Dental Abscess 

A dental abscess is an infection of the tooth socket. It often starts with a crack or cavity in the tooth. A pocket of pus forms between the tooth and the bone. The infection causes pain and swelling of the gum, cheek, or jaw. Pain may also be felt in the facial sinus or in the ear. The pain is often made worse by drinking hot or cold fluids or biting on hard foods. A severe infection can cause problems with swallowing and breathing.

Causes

  • Cavities

  • Injury

  • Past dental work

Symptoms

  • Pain and swelling of the cheek, jaw, or gum around the affected tooth

  • Redness

  • Bad breath

  • Bad taste in the mouth

  • Fever

You'll be started on an antibiotic. But final treatment requires draining the pus. This can be done by removing the tooth or getting a root canal. An oral surgeon typically removes diseased teeth. An endodontist does a root canal. This involves drilling an opening in the tooth to get to access the canals in the root. Once these are reached, the pus can be drained. Then the canals are cleaned and shaped before filling them with a special material called gutta percha. After the infection has healed, a crown is placed over the tooth.

Home care

The following guidelines will help you care for your abscess at home:

  • Don't have hot or cold foods and liquids. Your tooth may be sensitive to temperature changes.

  • If your tooth is chipped or cracked, or if there's a large open cavity, apply oil of cloves directly to the tooth to reduce pain. Oil of cloves is sold over-the-counter in pharmacies. Some pharmacies carry an over-the-counter toothache kit. This contains oil of cloves and a paste, which can be applied over the exposed tooth to decrease sensitivity.

  • Apply an ice pack over the injured area for 10 to 20 minutes every 1 to 2 hours the first day for pain relief. Do this 3 to 4 times a day until the pain and swelling goes away. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on your skin.

  • You can take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. If you have chronic liver or kidney disease, have ever had a stomach ulcer or gastrointestinal bleeding, or are taking blood-thinning medicines, talk with your healthcare provider before using these medicines.

  • An antibiotic will be prescribed. Take it as directed until completed, even if you're feeling better before taking all the doses as instructed.

Follow-up care

Follow up as advised with an endodontist or oral surgeon. Your pain may improve with the treatment given today. But only a dentist, endodontist, or oral surgeon can provide full treatment for this problem.

  • If a culture was done, you'll be told if the treatment needs to be changed. You can call in as directed for the results.

  • If X-rays were taken, they'll be reviewed by a specialist. You'll be given the results and told if they affect your treatment.

Call 911

Call 911 if any of these occur:

  • Wheezing or trouble breathing or swallowing

  • Hoarse voice or trouble speaking

  • Confusion

  • Extreme drowsiness or trouble waking up

  • Fainting or loss of consciousness

  • Fast heart rate

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Swollen or red face or eyelid

  • Pain gets worse or spreads to the neck

  • You have a fever of 100.4ºF (38ºC) or higher or as directed by your provider

  • Abnormal drowsiness, weakness, or a headache or stiff neck

  • Pus drains from the gum or tooth

  • You can't open your mouth wide

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