Dental abscesses are most often associated with a decaying tooth, but they may also occur due to underlying periodontal disease. The most obvious problem is that they are significantly painful, but if left untreated they can lead to life-threatening infections, especially due to their close proximity to the brain and major blood vessels. There are several ways to address dental abscesses and reduce the likelihood of serious problems.
Engage In Self Care
Although you cannot treat an abscess at home, there are ways you can help reduce pain and swelling until you can seek treatment. If you notice an abscess, use a cold compress on the outside of your cheek to help with pain and swelling. Unfortunately, some people may experience an increase in aching and throbbing, especially if there is underlying damage to the tooth's nerve. Warm compresses may seem like a better idea, because they may be temporarily more soothing. However, if you apply warmth, it will increase swelling and may cause the infection to spread quicker. To make the cold more tolerable, apply a cool rag or bottle filled with cold water to your cheek for a few seconds at a time. You do not need to use ice if it is too painful.
Try to continue your oral care routine as normal, being careful not to agitate the abscess by hitting it with your toothbrush. Since many mouthwashes contain alcohol, you may want to skip using your mouthwash temporarily since it will likely burn more so than normal. You may want to try hydrogen peroxide rinses instead. Do not use hydrogen peroxide at its full strength. Try half peroxide and half water, and swish it around your mouth for as long as you feel comfortable. Pay special attention to the abscessed area when rinsing.
Seek Emergency Treatment
In many cases, an emergency visit to your dentist is necessary to help alleviate the problem. If you cannot see a dentist promptly, consider a primary care doctor or an urgent care center. For most minor abscesses, you may receive an antibiotic and pain medication. Even if you have received temporary treatment with pain control and antibiotic therapy, you must follow up with a dentist for further treatment.
Once the underlying infection has been eliminated, your dentist will want to either extract the offending tooth or perform a procedure, such as a root canal, to salvage the tooth. Although it may be tempting to not follow up with the dentist once the initial problem is under control, the abscess will most likely come back and may be worse upon subsequent occurrences. There is also the risk of subsequent abscesses not responding as well to the same course of antibiotics. If your abscess is caused by changes consistent with gum disease, your dentist will likely refer you to a periodontist for further evaluation.
Significant abscesses, especially those that are moving toward important structures in the head, such as major blood vessels and the brain, may need to be drained to make it easier for antibiotic therapy and the body's own immune system to fight the infection. A doctor might use one of two approaches to reach and drain the abscess. Many abscesses can be drained by making an incision in the gum line, which is a better option for cosmetic appearance. However, it can be difficult to keep the incision open, and the infection may not completely drain and resolve.
Another approach to draining certain types of abscesses is making the incision on the face. The incision will need to be made deep enough to reach the pocket and help the area drain. The downside of an incision on the face is cosmetic concerns. You will likely have the incision packed and gauze will need to remain on your face until the area heals. After the incision heals, there will be little, if any, scarring. A major benefit of an outside incision is that is less likely to be re-infected by oral bacteria and it is easier to keep the pocket open throughout the healing process.
Since microbiology testing can take days to come back, your doctor will not be certain of the type of bacteria causing the infection. They will likely prescribe a full-spectrum antibiotic that covers the most likely offenders, but this may need to change once the results come back. Usually the doctor will contact you within two or three days if changes need to be made.
Dental abscesses can occur even with good oral care and regular checkups. Identifying the problem early can make treating the abscess easier and help you reduce the likelihood of subsequent abscesses. For help with this and any other dental emergencies, contact a dental office like Family Dental Care.