Causes – An overview
Possible causes for an abscess on the tooth are
- Untreated severe inflammation of the gums
- Deep, untreated gum pockets
- Periodontitis
- Root Cancer
- Alveolar inflammation
- Deep, untreated caries
- Inflammation in the dental pulp (pulpitis)
In order to be able to determine the exact cause of an abscess in the oral cavity, a distinction must first be made as to whether the inflammation originates from the surrounding periodontium (periodontal apparatus) or from the tooth itself. Deep caries can destroy the tooth to such an extent that bacteria and germs can get into the pulp and cause pulpitis (inflammation of the tooth marrow). If the pulpitis is not treated very quickly and still in the early stages of the inflammation, the tooth inevitably becomes avital, i.e. it dies.
The pulp lies inside the tooth and its root. It contains nerve fibres and small arteries and veins to nourish the tooth and keep it alive. If the pulp is inflamed or damaged, there is no way around endodontic treatment (root canal treatment).
In the following period, an inflammation of the root tip of this tooth often develops, technically speaking “apical periodontitis“. Normally the inflammation remains locally limited to the tooth, only in the rarest cases do the germs spread through the lymph nodes or the bloodstream in the body. Since this possibility exists, it is recommended that therapy be carried out as soon as possible to avoid further damage.
Sometimes the causes of an abscess are not found in the tooth but in the surrounding periodontium. Marginal periodontitis is a fairly common disease pattern and is the result of advanced and untreated gingivitis (inflammation of the gums). The bacteria and germs cause the bone that holds the tooth in the tooth socket to retract.
At the same time, deep gum pockets develop because the gingiva is also inflamed and separates from the tooth. The tooth loses its hold and begins to wobble because it can no longer be firmly anchored in the jawbone. Once bone has disappeared, it cannot be rebuilt.
As a result of marginal periodontitis, abscesses can develop, which can be seen as swollen cheeks. This topic may also be of interest to you: Gum bruisesNot only your own teeth, but also an implant can be affected by an abscess, although this is rare. Often this occurs directly after the implantation and can also be caused by the operation wound.
This is a big problem for the preservation of the implant. Therefore, quick action must be taken. An antibiotic should be administered to contain the inflammation.
If pus has formed, the abscess cavity must be opened so that it can drain away. Once healed, the doctor should take an x-ray to assess possible bone loss around the implant. Only then can he decide on the further procedure.
However, if all precautions are taken, this course is rather rare. Due to the dense structure of the bone in the lower jaw, almost all jaw abscesses occur here, whereas the upper jaw is hardly affected due to its softer bone. In the lower jaw, abscesses are named after their anatomical location (e.g. perimandibular abscess or submandibular abscess).
Due to a bacterial infection on the tooth, pus forms due to the body’s failed defence reaction, which can spread from the tooth in different directions. This tendency to spread may lead to life-threatening complications, such as sepsis. Symptoms of this abscess are swelling with pain and a strong feeling of pressure, the opening of the mouth and the ability to swallow can be restricted and the tooth is sensitive to chewing pressure.
Extreme caution is required if swallowing difficulties and airway obstructions occur. Action must be taken immediately and the dentist, emergency service or clinic must be consulted to relieve the abscess and drain the pus. The pressing or even independent piercing of the abscess must be avoided at all costs, as this can cause the pus blister to burst and the pus to spread in the tissue.
The surgical opening and removal of the abscess at the dentist or oral surgeon has become a routine procedure nowadays and the following applies: The smaller the abscess, the more minimally invasive the procedure and the faster the healing process. For therapeutic support, an antibiotic is usually prescribed to kill all bacteria as quickly as possible. The patient can cool the affected area before and after the procedure to prevent the abscess from spreading and enlarging.
