TABLE OF CONTENTS
What is a tooth infection?
A tooth infection occurs when bacteria gets stuck inside a tooth. Once a tooth gets infected it no longer has blood flow which means that antibiotics can’t kill the bacteria inside. This is what separates a tooth infection from another part in your body. A tooth acts like a petri dish and grows bacteria inside it quickly. It can then pump this infection out into the surrounding tissues causing, an abscess, swelling, pain, and drainage. Let’s look at the various stages of progression of this process.
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Typical symptoms include swelling and pain in and around the tooth and gums. It can become severe and typically get worse over time.
Other symptoms include:
- Sensitivity to hot and cold
- pain that wakes you up at night
- Pain in your jaw, ear or neck
- Pain tends to get worse when you lie down
- Pain from chewing or biting
- discolored or loose teeth
- bad breath or taste
- swollen lymph nodes in your neck or under your jaw
In severe cases you can have swelling that affects your vision or breathing. These symptoms are extreme and severe. If you experience these you should go to the emergency room right away.
Dental Decay is the leading cause of tooth infection
Millions of bacteria live in our mouth at any given time. Some bacteria is good while others can cause damage and destruction of the teeth and surrounding bone. In order for this bacteria to get inside the tooth it has to break through the enamel of the tooth. The bacteria does this by consuming sugar (from your diet) and creating a byproduct of acid. Acid, overtime, breaks down the enamel of a tooth and allows for the entry of bacteria. Once the bacteria has entered through the enamel it reaches the soft inner dentin. This portion is much softer and breaks down 8 times faster than the enamel. The most inner portion of the tooth is the nerve. As the bacteria starts to approach the nerve, it becomes inflamed in an attempt to fight off the bacteria.
Typically when a tooth becomes inflamed the vessels swell. Since the tooth nerve is a confined space, as it swells from inflammation it can be an extremely painful situation. Eventually the nerve will die and this extreme pain will subside. Even though the tooth might feel better it is still filled with bacteria on the inside. It continues to grow until it has no where else to go except for out the bottom of the tooth. As it pumps out the bottom it creates an infection called a periapical abscess. This can continue to grow around the teeth and into the adjacent spaces like inside the mouth, the sinuses and fascial spaces (the spaces between muscles, glands and organs). When the abscess grows in fascial spaces it can cause dangerous infections that can spread through the body, and even effect your breathing.
Other causes of periapical abscesses:
- Trauma can cause a tooth to die similar to decay. This is more common on front teeth. This process can be immediate or it can take years to form an abscess. Typically you can tell it abscessing if it hurts to tap or bite on the tooth.
- A cracked tooth can also kill the nerve and start the process of abscess formation.
Other types of infections
Abscess can form by bacteria getting stuck around the gums. There are several types of abscesses that form around the teeth.
Periodontal Abscesses occur due to advanced periodontal disease. Infections get stuck in pockets in and around the tooth.
Gingival Abscess occurs when a foreign body gets stuck in gums or between the teeth.
Pericoronal Abscess typically occurs around wisdom teeth when they don’t erupt correctly. If the tooth is impacted or partially erupted this is much more likely to occur.
When a tooth abscesses it forms a pocket or bubble of infections (pus) due to bacterial infection. It can be extremely painful. Without treatment they can grow and move into other parts of the body. In some cases it can progress into a life-threatening issue.
How is it treated?
Treating an abscessed tooth depends upon the cause. This can be diagnosed utilzing x-rays, CT Scans and by doing an intraoral exam. Once diagnosed it can be properly treated. Typically it is treated by removing the source of infection.
Treating a periapical abscess:
A periapical abscess due to decay, trauma or cracks can typically be treated either by removing the inside of the tooth (root canal) or removing the tooth all together.
With root canal treatment we remove the nerve and dead tissue from the inside of the tooth, thoroughly disinfect the inside, shape the canals and fill with a rubber material to seal it off.
This effectively saves the tooth allowing it to continue functioning normally.
With an extraction we are removing the tooth that is infected. This will eliminate the cause as well however it is always better to save a tooth whenever possible. If there isn’t sufficient tooth structure remaining to do a root canal an extraction is recommended. However going without a tooth long term can cause other problems. An implant is recommended to restore form and function and prevent teeth from shifting.
Treating a gingival abscess:
A gingival abscess is due to food impacted between the gums. Usually the treatment consists of cleaning out the impacted foreigh body. We will disinfect the pockets with an antibiotic rinse as well. Sometimes a gingival abscess can get large and will need to be drained.
Treating a periodontal abscess:
Typically the only treatment of a periodontal abscess is removal of the tooth. A dental implant is recommended to replace missing teeth to avoid shifting of your remaining teeth and to restore function to normal.
Pericoronitis is cause by an impacted wisdom tooth. The treatment for this type of abscess consists of removing the wisdom tooth.
Even if an abscess has ruptured it is still important to have it treated. The source of the infection must be removed. If left untreated for a significant period of time there is a risk that the infection can spread to other parts of your head, neck or brain. In rare cases it can lead to life threatening complications like sepsis. If you have a high fever, difficulty breathing or swelling near your eye you should go to the emergency room prior to seeing us. These are signs of a serious, life threatening infection
The best way to prevent infections is regular visits and good hygiene. Many times we can find these issues before they start.