Abscess

What is an abscess?

An abscess is a collection of pus that can form inside the teeth, in the gums, or the bone in which the teeth are anchored in place.  A periapical abscess is located at the end of the tooth whereas a periodontal abscess is located in the gum area.  Abscesses are usually painful but this is not always the case. It is important to get any swelling in your mouth checked by a dentist.

Why does an abscess form?

Bacteria enter the tooth through tiny holes caused by tooth decay (caries) that form in the tooth enamel (hard outer layer of the tooth). The caries eventually break down the softer layer of tissue under the enamel, called dentine. If the decay continues, the hole will eventually penetrate the soft inner pulp of the tooth - infection of the pulp is called pulpitis and can be extremely painful. As the pulpitis progresses the bacteria make their way to the bone that surrounds and supports the tooth, called the alveolar bone, and a periapical abscess is formed.

When bacteria which are present in plaque infect the gums the patient has something called Periodontitis.  The gums become inflamed, which can make the periodontal ligament (tissue surrounding the root of the tooth) separate from the base of the tooth.  A periodontal pocket, a tiny gap, is formed when the periodontal ligament separates from the root. The pocket gets dirty easily and is very hard to keep clean. As bacteria build up in the periodontal pocket a periodontal abscess can develop.

Can it be treated?

Yes it can be treated using a process known as root canal treatment.  In very severe cases with large swellings, antibiotics are sometimes prescribed prior to the start of treatment.

What does it involve?

The aim of the treatment is to remove infection from the nerve canals inside the root of the tooth.  The canals are then sealed to prevent re-infection.

What will my tooth look like after treatment?

The tooth will hopefully look just like it did before. Occasionally it may darken but this can usually be rectified using white fillings or special bleaching techniques.

What if it happens again?

This is unlikely but root canal treatment can be carried out again. The success rate for a re-root treatment is lower and for this reason we sometimes advise a referral to a specialist.

Is it expensive?

Root canal treatment is a time consuming procedure and sometimes can take 2-3 hours. The procedure also requires the use of expensive equipment which means that the costs can be significant.

What if I don’t have the treatment?

The infection will continue to develop and will undoubtedly cause further problems, probably leading to the loss of the tooth.

Where can this treatment be carried out?

We are happy to carry out this treatment here at Gentle Dental Care in St Andrews. Occasionally, for difficult cases, we may suggest that a specialist, called an Endodontist, carries out the treatment.

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