It all begins when we ignore our oral health. When bacteria and food are not removed by brushing, tooth decay occurs. Caries begins to infect the outer layer of the tooth, the enamel, and if it is not diagnosed in time, it infects the deeper layer, the dentin. In this phase, denervation can be prevented, because with a filling, the caries can be cleaned and removed. In the next stage, the discomfort starts in the tooth and when the caries moves deeper towards the pulp, i.e. the nerve of the tooth, the pain starts.

At this stage, the caries bacteria enter the nerve and the roots of the tooth, infect them and now have the ‘luxury’ of reaching through the root canals to infect the bone as well. At this stage denervation is recommended for pain relief and a modern method of restoring the decayed tooth. Depending on the extent of the caries, a simple or complex seal, shaft or case can be placed. When pains are ignored or treated only with drugs and antibiotics without treatment to remove the decay, then the infection spreads, with or without pain.

It is important to realize that our body is not capable of neutralizing infections in the teeth and jawbone, regardless of whether we give it systemic antibiotics. It may be deceiving that the pain subsides, but the anaerobic bacteria are still unmolested in the mouth. Dental procedures such as denervation and rhizectomy are local treatments that target the infection directly. These are precision treatments, and only when they are done, the body can recover by taking advantage of the antibiotic.

What is an abscess?

An abscess is defined as the collection of pus at the tip of the tooth root and in the jawbone, which is caused by the action of pathogenic, pyogenic microorganisms, such as staphylococci and streptococci.

What are the types of abscesses?

Apical Abscess: This is a purulent, exudative collection in or around the root of a tooth. Symptoms include pain in the bone around the tooth, discomfort when chewing, swelling of the gums, and tenderness to palpation. The differentiation of the abscess goes through stages of maturation, with the final stage being accompanied by its drainage through a fistula.

Periodontal Abscess: Occurs in the tissues surrounding the tooth, mainly in the periodontal pocket, due to periodontal disease. Treatment includes extraction of the responsible cyst and oral hygiene by the patient.

Periostephanitis: It is a special form of periodontal abscess caused by the collection of pus, food residues and microbial plaque in the gum cover. Treatment includes removal of the wisdom tooth, excision of the cap and oral hygiene.

How is the abscess diagnosed?

The dentist uses a number of diagnostic tools and instruments to locate the responsible tooth or teeth. Correct diagnosis is a process that requires experience, time and patience, as it is a cornerstone for choosing the right treatment and pain relief.

How is the abscess treated?

Treatment varies depending on the agent that caused the abscess. In general, drainage of the abscess is required, either by a fissure, where the dentist makes a hole in the gum to remove the pus, and to apply endodontic treatment, or by an apicectomy, or by extraction of the tooth in case of terminal destruction. In modern dentistry, extraction is a last resort, and restoration is done with a dental implant or bridge.

Endodontic treatment requires adequate anesthesia, and the dentist removes bacteria and toxins from all roots and root canals with special tools and sterile drugs. It then cleans the walls and seals permanently.

It is important to note that antibiotics and painkillers-anti-inflammatories alone do not cure the abscess, but they reduce the symptoms temporarily. According to the World Health Organization, the overconsumption of antibiotics may lead to up to 10 million deaths by 2050. Their use is recommended in combination with treatment, otherwise the body is overworked without treating the cause of the pain. Timely visit to the dentist is important to avoid complications. Re-examination of healed abscesses after six months is also important to control healing and prevent recurrence.
What causes an abscess?

The bacterial infection causes inflammation and eventually death of the pulp tissues, extending through the root canals into the bone around the root of the tooth and gradually creating the apical abscess. Additionally, the abscess can be caused by cracks in the tooth, faulty fillings, faulty prosthetic restorations or other conditions.

The pus that forms consists of dead cells and microbes and is a product of the body’s “battle” against pathogenic microorganisms.
The abscess is caused by pathogenic microbes and their derivatives present in decayed teeth. The variety and strength of microbes, as well as the body’s ability to defend itself, determine the intensity and extent of inflammation.

What should I be careful not to get an abscess?

In this case we recommend:

Diligent oral hygiene:
– Apply intensive daily brushing of your teeth, at least twice a day, using fluoride toothpaste.
– Use dental floss to clean the interdental spaces once before going to bed.

Replacing a toothbrush:
– Replace your toothbrush every 3 months or when it wears out in order to maintain brushing effectiveness.

Healthy diet:
– Follow a healthy diet that includes limited consumption of sugary foods, as excessive sugar consumption can contribute to tooth decay.

Visit to the dentist:
– Schedule visits to the dentist every 6 months for a mouth checkup. The dentist will detect incipient cavities and tartar and suggest simple treatments such as filling and cleaning before they progress to the point where treatment for an abscess is required.