Most swellings will be a dental abscess.
Abscessed teeth generally are either chronic or acute.
Chronic Tooth Ache:
This type will manifest itself as a low to medium grade throbbing in a particular tooth or area around a tooth. A bubble may be present on the gum tissue under the tooth allowing a drain point for the infection. In this situation, the body’s immune system and the fact that the infection is draining, may allow the situation to persist for many months without elevating to an extremely painful state. tooth abscess is dangerous because the patient risks increase damage to the bone surrounding the tooth while avoiding treatment. If the drain becomes blocked, pain may intensify risking swelling, intense pain, spread of infection, chewing impairment and lymph node involvement.
Typical chronic abscess showing as a bubble above the tooth root and leaking into mouth
Acute tooth abscess:
Characterized by rapid, painful onset. Sleep and overall function may be disturbed due to symptoms involved. Swelling of gum tissue and surrounding areas may be present. It can be very difficult to find relief during the painful peak of a tooth abscess. Daily activities are often interrupted during this time.
1. Toothache – Sharp pain or continuous throbbing pain
2. Pain during chewing
3. Spontaneous pain
4. Pain from cold or hot items that lingers long after the source is gone.
5. Foul taste and/or bad smell in mouth.
6. Possible fever
7. Possible swollen glands
How are tooth abscesses diagnosed?
1. Visually – Presence of gum bubble, redness, pus, cavites or swelling.
2. Percussion – Tapping on an affected tooth with a dental instrument will often produce a sharp pain.
3. X-rays – A tooth infection will often express itself on an xray as a dark circular lesion at the tip of the tooth’s root.
What causes a tooth to become infected?
1. Trauma – Trauma to a tooth may result in the nerve dying. Inflammation developes in the necrosing nerve causing a tooth abscess.
2. Decay – The spread of dental decay through a tooth down to the nerve will allow bacteria to flourish, multiply and initiate a tooth abscess.
3. Deep Fillings – In the case of deep fillings, the tooth’s nerve may be irreversibly injured during cavity removal. This can occur if the decay lies deep within the tooth in close proximity to the nerve. Bacteria from the cavity can cross into the tooth’s nerve. The nerve could then eventually die and abscess. Also, the actual mechanical process of decay removal near the nerve can imperceptibly cause irritation or damage to the nerve.
4. Existing Root Canals – In very rare instances, bacteria may remain trapped inside a root canal treated tooth. In these cases the bacteria can multiply causing the tooth to reabscess and the existing root canal to fail.
Treatments for abscessed teeth.
1. Initial antibiotic and pain medicine therapy if indicated.
2. Root Canal (Removal of the infected nerve in the tooth) or
3. Extraction (Removal of the infected tooth)
Once a tooth is infected, antibiotics will minimize the abscess, however, diseased tissue will remain and flare up again if not definitively treated. Once an infection begins, there are only two alternatives for the tooth. They are to remove the affected nerve or to extract the tooth.
To handle the pain while you wait to see the dentist, take paracetamol or ibuprofen. However, if you have a history of liver or kidney problems or peptic ulcers, or suffer from asthma, ibuprofen is not recommended for you. Also, avoid very hot and cold foods and drinks, because they worsen the problem.
If an abscess ruptures by itself, warm-water rinses will help cleanse the mouth and encourage drainage. Even then, a follow-up visit to your dentist is important