What is a dental abscess?

 

A dental abscess is a collection of pus that forms around the tissues of the tooth and can spread into the surrounding tissues.

It is most often caused by a bacterial infection of the pulp of the tooth secondary to decay or trauma to the tooth.

They are not always immediately painful or symptomatic, such that you may not be aware of it’s presence for some time until it’s too late.

There are two main types of dental abscess, a periapical abscess (related to the main body of the tooth) and a periodontal abscess (related to the gum tissue of the tooth).

What are the signs and symptoms of a dental abscess?

  1. Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
  2. Sensitivity to hot and cold temperatures from the tooth
  3. Sensitivity/pain on chewing or biting
  4. Fever/raised temperature
  5. Swelling in your face or cheek or lips/chin, or the area under the eye. You may also develop a swelling in the gum besides the tooth, and this may develop a pimple like opening.
  6. Tender, painful and swollen lymph nodes under your jaw or in your neck
  7. Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief if the abscess ruptures

    dental abscess and 24 hour dentist at emergency dentist
    A dental abscess causing a localised gum swelling.
  8. The offending tooth may feel loose and raised, such that you touch that tooth prior to any others when closing your mouth.

A dental abscess is something that you cannot ignore. Although symptoms may reduce, especially if any swelling bursts, they will not go away, may become more aggressive and may leave you open to dangerous complications.

You need to see a 24 hour dentist immediately. Left untreated the fluid may spread to other structures and cause difficulties breathing. There is also a risk of septicemia.

Signs of complications

  1. Difficulty in opening the mouth
  2. Very high fever
  3. Severe difficulty in breathing and or swallowing
  4. A raised tongue, such that your mouth feels smaller than usual
  5. In rare circumstances dental abscesses can spread to other organs including the brain
dental abscess
A swollen face can be distressing and debilitating. It is usually caused by a dental abscess

Treatment

The main principle is to manage the source of the abscess

  1. Opening the tooth to allow a portal for pus to drain (initiating root canal treatment)
  2. Removal of the offending to tooth
  3. Incisional drainage of any well-formed swelling. This is normally done inside the mouth, but in extreme cases may be required from the skin side.

    Drainage of dental abscess
    This procedure normally provides some immediate relief. Surface anaesthesia is used to numb the swelling, and a small incision is made to allow a path for drainage. a drain may be placed to help keep the incision open
  4. Prescription of antibiotics

Normally, a combination of some of these treatments is performed, the aim is to allow the abscess to resolve prior to definitive treatment.

Tips

  1. Do not ignore
  2. Do not hope that it will go away. You need to see an emergency dentist.
  3. Do not attempt to lance or drain the swelling yourself
  4. Do not attempt to remove the tooth yourself (yes, we’ve seen people try)
  5. Using your partner’s antibiotics that your girlfriend’s GP gave to her 2 years ago for a UTI will not help. You are just delaying appropriate treatment.
  6. If you are feeling very unwell, experiencing difficulties in breathing and running a very high temperature, then a trip to A/E may be in your best interest.

    emergency treatment of dental abscess
    Extra-oral drainage and drain placement

How to find a 24 hour dentist or an emergency dentist

emergency dentists in London, 24 hour dentist North London

 

Any unforeseen dental mishap can be classed as a dental emergency. You don’t have to be in pain-any situation that stresses you, has the likelihood of being to your detriment if left untreated, causes pain or affects not just form but function, can necessitate a visit to an emergency dentist.

There are some instances where it may be more sensible to go to hospital in the first instance. These include if you have suffered a trauma or medical condition that has caused other more serious injuries or loss of consciousness. It’s important to prioritize your health. In addition, if you are experiencing symptoms of a spreading infection like a very high fever or severe difficulties breathing, then a trip to hospital may be more appropriate in the first instance.

If you are fortunate enough not to require immediate medical help, then finding an emergency dentist can be fairly straight forward. Emergency dentist Essex and Emergency Dentist Hertfordshire can help with 24 hour emergency dental appointments for toothache, root canal treatments and teeth extractions, as well as swollen faces and dental abscess.

  1. Initially, call your own dentist and follow the advice on their answerphone. They may give details of emergency dentist arrangements in-house.

    Phone number for emergency dentists
    How to contact an emergency dentist
  2. If you are here in the UK, and you are a NHS patient, then call NHS emergency dental services. They may be able to help with dental emergencies, but do note that this service is often oversubscribed, they have limited slots available and they have a strict criteria for what constitutes a dental emergency. You will be assessed on the phone by a triage professional, and you may be offered an emergency slot at a clinic, but this may not be local to you and may not be on the same day.NHS England do provide a dental emergency helpline
  3. Private services are available and generally can deal with most dental emergencies. They will be more likely to provide you with an immediate appointment, and the costs although aren’t necessarily expensive, and should not be prohibitive. In order to minimise your cost and treatment, you are well within your rights to ask for all options available and the costs involved, and to do only what addresses your immediate concerns. Private services can be recommended by your own dentist’s emergency arrangement information, recommendation from a friend or by searching on the internet. A good guide if you want to find an emergency dentists near me. To find an emergency dentist in London, Yell is a very good source, and is also useful for finding an emergency dentist North London.

    Emergency dentists can be found online.
    Searching online for an emergency dentists needn’t be stressful
  4. Dental insurance providers. If you have dental insurance, try calling your provider, as some may be able to recommend clinics that they know of or are preferred providers. This also gives you an opportunity to ask exactly what kind of treatment, and how much you are covered for. Denplan, Dencover and Boots all have dental emergency insurance cover. Please retain all receipts and ask the dentist to provide an itemized invoice confirming that the visit was for an emergency.

What is root canal treatment?

root canal emergency dentist, pain after root canal treatment, 24 hour dentist of root infection

Root canal treatment or endodontic treatment is a procedure performed to help restore a tooth when there has been disease, infection or inflammation of the root canal system of the tooth.

The tooth consists of a crown (the part of the tooth that you can see in the mouth) and the roots (the part that sits beneath the gum line and secures your tooth to your jaw bone). The roots contain a blood and nerve supply, and if the health of this system is compromised by bacteria (through decay or trauma) or irritation (cracks and fillings) then the blood and nerve supply can start a process of disease or necrosis. This typically is very painful, and only two definitive treatment options are normally available-extraction or root canal treatment.

Root canal treatment involves:

  1. Thorough assessment. This includes a clinical examination, x-rays and vitality testing (with ice pellets or using an electrical current).
  2. If a root canal treatment is indicated, the dentist will give you local anaesthetic to numb the tooth.
  3. A rubber dam is placed to help isolate the tooth from the rest of your mouth. This ensures that natural bacteria from your mouth cannot enter the tooth and that chemicals and tools used during the procedure are unable to enter your mouth or airways.
  4. Using a drill, the dentist will remove decayed tooth or fillings and gain access to the pulp of the tooth.
  5. Once the pulp has been accessed, he will locate the openings of the root canals, there may be between 1 and 4 normally.
  6. Using a special meter called an apex locator, he will determine the length of the roots, normally we like to ensure that your root filling finishes within 0.5-2mm of the tip of the root visible on the x-ray.
  7. The root canals are normally very narrow, and specialised tools are now used to widen and bore out the root canals to the previously determined length. This is termed mechanical preparation, and the aim is to form a well tapered shape and to debride the walls of the root canals to help eliminate bacteria.
  8. Whilst the dentist is performing the mechanical preparation, he will also be using chemical solutions to help further disinfect the root canals and prevent clogging of the canals with debris.
  9. At this point the dentist may place an antiseptic dressing for a few weeks prior to completion of your treatment to help further disinfect the tooth, or he may proceed to completing the root canal treatment.
  10. The final stage is placement of a permanent filling in the root canals. The dentist normally takes an x-ray to confirm the length and size of gutta percha points prior to sealing them with a special endodontic sealer paste. He can seal the gutta percha in a few ways, but heated sealing is a popular method where the gutta percha is heated to allow it become more flowable and thus flow and fill any nooks and crannies. A final x-ray is taken to assess the quality of the treatment.
  11. Once the root canal treatment has been completed you will still require a permanent filling or crown to seal the root canal treatment from the mouth and to give the tooth some more strength.

    Healed-Tooth-Following-Root-Canal-300x273
    emergency dentist root canal treatment