On an x-ray, an accumulation of pus at the root tip due to a shadowing can be seen. The area with the pus appears darker than the surrounding area and the tooth. However, not all pus shading occurs, caries and the pulp, for example, are also darker in the X-ray.
There are different types of x-rays that a dentist can take to diagnose root apex inflammation: An OPG (orthopantomogram) shows the entire dentition, the diagnosis of apical whitening is roughly possible here. If the inflammation is only in its early stages, it may not be seen very clearly here, but advanced inflammation is very clearly visible. For a more exact clarification if there is really something to see or if the patient only has pain on a single tooth, an EZA, a single tooth scan is often ordered. The advantage of this type of image is the accuracy of detail and the low radiation exposure.
An abscess on a tooth in children
In children an abscess often occurs as a result of caries treatment on the milk tooth. As smaller children usually do not keep still for very long and are afraid of the dentist, the doctor often cannot remove the whole caries. This can then progress under a filling and in rare cases can cause the formation of an abscess.
If the dentist has to drill very close to the nerve, bacteria may enter the tooth cavity and cause the same consequences. An abscess is dangerous in this case mainly because of the formation of permanent teeth. The accumulation of pus can damage them, in the worst case even to such an extent that the permanent tooth cannot be preserved or has malformations. Therefore, an abscess in a small child should be treated quickly to prevent worse consequences.
Duration of a dental abscess
An abscess develops over a longer period of time, therefore it is not possible to give an exact indication of the duration of this process. It usually starts with an inflammation of the tooth root or infection of a wound, for example after pulling a tooth. If no further treatment is then initiated, bacteria can multiply and pus forms after some time.
At this stage one speaks of an abscess. Simple abscesses can be opened under local anaesthetic with a small incision along the gums and pus can be drained. This treatment usually takes only a few minutes at a specialist.
If deeper regions are already affected or if the abscess has become very large, a major surgical procedure must be performed. This is usually only possible in a clinic and involves an inpatient stay in hospital of about 3-5 days. This duration depends on the type of pre-treatment and the urgency of the operation.
Since an opening is not always possible from within the oral cavity, in severe cases an incision must be made through the skin. This may leave a small scar. Since it must be ensured that the pus actually drains, a plastic tube, also called a drainage, is inserted into the abscess cavity.
This must then be checked and rinsed daily until all the pus has drained away. Only then may the drainage be completely removed and the wound closed again, as otherwise bacteria could remain and the wound could flare up again.