Tooth abscess - Dental abscess

Low urgency
CommonModerately severe

It is a collection of pus in the gum secondary to a dental infection.

The most frequent cause is caries, but it can also appear due to trauma or infection of the tissues that support the tooth.  

It manifests with pain in an area of the mouth that is aggravated by chewing or temperature changes when taking food and drinks. It may cause swelling of one side of the face, inflammation of local lymph nodes, and in more severe cases, fever.

It is diagnosed by clinical interrogation and close inspection of teeth, gums, mouth and neck.

The first objective of treatment is to reduce pain with analgesics and treat the infection with antibiotics. In the second stage, endodontics or tooth extraction will be performed depending on the viability of the tooth.

Bibliographic references
  1. Diagnosis. En: Berman, LH, Hargreaves, KM. Cohen´s Pathways of the pulp. 12ª ed. Missouri: Elsevier: 2021. 
  2. Pumarola J, Canalda C, Segura JJ. Patología de la pulpa y del periápice. En: Canalda C, Brau E. Endodoncia. Técnicas clínicas y bases científicas. 3ª ed. Barcelona: Elsevier Masson; 2014. Cap. 6: 58-72.
  3. Absceso Dental. Biblioteca Nacional de Medicina de los EE.UU. https://medlineplus.gov/spanish/ency/article/001060.htm Consultado el 02/05/2021
  4. Sanz M, Herrera D, Van Winkelhoff AJ. The periodontal abscess. En: Lindht J, Lang NP, Karring T, editores. Clinical Periodontology and Implant Dentistry. 8ª ed. Oxford: Blackwell-Munksgaard, 2008. 
  5. Herrera D, Roldán S, Sanz M. The periodontal abscess: a review. J Clin Periodontol 2000; 27(6): 337-386.
  6. Anthony W Chow. Complications, diagnosis, and treatment of odontogenic infections. UpToDate. Octubre 2016
  7. Albandar JM. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol 1999; 70:13.
  8. Chow AW. Infections of the oral cavity, neck and head. In: Principles and Practice of Infectious Diseases, 7, Mandell GL, Bennet JE, Dolin R. (Eds), Elsevier Churchill Livingstone, Philadelphia 2009.
  9. Samuel C. Durso. Manifestaciones bucales de enfermedades. Harrison. Principios de Medicina Interna, 19e. Capítulo 45
Author
Ms. Nuria Campo
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Symptoms

    Toothache


    Pain increase when chewing


    Swollen gums


    Swollen face


    Pain in mouth

Symptoms to watch out for

Fever not relieved by antipyretics (paracetamol, ibuprofen)
Swelling of the face
Excessive sweating

Self-care

Take over-the-counter pain relievers or anti-inflammatories.
Maintain hydration of half a gallon per day. Avoid soft drinks and fruit juices with high sugar content.
Rinse the mouth with lukewarm water after meals.
Consult with your primary care physician regarding the prescription of antibiotics.