Dental Abscess
A dental abscess describes a collection of pus either around a tooth, on the gum or on the jaw bone, and is caused by a bacterial infection. If you have an abscess at the end of a tooth, this is called a periapical abscess. If you have one in your gum, this is called a periodontal abscess.
The symptoms of a dental abscess can vary but typically cause pain (although not in every case) that is often a persistent throbbing in your tooth or gum, with pain spreading to the ear on that side. You might also get redness and swelling of the face, and red gums if you look inside your mouth. It may be painful to chew food, difficult to take hot or cold drinks, and you (or others) might notice bad breath or an unpleasant taste in your mouth.
In severe tooth infections, the infection can spread to other parts of the body making you feel generally unwell and feverish. You may also find it difficult to fully open your mouth and may have difficulty swallowing.
Dental abscesses do not usually require antibiotic treatment unless the infection is severe or has spread more widely. It is also best to take simple painkillers, avoid hot or cold foods and drinks as your mouth may be quite sensitive, try softer foods and drink lots of fluids to prevent dehydration.
It is important to visit your dentist regularly to ensure you are maintaining good oral hygiene and follow their advice to maintain healthy teeth and gums at home.
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What causes dental abscess?
Dental abscesses form when bacteria build up in the mouth. This can be caused by poor oral hygiene, which is why it is important to floss and brush your teeth regularly.
Bacteria feed on sugars, so you may be putting your teeth and gums at higher risk if you're eating lots of sugary or starchy food and drinks. It can also affect those with poorly controlled diabetes.
You're at higher risk of any infection, including those in the mouth, if you are immunocompromised either from certain medical conditions or medications. Smoking and alcohol abuse both considerably raise your risk of an abscess, tooth decay and gum disease.
When to see your dentist?
It’s important to note that you should not contact your doctor for tooth problems – in the UK, doctors cannot prescribe antibiotics for teeth or gum problems, or perform treatments you require to treat the problem. These are done under a local anaesthetic and can include:
- taking the affected tooth out (a dental extraction) – this may be necessary if root canal treatment isn't possible
- root canal treatment – this procedure removes the abscess from the root of an affected tooth before filling and sealing it
- incision and drainage – here, a small cut (incision) is made in the gum to drain the abscess. However, this is usually only a temporary solution and so further treatment may be needed.
You should contact your own dentist or an emergency dentist if you think you have a tooth abscess. They will examine you and advise you on the next step. Some are registered as NHS dentists, but dental treatment is not always free. While waiting for this appointment, take painkillers such as ibuprofen or paracetamol.
If you feel very unwell with a fever and you can’t contact your dentist, call 111 or attend your nearest Emergency Department.
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Am I fit for work?
Aside from the pain, which may be too distracting to let you get on with work, you can be quite unwell with a dental abscess and it may spread if not appropriately treated. It's best to take time off work to get the treatment you need and recover.
Healthwords pharmacists' top tips
The pain is often the worst symptom for people with a dental abscess, and this can be managed with some simple painkillers, whilst you wait to see your dentist. Ibuprofen is best for this type of pain, or paracetamol could be used as a second option. You can also use antibacterial mouthwashes like chlorhexidine to prevent further build-up of bacteria.
Ensuring that you pay good attention to your oral hygiene is an important way of preventing dental infections. This can be done by brushing your teeth at least twice a day with a fluoride-based toothpaste and by using good dental floss or an interdental brush to clean underneath the gum line.
Dental Abcess vs Mouth Ulcer
Mouth ulcers, also known as canker sores or aphthous ulcers, are common painful lesions that develop on the mucous membranes inside the mouth. They can occur on the inner cheeks, lips, gums, tongue, or the roof of the mouth. Mouth ulcers are typically round or oval-shaped and may vary in size, ranging from a few millimetres to a centimetre in diameter.
Causes
Several factors can contribute to the development of mouth ulcers, including:
- Minor Trauma: Accidental biting of the cheek, lip, or tongue, or injury from sharp foods, dental appliances, or rough dental work can lead to the formation of mouth ulcers.
- Irritation: Certain foods and beverages, such as acidic fruits, spicy foods, or hot beverages, may irritate the delicate lining of the mouth and trigger ulcer formation.
- Hormonal Changes: Hormonal fluctuations during menstruation or pregnancy can increase the likelihood of developing mouth ulcers.
- Stress: Emotional stress or anxiety can weaken the immune system and make individuals more susceptible to mouth ulcers.
- Nutritional Deficiencies: Deficiencies in essential vitamins and minerals, such as vitamin B12, iron, or folic acid, may contribute to recurrent mouth ulcers.
Symptoms
The symptoms of mouth ulcers may vary depending on their size, location, and severity. Common signs and symptoms include:
- Pain or Discomfort: Mouth ulcers are often painful, especially when eating, drinking, or speaking. The pain may range from mild to severe and can interfere with daily activities.
- Sensitivity: The area around the ulcer may feel tender or sensitive to touch, and individuals may experience a burning or tingling sensation before the ulcer develops.
- Redness and Inflammation: The surrounding tissue may appear red and inflamed, and the ulcer itself may have a whitish or yellowish centre with a red border.
- Difficulty Eating: Severe mouth ulcers or multiple ulcers in the mouth may make it difficult to eat or swallow, leading to decreased appetite or unintentional weight loss.
Treatment
Most mouth ulcers heal on their own within 1-2 weeks without specific treatment. However, several measures can help alleviate symptoms and promote healing, including:
- Over-the-counter remedies: Topical oral gels or mouthwashes containing analgesic or anti-inflammatory ingredients, such as aspirin-based gels like Bonjela or local anaesthetics such as Orajel, can help reduce pain and inflammation associated with mouth ulcers.
- Pain Relief: Over-the-counter pain relievers, such as ibuprofen or paracetamol, may provide temporary relief from mouth ulcer pain.
- Avoid Irritants: Avoiding spicy, acidic, or rough-textured foods and beverages can prevent further irritation and promote the healing of mouth ulcers.
- Maintain Oral Hygiene: Gentle brushing with a soft-bristled toothbrush and regular flossing can help keep the mouth clean and prevent infection.
- Stress Management: Practising stress-reduction techniques, such as relaxation exercises, meditation, or yoga, may help reduce the frequency and severity of mouth ulcers in individuals prone to stress-related outbreaks.
In some cases, recurrent or persistent mouth ulcers may require medical evaluation to rule out underlying health conditions or nutritional deficiencies that may be contributing to their development. A dentist or healthcare professional may recommend additional treatment options, such as prescription-strength oral medications or dietary supplements, to manage chronic or severe mouth ulcers effectively.
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