Periapical Abscess: Symptoms, Treatment and Prevention

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Cavities and mouth trauma can spell trouble for a number of oral complications, one of which is an infection called a periapical abscess. Read on to learn more about it, the symptoms and how a dentist treats it.

What Is This Type of Abscess?

This abscess is an infection of the pulp which results in the destruction of the hard and soft tissues at the apex of the tooth. This will potentially result in pain and swelling. Sometimes a drainage of the inflammatory infiltrate will result in a fistula, according to the Danish dental journal Tandlaegebladet. The invasion of bacteria into the pulp chamber may cause a pimple at the apex of the tooth in the mucosa. The periapical abscess can be caused by a cavity that extends into the pulp. A fracture of the tooth or trauma can also be initiating factors.

Diagnosis and Symptoms

When the pulp goes non-vital there may or may not be a periapical abscess. There may be pain but sometimes the person is totally unaware that the tooth has gone non-vital. The vitality of the pulp can be determined through attempting to stimulate the nerve in the pulp tissue. Radiographs can also help with the diagnosis. At the apex of the tooth there can be changes in the bone. It will be destroyed by the drainage of the infection from the pulp. With enough loss of bone a swelling can start and spread beyond the apex of the tooth.

The tooth with a periapical abscess can feel painful to chewing or touching. It can feel loose or higher than the adjacent tooth. Spontaneous pain is also possible with the infection of the pulp.

Treating the Infection

The infection cannot be treated with antibiotics alone. Drainage is usually required to contain the infection. The drainage can be obtained through the start of the root canal. Sometimes there is no swelling so the best approach is to do a root canal. Antibiotics may not be indicated if only a root canal is necessary.

If the tooth is not restorable, it may be best to extract it. This will be the case if it is fractured or the cavity is extremely large and has destroyed much of the clinical crown.

A large swelling will need to be drained. The area is anesthetized with local anesthesia and an incision is made down to the jaw bone, creating a path for pus and fluids to drain. Drainage will reduce pain and allow for antibiotics to control the infection. The antibiotic of choice is usually some derivative of penicillin.

Preventing an Abscess

Maintaining good oral hygiene routine is key to keeping your entire mouth healthy and preventing any sort of abscess. Floss daily and brush twice daily with a toothpaste like Colgate Total Advanced Deep Clean. It fights germs for 12 hours and helps prevent cavities. Also, visit your dentist regularly. A dentist will spot the early signs of decay, and early detection is key to preventing infections and abscesses.

Look after your teeth, help prevent cavities

Bacteria that live in your mouth can stick to your teeth and cause cavities. Use one of our fluoride toothpastes to help prevent cavities.