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What is an Abscess
Q: My friend has an abscess and she's worried. What is an abscess? What damage can it do if left undetected or untreated?
A: An abscess is basically an inflammatory and infectious process. There are several different types of abscesses. Two of the most common abscesses that occur in the oral cavity are related to either the tooth (due to necrosis of the pulpal tissue) or the gum tissue (due to periodontal disease.) In either case, it is important to have the abscess examined and treated as soon as it is detected by contacting a dental professional.
Treatment for a periodontal abscess may include anesthetizing the area and cleaning the tooth. The area may be irrigated with warm salt water and/or hydrogen peroxide. An antibiotic may also be prescribed. If enough bone loss has occurred, the tooth may need to be extracted.
A periapical abscess resulting from pulpal necrosis should be treated by root canal therapy or extraction. If untreated, several consequences could occur. These consequences depend upon the types of microorganisms involved and upon the patient's defense mechanisms. The inflammation, which begins in the pulp tissue, eventually extends into surrounding tissues. If it is a chronic condition, a cyst may be present; if it is an acute condition, it is an abscess.
Periapical abscesses typically cause severe pain because of the pressure and the various infectious processes that are occurring. Swelling and/or drainage may be present. The area of the abscess is generally sensitive to touch, and the affected tooth is usually sensitive to tapping.
Treatment for an abscess involves either root canal therapy or extraction of the tooth. Drainage of the abscess should be established either through an opening in the tooth or through the soft tissue in the area. Antibiotics to fight the offending organisms should also be prescribed and taken as directed. It is important to seek treatment for the abscess because delay in treatment can occasionally lead to life-threatening consequences.
If left untreated, the abscess can spread to the soft tissues to form an abscess or cellulitis there, or it can spread through the jaw to cause osteomyelitis or periostitis. Cellulitis is potentially life-threatening! This is because it is an acute inflammatory process that spreads quickly through the soft tissue, rather than being localized. If the lower jaw becomes inflamed, the airway can become blocked. In another potentially life-threatening scenario, bacteria from the abscess can move into the blood stream. This spreads bacteria throughout the body. I strongly advise your friend see a dentist to have the area evaluated and treated as soon as possible.