Abscess

A dental abscess is not an independent disease but a complication. The process of abscess formation looks as follows: chronic inflammation of a tooth leads to the formation of exudate, which in turn penetrates through the bone tissue into the periosteum area. Confined to the periosteum and mucosal tissues, the abscess appears as a reddened, swollen area.

It is important to note here that a swollen area of the mucosa is not necessarily an abscess. Depending on the composition of the exudate (fluid), there are two types: serous edema and abscess. Externally, both complications look similar, but in the case of an abscess, the exudate consists of pus (dead neutrophils), while in serous edema it consists of proteins dissolved in water (predominantly albumin).

It is believed that serous edema can be treated with anti-inflammatory medications. However, the chief surgeon of “Osadchyi Dental Clinic” – Ihor Oleksandrovych – says the following: “Even with serous edema, I make a relieving incision – I give the exudate an opportunity to drain and prevent its further transformation into pus.”

An abscess is a complication in 100% of cases, so its symptoms include five signs of inflammation:

• pain (especially pronounced upon palpation – pressing);
• redness (redness of the mucosa in the area of localization);
• swelling (caused by accumulation of pus);
• elevated body temperature;
• functional impairment.

Dental abscess: additional symptoms

• increased tooth sensitivity (reaction to cold or hot food);
• tooth mobility;
• pus discharge from tooth pockets;
• enlargement and tenderness of lymph nodes under the jaw or in the neck;
• general malaise (headache, fatigue, etc.);
• unpleasant taste and odor from the mouth.

The development of an abscess can be triggered by a number of causes:

Inflammatory causes:

• Gingivitis (inflammation of the oral mucosa tissues).
• Periodontitis (inflammation of the bone and mucosal tissues surrounding the tooth).
• Purulent periodontitis (inflammation and purulent processes in the alveolar ridge surrounding the tooth root).
• Osteomyelitis (bone inflammation).

Infectious causes:

• Bacterial infection that occurs when bacteria penetrate inside the tooth through carious cavities or damaged tissues.
• Viral infection (for example: herpes simplex virus).

Traumatic causes:

• A blow, injury, or tooth fracture that disrupts the integrity of the dental crown, root, or bone, creating conditions for infection development.
• Trauma caused by surgical procedures (abscess after tooth extraction).

Note that the risk of abscess development also increases with systemic diseases such as diabetes mellitus: the disease increases the risk of infection and slows healing processes due to vascular pathology. In addition, poor hygiene can be a factor contributing to abscess formation, as it promotes the accumulation of bacteria and the development of carious processes.

Three methods are used to diagnose an abscess:

• clinical examination (examination of the oral cavity and palpation);
• X-ray (a dental abscess may require an image to assess the condition of bone tissue and root canals, as well as the severity of infection);
• CT scan (may be ordered to obtain a more detailed picture of tooth anatomy and surrounding tissues).

It should be noted that at the diagnostic stage, it is important to understand the cause – the underlying disease that led to abscess formation. The logic is as follows: the abscess is a consequence that must be eliminated, but it is also important to address the cause to prevent recurrence of abscesses and other pathological conditions.

Therefore, abscess treatment can be conditionally divided into two medical procedures: incision of the abscess (its elimination) and treatment of the underlying disease.

Abscess removal: stages

Ignoring an abscess is quite difficult, yet some patients manage to do so. This behavioral strategy is not only wrong but also extremely life-threatening.

If a dental abscess is not incised in time, the following complications may develop:

• fistula formation;
• tooth loss;
• cosmetic problems (facial abscess);
• jaw osteomyelitis (inflammatory process in bone tissue);
• sinusitis (paranasal sinus infection);
• phlegmon (diffuse purulent inflammation);
• sepsis (generalized blood infection).

Warning! Osteomyelitis, sinusitis, phlegmon, and sepsis – all of these conditions are potentially fatal. Untimely or improper treatment can lead to the patient’s death. Therefore, ignoring dental abscesses and provoking the development of complications is extremely dangerous; immediate medical attention should be sought.

The cost of abscess removal surgery depends on the degree of complexity, individual clinical presentation, and the size of the abscess. The price of abscess incision in Kyiv averages 3–5 thousand hryvnias.