Tooth abscess - causes of appearance, methods of treatment in the clinic and at home

The gum is red, swollen, painful – these are classic signs of a tooth abscess, an inflammatory process in which pus is formed. Accumulating in the cavity, as in a pouch, pus causes swelling of the gum. In the people it is called flus.

Purulent inflammation can lead to serious consequences, so self-treatment, if the gum is swollen, you can not. Dentistry will determine the cause of the abscess and carry out specific treatment.

Purulent abscess of the tooth – causes of occurrence

With weakened immunity, as a result of trauma or infectious diseases of the teeth, pathogens penetrate into the tissues surrounding the tooth (periodontium). In response, the body produces special cells, neutrophils. They neutralize pathogens, but die themselves. Pus is the remains of dead cells, destroyed proteins of bacteria and neutrophils.

In dentistry, 3 types of abscess are distinguished, depending on the cause of occurrence:

PeriapicalA pus pouch forms at the apex of the root.

PeriodontalAbscess occupies the place between the gum and the root.

GingivalIt is localized in the soft tissues, does not affect the root.

The type of abscess depends on how pathogens have penetrated the tissue.

Caries that led to periodontitis

Advanced tooth decay destroys the hard tissues of the tooth and penetrates the pulp, the nerve and vascular bundle. Most often, pulpitis is accompanied by severe pain, but in some cases, the pain is not strongly pronounced, attack-like. If you do not treat pulpitis in time, the tissues around the root become inflamed, periodontitis develops. Active formation of pus begins. Soon the sac protrudes under the mucous membrane of the gum. In some cases, the root abscess ruptures and a fistula forms in the gum, through which the pus comes out. Because the pressure on the tissue is reduced, the patient experiences a sense of relief. However, the formation of a fistula does not mean recovery. The inflammatory process continues and will eventually lead to tooth loss.

Improper treatment

Periodontitis can occur as a result of a doctor’s negligence. If the canals of a tooth are not filled completely, bacteria begin to multiply in the cavities created, triggering an inflammatory process.

Abscess after tooth extraction occurs in 2 cases:

The surgeon did not calculate the forces and caused trauma during the extraction, damaging the bone tissue.
The patient did not follow the recommendations of the dentist, which led to the penetration of pathogens into the wound.

Periodontitis

When the periodontium (the tissues and ligaments that hold the tooth in the cavity) becomes inflamed, the tooth-gum attachment weakens, the gum no longer fits tightly around the tooth, and tartar accumulates in the gap (periodontal pocket). It is a breeding ground for bacteria, which multiply rapidly, causing an immune response of the body, and thus the formation of pus. A swelling forms in the projection of the pocket. This can be an abscess of the anterior tooth or lateral tooth. Where the pocket is deeper, there is a higher probability of suppuration.

Pericoronitis

Teething, especially third molars (wisdom teeth), can become a painful process. If improper positioning or thick mucosa prevents the “eight” from erupting completely, a hood of mucosa forms on the tooth. This is where food debris gets trapped. Decomposing, they supply nutrients for bacteria, and those, in turn, cause inflammation. It can spread to the gum, forming a wisdom tooth abscess.

Trauma

It happens that when brushing teeth, while eating or with poor-quality prosthetics, the gum is traumatized. The integrity of the mucous membrane is compromised. Pathogens, all the time present in the oral cavity, penetrate inside. As a result of their active reproduction, pus begins to accumulate, a gingival abscess develops.

Symptoms

It all starts with minor painful sensations when biting. Then swelling appears on the gum. Pain syndrome increases. The general condition worsens. Temperature rises, pain goes to the ear and head. Lymph nodes increase in size, regardless of whether the abscess develops in the upper or lower tooth. There’s a putrid odor coming from the mouth. When the pustule bursts, a fistula is formed. Pus is released from it. When the acute process subsides, the fistula closes, but only until a new exacerbation.

Treatment

Diagnostic measures help to determine the cause and make a treatment plan.

For diagnosis, they use:

Interview with the patient
External examination
Radiography

X-rays will help identify the causative tooth and show what is causing the suppuration: inflammation of the root, periodontal pocket, or trauma.

At this stage, the decision is made whether to extract or save the tooth.

If the tooth is decided to save, the algorithm of therapeutic measures in periodontitis is as follows:

Remove all caries-affected tissues.
The tooth is depulped, the canals are left open.
If the canals have already been treated, the old fillings are removed, the canals are cleaned, but not filled. This facilitates the outflow of pus. If the tooth has a crown, immediately proceed to the next stage.
The gum is opened. A drain is inserted. After some time, it is removed. This stage is not always carried out.
In the canals of the tooth is inserted therapeutic paste. The cavity is closed with a temporary filling. After 4-8 weeks, a control examination is carried out. If there is no relapse, the canals are filled with gutta-percha, a permanent filling is placed on the tooth.

If therapeutic methods do not help, or the tooth is fixed prosthesis, then the surgical method is used. The top of the root is amputated, eliminating the cause of inflammation. At the same time remove the tooth cyst, abscess or granuloma.

The scheme of treatment for periodontitis is somewhat different. The main method of removing pus is open curettage or flap surgery. The paradontist peels off the gum flap, opens access to the root and cleans it of hard plaque and decomposition products. The wound is disinfected, sutures or periodontal dressing is applied. After a week, the sutures are removed.

In mild cases, gingivectomy is performed. An incision is made in the gum, through which pus is removed.

In pericoronitis, the hood is excised, allowing the tooth to erupt. This also allows the pus to drain freely. The wound is treated with an antiseptic solution, a bandage is applied.

In case of trauma, the irritant is removed. If the gum is traumatized by a denture – it is changed. A foreign object (fish bone, for example) is removed. Provide an outflow of exudate.

Regardless of the cause of the abscess, antimicrobial therapy is necessarily prescribed. For better healing, dentists recommend salt baths for several days.

Relieve pain will help to relieve the usual non-steroidal anti-inflammatory drugs, for example, paracetomol. After opening the pustule, relief comes quickly and painkillers are required only for the first day or two.

Home remedies

Folk healers advise to rinse the mouth with saline, soda solutions, infusions of sage, calendula, chamomile. They recommend using propolis in the form of alcohol lotions.

These means can temporarily relieve pain, but they do not eliminate the cause of inflammation. Therefore, relief is temporary, inflammation increases and can turn into serious complications. And alcohol infusions also lead to chemical burns of the mucosa.

Tooth abscess cannot be cured without the intervention of a dentist. Only a comprehensive approach to treatment allows you to stop the inflammatory process.

What is the danger of a pustule

If the symptoms of inflammation are not strongly pronounced, most people postpone a visit to the dentist. This leads to complications, develops:

Chronic abscess of the tooth The disease acquires a cyclic character: pus-fistula-flux of pus-closure of the fistula. Then a cold, exacerbation of general illnesses or another cause provokes a new cycle. Each time the danger that the pus penetrates deep into the tissues or spread by blood flow throughout the body, increases.

Phlegmon This is already a spilled purulent process, which takes over large areas. There is a strong intoxication of the body, the general condition worsens. Phlegmon is dangerous with its main complication – blood poisoning.

Sepsis As a result of the fact that the infection spreads throughout the body, sepsis affects all organs, leads to their failure. Causes fever, drop in blood pressure. Treatment of sepsis is complex, the prognosis is not always favorable.

Prevention

The simplest and most effective way of prevention is daily oral hygiene. With its help, it removes most of the plaque, which means that the risk of caries and its complications is significantly reduced.

Professional teeth cleaning prevents the formation of tartar, minimizes the possibility of periodontitis.

Visiting a dentist once every 6 months allows you to detect dental diseases in time, before they are complicated by abscess formation.

Care and timely treatment preserve teeth and prevent complications.