Understanding Abscessed Tooth

Localized collection of pus in the alveolar bone at the root apex of the tooth with extension of the infection through the apical foramen into the  periradicular tissue.It may be

  • Acute Apical
  • Acute Gingival
  • Chronic Apical
  • Gingival
  • Periodontal
  • Phoenix
The abscessed tooth can be there because of many reasons. The most common is because of dental caries. Gum problems and the trauma can also cause abscessed tooth.
 
CLASSIFICATION  OF ABSCESSED TOOTH
Depending upon the symptoms and the cause the abscessed tooth can be divided into two groups
Acute alveolar abscess
Chronic alveolar abscess
 
SYMPTOMS
Acute Alveolar Abscess As the name implies the symptoms are very acute initially there is  

Tenderness

  • Severe throbbing pain with soft tissue 
  • Swelling
  •  As it progresses
  • Swelling becomes more pronounced
  • Tooth becomes elevated & mobile.
    Patient presents with inflammation, swelling, pain, fever and malaise. in case of children prompt treatment is important as children are prone to dehydration especially if they are not eating well due to pain and swelling. Untreated leads to infection in bone
     
     
     
    Chronic Abscess
    Due to long standing ,low grade infection of the periradicular bone
    Seen when there is continual discharge through the formation of the sinus tract.
     
     
     
    GENERAL SYMPTOMS
       Irritability, pale & loss of sleep
    • Slight rise in body temperature.
    • Chills, malaise & headache
    • Lymphadenopathy 
     RADIOGRAPHIC CHANGES
     These are minimum in case of acute form-due to short period of time & as it is confined to medullar bone only. Whereas in case of chronic, better defined radiographic lesion is seen.
    TREATMENT
    Treatment of acute alveolar abscess
    • Acute symptoms can be relieved by using antibiotic therapy.
    • Relief of the symptoms is more efficient if drainage is also established.
    • Drainage may be established through the pulp chamber of tooth or the associated gingival or by extraction of the tooth.
    • Should pain occur during the excavation of tooth structure to establish drainage, The discomfort can be lessened if the tooth is stabilized by the dentist’s fingers.
    • Warm saline mouth rinses often aid in localizing the infection & maintaining adequate drainage before endodontic treatment or extraction.
    •  Plenty of fluids intake and the rest is recommended. 
    TREATMENT OF CHRONIC ABSCESSED TOOTH
    In case of chronic abscessed tooth a radiograph is recommended to ascertain whether the particular tooth can be saved by the endodontic treatment like root canal therapy or it has to be extracted.