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02 Mar, 2021
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dental abscess

Dental Abscess? – Ask Dr. Farooq Sorathia

Dental Abscess? What’s That?

First, let’s talk about what an abscess is. An abscess is a collection of pus that is caused by an infection. There are two main kinds of dental abscesses. These abscesses are periapical and periodontal abscesses. A periapical abscess happens when the infection originates from the tooth and spreads into the surrounding tissue around the tooth, while a periodontal abscess originates from the gums whilst the tooth remains healthy – up to a certain level. If the abscess continues to spread to the surrounding tissues, the infection can spread from the gum and into the tooth. This is called a perio-endo lesion.

Earlier I had written about root canal therapy and what it entails. Bacteria that cause decay, break down the hard outer surface of the tooth (enamel), then spreads into the dentin (beneath the enamel), and then eventually progresses to the pulp (the area within the centre of the tooth that contains blood vessels, nerves and connective tissue).

If an infected tooth isn’t treated, the infection can then further spread down to the root thereby affecting the surrounding structures, and resulting in a periapical abscess. When that happens, the patient would feel throbbing pain and would have difficulty chewing because the tooth would apply pressure on the abscess, causing a lot of pain that would radiate to the jaw bone, the neck, or the ear and result in sleepless nights. My patients describe to me that the pain sometimes feels like someone is hitting their head with a hammer.

People with certain medical conditions such as uncontrolled diabetes are at a higher risk of developing periodontal abscesses. This is because people with uncontrolled diabetes have poor immunity and healing, therefore more prone to developing abscesses as the body will not be able to fight off the infection. Uncontrolled diabetes delays wound healing because of the reduced blood flow, and also decreased tissue production that is responsible for healing. An abscess needs to be dealt with immediately so that it doesn’t spread to the surrounding tissues and cause more harm. This is even more important for people with medical conditions.

When an abscess is left unattended, it spreads and can become a life-threatening condition if not dealt with appropriately. The infection can spread to the surrounding tissues and spread through the spaces between the muscles. This can cause the face or neck to swell up, depending on the location of the spread of the infection, and if still left untreated, can cause a blockage of the airway, eventually resulting in death. I remember our professor telling us, “… don’t let the sun set on an abscess” to remind us of the dire consequences of spreading infection.

Abscesses can be avoided if we maintain good oral health. It is important to get regular dental checkups to make sure all your teeth and tissues remain healthy. Flossing daily and brushing at least two times a day with fluoridated toothpaste reduces the chance of developing dental caries, as well as avoiding sugary and sticky foods!

Article Written by Dr. Farooq Sorathia (BDS – University of the Witwatersrand, Johannesburg)

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