Wednesday, February 6, 2013

What is an abscess?

An abscess is a collection of pus. It occurs as a result of an inflammatory response to bacteria, parasites or foreign bodies such as a splinter. It's the body's way of responding to a threat. A large number of white blood cells will be drawn into the area in an attempt to kill or eliminate the threat. A wall of cells forms around the source of infection in an attempt to isolate it. This can occur anywhere in the body.

A tooth abscess is simply an abscess that forms in the jaw bone surrounding an infected tooth. This most commonly occurs when the pulp (the space within each tooth that contains nerves and blood vessels) becomes infected. The bacteria and necrotic tissue then leaches out at the apex of the root. The pulp can become infected when untreated decay, cracks or periodontal disease occur.

You may notice pain when you bite or push on the affected tooth. In many cases the pain can become incredibly severe. Abscesses occur on teeth that are dead. So, you may not notice any temperature sensitivity.

Sometimes you may not experience any pain whatsoever. This occurs when the pus is draining through a "bump" on the gum in close proximity to the root of the tooth. The reason why it may not hurt is because the draining of the pus is preventing the tissues from expanding like a water balloon. It's as if the water balloon has popped. This is good and bad. Obviously it's good because there isn't any pain. But it's bad because people aren't prompted to do anything about it.

Tubes placed to allow drainage

If you suspect that you have an infection, get it checked out immediately. Infections can significantly worsen in an extremely short period of time and can become life-threatening. Yes, life threatening! There are a couple reasons why. First, the swelling can become so severe that it can compromise your airway. Breathing is kind of important. I certainly like to breath. A second reason why it could become life-threatening is because the bacteria is circulating throughout your blood stream. You run the risk of becoming septic. This is when the concentration of bacteria has become so severe that it has overwhelmed your ability to fight it off. People have succumbed to septic shock originating from odontogenic (tooth borne) infections.

There are a several treatment options. If the tooth is salvageable, then simply removing the bacteria and necrotic tissue from within the tooth is indicated. After the internal part of the tooth is thoroughly cleaned out, it is sealed in order to prevent migration of bacteria back into the tooth. We then rely on the immune system and antibiotics to remove the bacteria inside the the bone. Most people refer to this treatment as a root canal. By the way, root canals don't hurt. A second option should only be considered when the tooth is not salvageable. In these cases, the only remedy is the removal of the offending tooth. A third treatment is only necessary when there is significant swelling. Incision of the lump of pus will allow it to drain. It sounds gruesome to cut into a lesion, but patients get significant relief immediately.

Dog afflicted with a tooth abcess

Many people believe that antibiotics alone will solve the problem. This is only a temporary fix. The only solution is the complete removal of the source of infection with either a root canal or an extraction. Antibiotic treatment without removal of the source is encouraging the development of antibiotic resistant strains of bacteria.

As soon as you notice an unusual bump, get this evaluated and treated right away. Delays in treatment can result in dire consequences.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

1 comment:

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