that they cannot spread throughout the body.

There are at least three types of dental abscesses that resemble each other. A gum or gingival abscess is the result of injury to, or infection of, the surface of the gum tissue. If an infection moves deep into gum pockets, drainage of pus is blocked and a periodontal abscess results. A periapical abscess refers to a tooth in which the pulp is infected, usually secondary to tooth decay.

An abscess may occur when bacteria invades the dental pulp (the nerves and blood vessels that fill the central cavity of the tooth), causing the pulp to die. This most commonly happens as a result of dental caries, which destroy the tooth's enamel and dentin, allowing bacteria to reach the pulp.

The abscess is called acute or chronic, depending on how rapidly it forms and how effectively the body defends itself. An acute abscess is characterized by pain, swelling, and fever. A chronic abscess may be painless, with the patient completely unaware of its presence even as it continues to grow inside the jawbone.

Symptoms of Dental Abscesses. Pain is gnawing and continuous. The involved tooth is painful when percussed (tapped), and often the teeth cannot close without added discomfort. Hot foods may increase the pain. Local swelling and gingival fistulas may develop opposite the apex of the tooth, especially with deciduous (temporary) teeth. Drainage into the mouth causes a bitter taste.

Treatment of Dental Abscesses. It is important to determine which type of abscess is present so that the appropriate treatment may be rendered. In all three types of abscesses, the pus must be drained. Antibiotics may be prescribed if systemic symptoms such as fever and swelling in the lymph glands are present. Deep cleaning will be undertaken for gum pocket (periodontal) abscesses.

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