Abscessed Tooth

Treatment of an Abscessed Tooth

An abscess is an infection.  An abscessed tooth is one that has an infection in the gum tissue around it, or infection that is coming from the inside, or pulp space of the tooth.

Most abscessed teeth are teeth that have had large cavities, and possibly even restorative procedures such as a filling or a crown.  Sometimes when a tooth (and therefore its own individual pulp or nerve and blood supply) has sustained enough damage over a lifetime, it dies and an infection can begin.  Not all “dead” teeth are abscessed, but all abscessed teeth are dead (or non-vital).

You may have an abscessed tooth and not know it.  We sometimes can spot an abscess cavity around the root of a tooth on a routine x-ray.  More often, as a tooth is dying or becoming infected, it creates quite a bit of pain.  In fact the pain can be severe.  So a tooth that is abscessed requires treatment to make you feel better and prevent the infection from spreading to other areas in your head and neck.

The source of the infection must be removed in order for an abscess to heal.  This can be done in two ways.  Either the tooth can be extracted, or the pulp can be removed and the remaining space disinfected.  This is essentially a root canal treatment.  Once the source of the abscess is removed, the tooth needs to be rebuilt so that you can keep your tooth for chewing and smiling purposes!  Many times antibiotics are prescribed and need to be taken for about a week to help your body heal.  In addition, pain medication will be used to make you more comfortable.

The kind of abscess that occurs around the tooth in the gum area is called a periodontal abscess.  It occurs most commonly in patients who suffer from gingivitis or the more severe periodontitis but it can occur from “food trauma” as well.  When gum disease is present, the gum tissues detach from the tooth starting high on the tooth and working its way down to the root end.  This creates a pocket around the tooth where food and tartar can get stuck, collect bacteria, and then become infected.  Antibiotics and a thorough cleaning of the area will bring about healing.  However, routine periodontal cleanings are necessary to prevent future abscesses.

Periodontal abscesses can also occur in patients with healthy gums that have a food item lodged between a tooth and its surrounding gum.  Popcorn hulls are frequent offenders, as well as unexpected bones in meat or fish.