Abscess of the tooth: root, gums, wisdom tooth and milk tooth

Teeth are a matter of concern and concern for every person, from infancy to the end of life. Their incision in childhood is accompanied by edema and inflammation of the gums, pain, they need daily care, and the problems that arise require timely intervention, which many people fear, delaying the visit to the dentist. But there is one disease that can not wait and urges anyone, the most cowardly to the doctor. This is an abscess of the tooth - an inflammatory process, accompanied by accumulation of pus in the root part.

[1]

Causes of the tooth abscess

The cause of tooth abscess is the penetration of bacteria into the pulp of the tooth through the damaged layer of enamel. This leads to:

• dental diseases (pulpitis, caries, periodontitis, cyst, etc.);
• tooth damage due to cleavage or fracture;
• infectious diseases (influenza, angina);
• violation of the integrity of tissues in the mouth;
• blisters of the face;
• hit pathogenic microorganisms during various manipulations of the doctor (unsuccessful filling of channels, work with non-sterile instruments).

[2], [3]

Risk factors

To the risk factors for tooth abscess is poor oral care. Another negative aspect of enamel damage is the development of caries due to excessive consumption of sweets. In the risk zone, people who avoid dental examinations, as well as diabetics.

[4], [5]

Pathogenesis

The pathogenesis of tooth abscess is the penetration of infection through damage to the tooth covering or soft tissues around the tooth in the outer or inner part of its alveolar process. Reproduction of bacteria leads to the accumulation of pus in the soft pulp of the tooth, most often already dead at this point. If you do not allow pus to escape, abscesses involve parts of the tooth outside the jaw - the jawbone, periodontal tissues, adjacent teeth.

[6]

Symptoms of the tooth abscess

Symptoms of tooth abscess poured into the following state of the body:

• pulsating, "pulling" toothache;
• pain with pressure, including biting, chewing;
• redness and edema of the gingiva, the appearance of densification;
• swelling of cheeks;
• an increase in the lymph nodes of the neck;
• reaction to hot or cold food;
• bad breath;
• fever, chills, fever;
• general malaise;
• the appearance of an open purulent wound.

The first sign of an abscess is the appearance of aching, throbbing pain, which can not be ignored. Over time, it only intensifies, the gum around the aching tooth begins to swell and blush. A night without sleep is possible. Over time, the swelling appears on the face. To hope that this will pass by itself, it is not necessary, it is necessary to intervene the dentist.

Stages

There are two stages of tooth abscess: acute and chronic. All the signs of the acute stage are described above. In some cases, it can stop and without the intervention of the dentist, i.e. The abscess is opened by itself, the pus enters the oral cavity and comes relief. But this can lead to a chronic form, which will lead to further complications and the formation of fistula.

[7]

Forms

There are several types of abscesses, depending on the location of the purulent focus, namely:

• gum or flux, does not spread to the tooth;
• periodontal, concentrated closer to the root of the tooth in the periodontal pocket;
• periapical, develops in the tooth itself, which has a dead pulp.

Purulent abscess of tooth

A sharp stage is also called a purulent abscess of the tooth. It is not always characterized by shooting pain, it can flow painlessly, but there will always be edema near the tooth. It is also possible swelling of the cheeks, an increase in lymph nodes, the appearance of a headache. Over time, there will be an acute growing pulsating pain, a gum tumor will increase even to the size of a walnut. The general condition worsens, the body temperature rises.

[8]

Chronic abscess of tooth

Chronic abscess of the tooth is characterized by moderate pain when pressed on it, but this does not affect the overall condition of the body. Often when a purulent abscess occurs a spontaneous breakthrough of the abscess, the symptoms disappear. Nevertheless, the infection does not disappear anywhere, but goes into a chronic form and continues its destructive effect. Repetition of exacerbations is inevitable.

[9], [10], [11]

Abscess after tooth extraction

Often there is a need to remove a sick tooth. Anesthesia relieves pain at the time of surgery, but there remains a bleeding and afflicted hole. Until the wound is healed, we have to endure, observe certain rules of hygiene and eating (excluding hard, rough, hot food). Symptoms such as prolonged bleeding, increasing pain, the appearance of a purulent plaque, bad breath from the mouth should be the reason for immediate treatment to the dentist. The healing process is the replacement of the blood clot with a granulation tissue, from which the bone is formed. If it did not form and the infection got into the open wound, an abscess occurs after the tooth is removed. Another reason may be the non-sterility of the instrument used by the surgeon.

[12], [13]

Abscess of the root of the tooth

Abscess of the root of the tooth is also called periapical. The most frequent cause of its occurrence is deep caries against the background of poor oral hygiene. Disease-causing microbes enter the bloodstream, causing an inflammatory process. The danger of such an abscess is that the roots of the tooth are located in close proximity to the blood vessels, through which the infection spreads rapidly throughout the body. Symptoms of tooth root abscess do not keep you waiting long: a pain that aggravates at night, a temperature jump, general weakness, swelling of the gingival tissue, swelling of the facial jaw.

Abscess of wisdom tooth

Often due to the peculiarities of its location and the complexity of removal. He is ingrown into a soft well-supplied blood tissue. If for the removal there is a need to split the tooth into fragments, then the traumatic area increases. After removal, a high temperature is possible, and the tissues around the hole are red and swollen. Heals such a wound longer than usual. But if on the second or third day there is no relief and the temperature keeps, and the edema increases, then infection occurs, the abscess develops and it is necessary to urgently consult a doctor.

[14], [15], [16]

Abscess of gum tooth

Abscess of the gum of the tooth is also called a flux. It is the accumulation of dead tissue resulting from inflammation. The purulent area extends to soft gum tissue without touching the bone of the tooth. However, if you do not take measures to eliminate it, the abscess can move to other areas, including the tooth.

Abscess of the milk tooth

Dangerous that under it is the rudiment of a permanent tooth. Infection can get on it from the bottom of the root of the milk and lead to death. The tooth enamel in a child is thinner, the pulp chamber is larger than that of an adult. This allows the infection to move faster into the jaw. The danger consists in the ingress of toxins into the blood from the focus of inflammation, which can lead to allergies, asthma. Infection of the mouth during fistula formation is fraught with persistent colds, tonsillitis. The child must show the doctor, who will decide to treat or remove the milk tooth.

[17]

Frequent tooth abscesses

Frequent abscesses of teeth indicate an untreated infection, its flow into a chronic form. Toothache in the presence of an abscess can stop, if the nerve endings are already dead, the edema is gone. But the inflammatory process is not stopped and the infection spreads to nearby teeth or deep into the jaw bone. Thus, new foci of suppuration arise.

Complications and consequences

The consequences and complications of the disease are serious enough to ignore it. The appearance of the fistula is fraught with the infection of other organs. Phlegmon of the mouth - a vast, diffuse purulent inflammation of the cellulose requires great effort to eliminate it. Very dangerous appearance of abscesses in bone tissues. In addition to tooth loss, the abscess is dangerous for the development of osteomyelitis, cellulitis, sepsis, diabetes, inflammation of the brain, pneumonia, cardiovascular ailments. Treatment of them will take much more time and money than a visit to the dentist. Danger and relapse of the abscess.

[18], [19], [20]

Diagnostics of the tooth abscess

Diagnosis of tooth abscess is carried out by the dentist when examining the patient: puffiness and redness of the gums are fixed, the degree of sensitivity to cold and hot is determined. Pressing and tapping the tooth will cause the patient pain. This information will help to make a preliminary diagnosis, and instrumental research using X-rays will confirm it.

When the abscess is sent for blood and urine analysis before and after the operation, and also take material from the focus of inflammation for microscopic and bacteriological examination.

[21], [22]

Differential diagnosis

The task of differential diagnosis is to identify the abscess from

Cysts, hematomas, tumors, phlegmon. Abscess - a limited inflammation of soft tissues, and phlegmon - diffuse purulent inflammation, more dangerous for a person with its consequences. Symptoms of tooth abscess are similar to purulent periostitis. The difference in the localization of the focus of inflammation: the latter are located more superficially, in the vestibular surface. Based on clinical observations, diagnostic puncture and bacteriological studies of the material taken, the doctor diagnoses the disease and determines the sensitivity of the pathogen to antibiotics.

[23], [24], [25], [26]

Treatment of the tooth abscess

Treatment of tooth abscess is to eliminate the focus of inflammation. To do this, resort to his autopsy and the following procedures:

• drainage - through the drilled tooth the suppuration is removed, disinfection is carried out, the canal is sealed, then the crown is placed on the tooth;
• drainage through the incision of the gum, if the tooth is not affected;
• removal of the tooth with a large abscess and the inability to preserve it, scraping out dead tissue;
• the use of an antibiotic after suppression of suppuration to prevent the growth of the focus of the infection and its destruction;
• rinsing with warm salt or soda solutions to completely wash out the pus and quickly heal the wound;
• use of pain medications with severe pain and immunostimulants.

Treatment of recurrence of tooth abscess

It happens that after surgery there are complications in the form of bleeding and relapse of tooth abscess. In the risk zone, people with obesity, smoking, alcoholics, drug addicts, diabetics, hypertensive people who take blood thinning medications. The body will let you know about the relapse by deteriorating health, fever, suppuration around the wound, its redness and swelling. In this case, you should immediately contact your dentist. Treatment for the recurrence of tooth abscess is carried out according to the same scheme as the primary abscess, with the mandatory prescription of antibacterial agents. Recovery will be more protracted.

Treatment of tooth abscess in pregnancy

Pregnancy is a predisposing factor for the development of the disease. During this period, the woman's immunity decreases. Treatment of tooth abscess during pregnancy is complicated by the undesirability of using antibiotics. The specialist conducts the same therapeutic measures to eliminate the focus of the infection as other patients, with a comparison of the risk and benefits of using analgesics and antibacterial drugs, prescribes rinsing the oral cavity. For anesthesia, preference is given to agents with a moderate content of vasoconstrictor components that slow the absorption of the drug into the blood, respectively, and into the placenta.

Medications

The drugs used in the treatment of abscess include anesthetic drugs that relieve pain during surgical procedures and in the postoperative period, antibiotics, rinsing mouth solutions, immunity-strengthening preparations, vitamins. Most often resorted to the so-called infiltration anesthesia, in which a number of injections are made in close proximity to the diseased tooth. As it is used as a means, long used in dentistry - lidocaine, novocaine, and a new generation - ultracaine, scandinavian, septanest.

Ultracaine - its dose depends on the time of surgery and the depth of anesthesia. Usually 1.7ml of substance is enough. It is inadmissible to administer the drug into the vessel. To prevent this, a trial aspiration is made (the syringe, after insertion into soft tissues, drags on itself and, if the needle has got into the vessel, the blood gets into the syringe). Possible side effects: headache, increased blood pressure, arrhythmia, blurred vision, nausea, vomiting, itching of the skin, urticaria. The drug is contraindicated in patients with allergies to its components. It is not recommended for patients with bronchial asthma, with heart failure, arterial hypertension. Ultrakain can be used in pregnancy because of insignificance of its penetration into the placenta.

Septanest - starts to act in 1-3 minutes after the introduction for over an hour or more. A sufficient dose for intervention in the case of tooth abscess is 1.7ml. Do not use for children under 4 years old and sick with serious cardiovascular diseases, for example, who underwent myocardial infarction. Side effects are expressed in the form of arrhythmia, increased pressure, sensitivity to the drug.

Antibiotics for tooth abscess

To avoid negative consequences and complications in dentistry with tooth abscess, antibiotics of a wide spectrum of action are used. These include amoktsilin, lincomycin, ciprofloxacin, metrogidazole, azithromycin, clindamycin, oxacillin.

Amocilin is a bactericidal preparation, available in the form of tablets, capsules for oral administration and powder for injections. The dose is determined by the doctor depending on the severity of the condition. Recommended - 0.5 g three times a day (for body weight exceeding 40 kg). If necessary, increases to 1g per reception. Children 5-10 years - to 0.25 g three times a day. Amocilin is contraindicated in cases of hypersensitivity to penicillins, mononucleosis. Care must be taken by pregnant and lactating women. In this case, only the doctor should determine the prevalence of benefit over the negative effect of the drug. Side effects can manifest as skin rashes, rhinitis, conjunctivitis, joint pain.

Lincomycin is a drug from the family of lincosamides. It is very popular in dentistry in the treatment of various inflammatory processes, including tooth abscesses, because of its properties accumulate in bone tissues and prevent relapses. It is available in capsules, ointments and solutions for intramuscular and intravenous administration. Capsules are taken by adults 3-4 times a day for 500 mg a few hours before meals. Injections of 600 mg are done twice a day. For children, doses are calculated based on the proportion of 30-60 mg of medication per 1 kg of weight, intravenously - 10-20 mg. The drug is not recommended for pregnant, lactating, with allergies to its components, kidney and liver diseases. Adverse reactions include nausea, diarrhea, urticaria, swelling, pain of the gastrointestinal tract.

Oxacillin - its dosage form - tablets and powder for the preparation of injections. Tablets of 0.5-1g are recommended to be taken every 4-6 hours. Injections are administered intramuscularly or intravenously with the same interval (0.25-0.5 g of powder per 1.5-3 ml of water for them). There may be adverse reactions from the food tract, the genitourinary system, allergies. The drug has contraindications for hypersensitivity to its components, bronchial asthma, renal failure, breast-feeding. Prescription to pregnant women is acceptable if the potential benefit exceeds the risk to the fetus.

[27],

Vitamins

To strengthen immunity with food in the body must receive a sufficient amount of vitamins and trace elements. To strengthen teeth and enamel, calcium and fluorine are needed, which are found in natural dairy products, carrots, apples, citrus fruits. You can drink a pharmacy complex, in which all the necessary elements are balanced.

Physiotherapeutic treatment

Physiotherapeutic treatment is successfully used in dentistry, including with abscesses of the tooth. Especially it is effective in combination with therapeutic methods, both during treatment and during rehabilitation. At an early stage of the disease, local hypothermia with UV irradiation, fluctuorization (the action of current pulses) is prescribed. At more extensive focus apply UHF, electrophoresis using antibiotics.

Treatment of tooth abscess at home

Abscess of the tooth requires the intervention of a specialist, but what can you do at home to ease your condition? In no case should you apply hot to the edema area. You can apply ice to the outside of the cheek and take an anesthetic, lowering temperature and swelling remedy: panadol, ibuprofen, aspirin. You can also rinse the oral cavity using alternative recipes to prepare the liquid.

Alternative treatment

Alternative treatment is used in case the tooth abscess is open, either after its treatment, or after tooth extraction, to avoid further infection and tissue suppuration. To do this, rinse with salt water. On a glass of warm water, put a teaspoon of salt, put into the mouth and hold for 20-30 seconds, then spit out. Helps to draw out the abscessed raw unsalted fat. Cut into plates, it needs to be cooled in the freezer. Taking alternately from the refrigerator, applying suppuration to the hearth, changing to a new, colder portion. Similarly, you can use a plate of garlic or ginger, you do not need to cool them.

[28], [29], [30]

Herbal Treatment

For the treatment of herbs abscess of the tooth must use its known bactericidal and antiseptic effect. These include chamomile, St. John's wort, oak bark, calendula, sage, arnica. They can be used alone or as a mouthwash. A glass of boiling water will need a tablespoon of herbs. Bay, let it brew to cool, rinse with warm. You can take advantage of the medicinal properties of geranium. To do this, grind the washed leaf of the plant, grind it to the state of gruel, put on a sterile bandage and attach it to the sore spot. After holding for 10-15 minutes, rinse your mouth with boiled water.

Homeopathy

Homeopathy in dentistry is a safe and effective method of treatment, consisting in stimulating the defenses of the body. Tinctures are made from vegetable, animal or mineral raw materials. These are concentrated solutions of basic substances based on ethanol. Later they use their dilutions. At abscesses appoint ferrum, ferrum phosphoricum, arnica, belladonna, bryonia, mercurius, meserium, etc.

Ferrum phosphoricum is a mineral salt in tablets used at the initial stages of the inflammatory process. In acute conditions, one dose is prescribed 6 times a day, children 3-4 times, for chronic - 1-3 times adults and 1-2 children. Contraindicated in patients with increased sensitivity to the active ingredient or wheat starch that is contained in the preparation. Possible adverse reactions in the form of allergies. For use by pregnant women, a doctor's consultation is necessary.

Arnika - drops, a complex homeopathic preparation. Drip on the water (10 drops per 10ml of water) or just under the tongue three times a day. Take a quarter of an hour before a meal or an hour after. Contraindicated in pregnant, lactating and children under 18 years of age. The side effect is expressed in gastrointestinal disorders.

Mercurius - used in the 6th dilution and above. Adverse reactions are possible from the gastrointestinal tract, kidneys, liver. Contraindicated in children, pregnant, with pathology of the food tract.

Mesereum - drops, solution for injections. The dosage is determined by the doctor depending on the condition of the patient. Approximately 10 drops three times a day or first 1 ampoule a day subcutaneously, intravenously or intramuscularly, several times a week later. The instruction to the preparation does not contain any cautions for use.

Autopsy of tooth abscess

Sometimes you have to resort to surgery if the abscess is neglected and spread to nearby soft tissues. In this case, the dissection of the tooth abscess is performed under general anesthesia. After that, drain drainage for the outflow of pus and recommend frequent mouth rinses.

[31], [32]

Prevention

To prevent tooth abscess, proper care for teeth and oral cavity is necessary. For the prevention of disease recommend the following activities:

• twice a day brush teeth with paste containing fluoride;
• timely remove tartar;
• visit the doctor at least twice a year for examination and timely dental treatment;
• saturate the diet with vitamins and microelements.

[33], [34]

Forecast

The prognosis of treatment of abscesses is favorable with timely and correct treatment. In another case, there may be a leakage into its chronic form or the infection of other organs that can turn into a threat to life.

[35], [36]