The oral cavity is a septic environment, contaminated with numerous types of bacteria which, however, in a healthy organism, are kept inactive or of low pathogenic potential by local defense systems.
These defense factors are mainly found in saliva.
When the body’s defense capacity is exceeded, there is a bacteremia in the oral cavity and untreated dental infections, a dental abscess can form, which is painful for the patient.
Dental abscesses are of two types:
Localized to the tooth or teeth in question, concentrated at the root tip, forming the periapical abscess
Present in the vicinity of the root tip, in the gums and is called periodontal abscess. This type of abscess usually drains in the vicinity of the tooth at the gum, the patient feeling the emission of pus, with its characteristic color and taste.
The presence of a dental abscess is painful for the patient and manifests itself as follows:
The pain presents pulsatile character, the patient reporting that he feels the pulsations synchronous with the heartbeats.
The character of the pain is strong and the intensity increases from hour to hour. The longer treatment is delayed, the more excruciating the pain.
One exception is children’s dental abscesses, which in many cases spontaneously fistulize, i.e. the pus pus pushes out through the gums and the pain disappears.
Sensitivity can be felt both in the tooth and in the surrounding soft tissues.
Opening the mouth is difficult and is accompanied by exacerbated pain. Also, the more posterior the abscessed tooth is located, the more marked the limitation of mouth opening.
The general condition is altered and a high temperature may also be present.
Tooth abscesses are caused by bacteria colonizing the tooth, reaching the root tip and further down to the ligaments and bone.
This requires the presence of a portal of entry for microorganisms, most often a large cavity that has reached the nerve.
A diet high in sugars favors the development of caries which, due to poor hygiene, can lead to dental abscesses.
Dental abscesses are treated in this way:
The mucous membrane in which the abscess has exteriorized is incised, under local anesthesia, to allow the purulent collection to drain. This temporarily reduces inflammation and pain. Lavage with mild antiseptic solutions is also practiced.
In order to keep the drainage pathway open, the patient should have daily enemas until the acute pus is considered to be gone.
Along with the mucosal incision, the pulp chamber of the affected tooth should be opened and the canals cleaned. Otherwise, the abscess will recur.
In parallel, antibiotics and anti-inflammatory drugs are administered.
After the acute phenomenon has subsided, it will be decided what will happen to the tooth. Either it will be extracted or, if it is salvageable, endodontic treatment and coronal restoration will be performed.
