A tooth abscess is a pocket of pus that's caused by a bacterial infection. The abscess can occur at different regions of the tooth for different reasons. A periapical (per-e-AP-ih-kul) abscess occurs at the tip of the root, whereas a periodontal (per-e-o-DON-tul) abscess occurs in the gums at the side of a tooth root. The information here refers specifically to periapical abscesses.
A periapical tooth abscess usually occurs as a result of an untreated dental cavity, an injury or prior dental work.
Dentists will treat a tooth abscess by draining it and getting rid of the infection. They may be able to save your tooth with a root canal treatment, but in some cases the tooth may need to be pulled. Leaving a tooth abscess untreated can lead to serious, even life-threatening, complications.
Signs and symptoms of a tooth abscess include:
Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
Sensitivity to hot and cold temperatures
Sensitivity to the pressure of chewing or biting
Swelling in your face or cheek
Tender, swollen lymph nodes under your jaw or in your neck
Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief, if the abscess ruptures
Difficulty breathing or swallowing
When to see a doctor
See your dentist promptly if you have any signs or symptoms of a tooth abscess.
If you have a fever and swelling in your face and you can't reach your dentist, go to an emergency room. Also go to the emergency room if you have trouble breathing or swallowing. These symptoms may indicate that the infection has spread deeper into your jaw and surrounding tissue or even to other areas of your body.
A periapical tooth abscess occurs when bacteria invade the dental pulp — the innermost part of the tooth that contains blood vessels, nerves and connective tissue.
Bacteria enter through either a dental cavity or a chip or crack in the tooth and spread all the way down to the root. The bacterial infection can cause swelling and inflammation at the tip of the root.
These factors may increase your risk of a tooth abscess:
Poor dental hygiene. Not taking proper care of your teeth and gums — such as not brushing your teeth twice a day and not flossing — can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications.
A diet high in sugar. Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.
Dry mouth. Having a dry mouth can increase your risk of tooth decay. Dry mouth is often due to the side effect of certain medications or aging issues.
A tooth abscess won't go away without treatment. If the abscess ruptures, the pain may decrease significantly — but you still need dental treatment. If the abscess doesn't drain, the infection may spread to your jaw and to other areas of your head and neck. You might even develop sepsis — a life-threatening infection that spreads throughout your body.
If you have a weakened immune system and you leave a tooth abscess untreated, your risk of a spreading infection increases even more.
Avoiding tooth decay is essential to preventing a tooth abscess. Take good care of your teeth to avoid tooth decay:
Use fluoridated drinking water.
Brush your teeth at least twice a day with a fluoride toothpaste.
Use dental floss or an interdental cleaner to clean between your teeth on a daily basis.
Replace your toothbrush every three or four months, or whenever the bristles are frayed.
Eat healthy food, limiting sugary items and between-meal snacks.
Visit your dentist for regular checkups and professional cleanings.
Consider using an antiseptic or a fluoride mouth rinse to add an extra layer of protection against tooth decay
What Can You Do About Sensitive Teeth?
If you pass on hot or cold drinks because you know they’ll make your teeth hurt, it may be time to talk to your dentist about the possibility that you have sensitive teeth.
Sometimes other things can aggravate them, too, like sweet and sour foods or even cold air.
To be able to treat these tooth twinges, it helps to know what might be behind them. Once you’ve nailed down the cause, you can find a solution.
Take Care of Your Tooth Enamel
That’s a hard, protective layer that helps your teeth deal with everything you put them through. When it’s gone, nerve endings that cause pain are exposed.
If you have sensitive teeth, it’s possible some of your enamel has worn away.
To prevent or put the brakes on that damage:
Don’t brush too hard. Do you clean your teeth with a heavy hand? You might be taking off more than just plaque. Side-to-side brushing right at the gum line can make your enamel go away faster. You should use a soft-bristled brush and work at a 45-degree angle to your gum to keep enamel clean and strong.
Avoid acidic foods and drinks. Soda, sticky candy, high-sugar carbs -- all of these treats attack enamel. Instead, snack on:
Fiber-rich fruits and vegetables
These will moisten your mouth and help fight acid and bacteria that can eat away at your teeth. Saliva is one way your mouth deals with them.
You can also drink green or black tea or chew sugarless gum. If you do eat something acidic, don’t rush to brush. Wait an hour or so to strengthen before you scrub.
Unclench your teeth. Over time, teeth grinding wears away your enamel. Sometimes, addressing your stress can stop the problem. If that doesn’t work, your dentist can fit you for a splint or a mouth guard.
If the problem is severe, you may need dental work to change your teeth’s position, or a muscle relaxant.
Take a break from bleaching. The quest for pearly whites may cause your pain. Thankfully, sensitivity from bleaching is usually temporary. Talk to your dentist about how the treatment might be affecting you, and whether you should continue it.
Get to the Root of the Problem
Sometimes, tooth sensitivity can be a sign of other issues, like:
Naturally shrinking gums. If you’re over 40, it could be that your gums are showing signs of wear and tear by pulling away from your teeth and uncovering your tooth roots. Those roots don’t have enamel to protect them, so they’re much more sensitive than the rest of your tooth.
Tell your dentist if your gums look like they’re receding. It can be a sign of other problems, like gum disease. Serious cases may need a gum graft. That moves tissue from somewhere else to cover the bare area.
Gum disease. Plaque and tartar buildup on your teeth can make your gums pull back. Sometimes, disease can set in. It can destroy the bony support of your tooth. Don’t smoke. It can lead to gum disease. To treat it, your dentist may do a deep clean of your teeth, called planing or scaling, that scrapes tartar and plaque below the gum line. You could also need medication or surgery to fix the problem.
A cracked tooth or filling: When you break a tooth, the crack can go all the way down to your root. You’ll notice pain when your tooth is cold. How your dentist fixes the crack depends on how deep it goes. If it’s a small crack that ends before your gums start, your dentist can fill it. If it’s below your gum line, your tooth will have to be pulled.
Once you’ve found the problem, there are things your dentist can use to help ease your pain, including:
Toothpaste for sensitive teeth
Fillings that cover exposed roots
Desensitizing pastes (not used with a toothbrush) you can get from your dentist
Mouthguard to protect teeth if you grind
If your case is serious, your dentist might suggest a root canal.
It’s also important not to shy away from dental care because of tooth pain. Ignoring your teeth can make things worse. Brush and floss twice a day to help keep your smile bright and pain-free. And see your dentist for a checkup twice a year.
Repairing a Chipped or Broken Tooth
You're crunching ice or a piece of hard candy when you notice something hard in your mouth that doesn't melt or dissolve. You get a sick feeling as you realize what it is -- a piece of broken tooth.
Although the enamel that covers your teeth is the hardest, most mineralized tissue in the body, its strength has limits. Falling, receiving a blow to the face, or biting down on something hard -- particularly if a tooth already has some decay -- can cause a tooth to chip or break. If you discover you have broken or chipped a tooth, don't panic. There are many things your dentist can do to fix it.
How to Care for a Chipped or Broken Tooth
If your tooth is broken, chipped, or fractured, see your dentist as soon as possible. Otherwise, your tooth could be damaged further or become infected, possibly causing you to end up losing the tooth.
In the meantime, try the following self-care measures:
If the tooth is painful, take acetaminophen or another over-the-counter pain reliever. Rinse your mouth with salt water.
If the break has caused a sharp or jagged edge, cover it with a piece of wax paraffin or sugarless chewing gum to keep it from cutting your tongue or the inside of your lip or cheek.
If you must eat, eat soft foods and avoid biting down on the broken tooth.
Treatment for a broken or chipped tooth will depend on how severely it is damaged. If only a small piece of enamel broke off, the repair can usually be done simply in one office visit. A badly damaged or broken tooth may require a more lengthy and costly procedure. Here are some ways your dentist may repair your broken or chipped tooth.
Dental Filling or Bonding
If you have chipped off just a small piece of tooth enamel, your dentist may repair the damage with a filling. If the repair is to a front tooth or can be seen when you smile, your dentist will likely use a procedure called bonding, which uses a tooth-colored composite resin.
Bonding is a simple procedure that typically does not require numbing the tooth. To bond a tooth, the dentist first etches its surface with a liquid or gel to roughen it and make the bonding material adhere to it. Next, the dentist applies an adhesive material to the tooth followed by a tooth colored resin. After shaping the bonding material to look like a natural tooth, the dentist uses an ultraviolet light to harden the material.
Dental Cap or Crown
If a large piece of tooth breaks off or the tooth has a lot of decay, the dentist may grind or file away part of the remaining tooth and cover it with a crown, or tooth-shaped cap, made to protect the tooth and improve its appearance. Permanent crowns can be made from metal, porcelain fused to metal, all resin, or all ceramic. Different types have different benefits. All-metal crowns are the strongest. Porcelain and resin crowns can be made to look nearly identical to the original tooth.
If the entire top of the tooth is broken off but the root is still intact, the dentist or an endodontist (a dentist who specializes in root canals) may perform root canal therapy and place a pin or a post in the canal, and then build up enough of a structure onto which a crown can be made. Later, the dentist can cement the crown over the pin or post-retained restoration.
Getting a crown usually takes two visits to the dentist’s office. During the first visit, your dentist may take X-rays to check the roots of the tooth and surrounding bone. If no further problems are detected, the dentist will numb the tooth and surrounding gum and then remove enough of the remaining tooth to make room for a crown. If a break or chip has left a large piece of the tooth missing, your dentist can use a filling material to build up the tooth to hold the crown. Next, your dentist will use a putty-like material to make an impression of the tooth receiving the crown as well as the opposing tooth (the one it will touch when you bite down). The impressions are sent to a lab where the crown is made. In the meantime, your dentist may place a temporary crown made of acrylic or thin metal.
During the second visit, typically two to three weeks later, your dentist will remove the temporary crown and check the fit of the permanent one before permanently cementing it in place.
Some dental offices, however, have special digital milling technology that enables them to make a crown the same day without taking a putty impression.
If a front tooth is broken or chipped, a dental veneer can make it look whole and healthy again. A dental veneer is a thin shell of tooth-colored porcelain or resin composite material that covers the whole front of the tooth (much like a false nail covers a fingernail) with a thicker section to replace the broken part of the tooth.
To prepare your tooth, your dentist will remove from about 0.3 to 1.2 millimeters of enamel from its surface. Next the dentist will make an impression of the tooth to be sent to a dental laboratory, which will make the veneer. When the veneer is ready, usually a week or two later, you'll need to go back to the dentist to have it placed. To place the veneer, your dentist will first etch the surface of the tooth with a liquid to roughen it. The dentist then applies a special cement to the veneer and places the veneer on the prepared tooth. Once the veneer is in position, your dentist will use a special light to activate chemicals in the cement to make it harden quickly.
Root Canal Therapy
If a tooth chip or break is large enough to expose the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria from the mouth can enter and infect the pulp. If your tooth hurts, changes color, or is sensitive to heat, the pulp is probably damaged or diseased. Pulp tissue can die and if it's not removed, the tooth can become infected and need to be extracted. Root canal therapy involves removing the dead pulp, cleaning the root canal, and then sealing it.
Root canal therapy may be performed by general dentists or specialists called endodontists. Most root canal therapies are no more painful than having a cavity filled. In most cases, the remaining tooth must be covered with a crown to protect the now-weakened tooth.
The enamel on your pearly whites tends to wear out with age and prolonged usage; which is why it is important to take special care of your teeth.
Some of the basic rules of keeping your teeth clean are to brush them at least twice a week and eat foods that help keep them white and strong. While most of us vouch for commercial toothpastes, there are some who turn to 'gharelu nuskhe' or home remedies to maintain oral hygiene.
One of the age-old home remedies used was that of mustard oil and salt. A mixture of these two ingredients made a thorough cleanser for teeth.
Apart from just yellowing teeth, tooth decay, bleeding and swollen gums have also become a part of the oral health problems. Some of the common reasons for teeth related issues include-
High intake of sugary and processed foods
Poor oral hygiene and improper teeth cleaning
Irregular teeth cleaning and dental check-ups
Excess intake of tobacco in any form
Consumption of hard water
While these are just a few reasons, there can be more that are attributed to poor oral health.
Mustard oil and salt is an age-old home remedy that is used to clean your gums and remove the plaque on your teeth. Salt acts as a mild abrasive that helps remove strain and brighten teeth.
Moreover, it contains a natural source of fluoride, which is a bonus for your teeth and gums. On the other hand, mustard oil helps strengthen your gums and makes it easier to remove the plaque.
Plaque is generally formed due to bacteria that is surrounded by fatty membranes. Swishing mustard oil can help loosen the fat soluble bacteria and further avoid gum bleeding.