Definition
An abscess in the jaw is an accumulation of pus in the cavities of the jawbone. A jaw abscess is characterized by a painful, pus-filled, heated, pressure-sensitive swelling in the upper or lower jaw. If the upper jaw is affected, there may also be swelling of the eyes.
A lower jaw abscess can be accompanied by difficulty swallowing. An abscess in the jaw can be distinguished from an oedema or doughy swelling, an infiltrate. These usually show up as a preliminary stage of an abscess.
Causes
Abscesses in the jaw are caused by inflammation. Especially immunocompromised persons or persons with previous illnesses have a higher risk of inflammation and the resulting abscesses in the jaw. The inflammation can be caused by a gingival pocket, an inflamed dental bed, a dead tooth, a wisdom tooth that has not yet erupted or a dental cyst.
In the oral area it is usually bacterial infections that lead to an abscess. When a tooth is dead, the protein releases toxins. These provide a breeding ground for bacteria.
The entry of bacteria is facilitated by dental caries. This can set inflammatory processes in motion. Eventually, the tooth pulp can die off.
An undersupply of blood in the area leads to the decay and breakdown of cells. As a result, a foul-smelling gangrene and a “thick cheek” can develop. In dentistry, a gangrene is defined as a necrosis of the dental pulp.
This means that cell death occurs in the area caused by an infection. The pulp is the part of the tooth that supplies the tooth with nerves. It is therefore sometimes incorrectly called the dental nerve.
As this area contains nerve fibres in addition to connective tissue with blood and lymph vessels, it is these fibres that transmit thermal, mechanical or chemical stimuli as pain stimuli. When the tooth pulp has died, these protective signals are no longer transmitted and the development of a jaw abscess is promoted. If the tip of the tooth root is inflamed, this leads to increased activity of the body’s own defence cells.
This can lead to the degradation of the jawbone. During these processes a cavity can develop. Bacteria can accumulate in increased numbers. This causes the cavity to be filled with pus. The result is an abscess in the jaw.
Diagnosis
If there are signs of development of a jaw abscess, a dentist should be consulted. The dentist first conducts an interview, a so-called anamnesis. It is useful to think about what information should be given before the visit to the dentist.
Previous illnesses and medication should always be mentioned. The dentist will examine the oral cavity from the inside and outside. In the case of an advanced abscess, swelling of the cheek is usually obvious.
With a mature jaw abscess, a central yellowish greenish area can be seen. A moving fluid can often be palpated. When touched, pus usually comes out.
A smear is taken from this to find out the pathogen. In order to make a reliable diagnosis, an x-ray of the jaw is usually also taken. In case of a weakened immune system and/or other previous illnesses, blood tests and further diagnostics may also be necessary.
