Dental abscess is an acute inflammatory disease of the oral cavity, which is characterized by a focal accumulation of pus in the tissues. With dental abscess there is a limited compaction and swelling of the mucous membrane, painful when touched, which is accompanied by a deterioration in general well-being and an increase in body temperature. This disease is diagnosed by a dentist during an examination based on an assessment of the condition of the tissues. Treatment of dental abscess includes surgical operation – opening of the abscess, as well as drug anti-inflammatory therapy.
ICD 10
K12.2 Phlegmon and abscess of the mouth area
General information
Dental abscess is a local purulent inflammation of the tissues of the gum, tongue, palate or cheek. This disease is among the most common problems of surgical dentistry and manifests itself regardless of the age and gender of the patient. Most often, dental abscess occurs as a result of complicated dental pathology, but its development is also possible due to a violation of the integrity of the mucous membrane or with general infectious diseases.
In the absence of timely and proper therapy, dental abscess can flow into a chronic form, as well as cause severe complications such as phlegmon and sepsis. Therefore, it is strictly forbidden to self-medicate with dental abscess. In order to prevent the consequences, it is necessary to urgently contact a specialist at the first symptoms of the disease.
Causes of dental abscess
Most often, dental abscess occurs as a complication of dental pathologies, for example, periodontitis or advanced periodontal disease. These diseases are characterized by the destruction of dentoalveolar joints and the formation of so-called periodontal pockets, in which there is an intensive multiplication of pathogenic microorganisms that cause the inflammatory process.
Dental abscess can form as a result of infection entering the wound with a violation of the integrity of the mucous membrane, for example, with a syringe needle during anesthesia or in the case of mechanical injury. The cause that provokes the development of pathology can be boils in the face, streptococcal and staphylococcal sore throats. It has been noted that abscesses of the oral cavity often occur against the background of influenza or other common infectious diseases that weaken the immune system.
In most cases, dental abscess is caused by an infection involving more than 3-5 microorganisms. The most frequent etiological agents are staphylococci, streptococci and gram-negative anaerobic flora (Eikenella corrodens, Porphyromonas gingivalis, Enterobacteriaceae spp., etc.).
Classification
Depending on the localization , there are several types of oral abscess:
- Gum abscess appears next to a certain tooth. This is the most common type of abscess. In the absence of proper treatment, it can flow into a diffuse inflammation or into a chronic form, which is characterized by periodic exacerbations, the expiration of pus from the formed fistula, a bad smell from the oral cavity and intoxication of the body.
- Abscess of the bottom of the oral cavity is located under the tongue, causing severe pain during conversation and eating. With spontaneous autopsy, the leakage of pus can cause secondary foci of inflammation in the pharynx and neck.
- Abscess of the palate most often occurs due to periodontitis of the teeth of the upper jaw. It threatens the transition of infection to the neighboring tissues of the palate and peritonsillar region, as well as the development of osteomyelitis of the palatine plate.
- Abscess of the cheek, depending on the depth of the lesion, can be localized both inside – on the side of the mucous membrane, and exit to the outer surface of the cheek. An abscess of this localization is extremely dangerous due to the possible spread to nearby facial tissues.
- Abscess of the tongue is characterized by swelling of the tongue, difficulty eating, talking and even breathing. This type of abscess is the most dangerous, with the development of the first symptoms, urgent hospitalization is necessary.
Dental abscess symptoms
The formation of dental abscess, as a rule, occurs quite quickly. At first, painful sensations may appear that resemble the symptoms of periodontitis – the pain is localized in the area of a particular tooth and increases with biting. Soon after, a painful and dense to the touch swelling occurs at the site of the development of the pathological process. Externally, it is a rounded formation on the gum, which in some cases can reach the size of a walnut.
The abscess of the tongue develops rapidly – rapidly increasing pain appears in the thickness of the organ, it quickly increases in volume; the patient experiences difficulties with the processes of chewing and swallowing, and in severe cases suffocation occurs. When the inflammation is localized under the mucous membrane of the soft tissues of the oral cavity, as well as closer to the surface of the skin (face or submandibular area), redness and swelling can be observed at the site of infection.
Any abscess of the oral cavity, as a rule, occurs against the background of deterioration of general well-being, an increase in body temperature, sleep disorders and appetite. The progression of pathology can lead to a breakthrough of the abscess. The release of pus brings significant relief to the patient: pain decreases, the tumor subsides, the temperature decreases, general well-being improves, but this should not be a reason to calm down due to the possible development of complications.
Complications
The inflammatory process can continue, flow into a chronic form and spread to nearby tissues. Dental abscess threatens with many serious consequences, for example, the loss of one or more teeth, the development of phlegmon and sepsis. In order to avoid complications, it is necessary to consult a doctor as soon as possible, who will prescribe the correct treatment.
Diagnostics
Dental abscess is diagnosed by a specialist based on a visual assessment of the condition of the mucous membrane during a dental examination. It is absolutely unacceptable to expect spontaneous opening of dental abscess or the independent use of antibacterial agents. To relieve symptoms before contacting a doctor, you can use painkillers and rinse the oral cavity with warm solutions of antiseptics.
Dental abscess treatment
Dental abscess is treated exclusively by surgical intervention. In order to eliminate the focus of infection and prevent the spread of the inflammatory process, the dentist performs the opening of the abscess, drainage and antiseptic treatment of the cavity. Suturing after such an operation is usually not required, since the size of the incision is small.
After the removal of pus, as a rule, the patient feels better, the pain subsides, the tumor subsides, the normal contours of the face are restored, but if the abscess of the oral cavity has managed to develop significantly, then the final recovery may be somewhat delayed.
In the postoperative period, antibiotics, antihistamines, immunostimulants and vitamin and mineral complexes are prescribed. In some cases, physiotherapy procedures are used for a speedy cure, for example, fluctuation or UHF therapy. Also, after the operation, it is recommended to avoid solid food and adhere to a full diet.
Prognosis and prevention
In general, the success of the treatment of oral abscesses depends on the timeliness of contacting a doctor and the general condition of the patient’s body. It is very important to start treatment measures as early as possible – in this case, the prognosis is usually favorable. If the surgical operation is performed on time and there are no complications, the abscess of the oral cavity is completely cured within 1-2 weeks.
To prevent dental abscess, it is necessary to observe hygiene rules, avoid injuries to the mucous membrane, and also, in the presence of periodontal diseases, treat them in a timely manner.