Abscess is an acute tissue inflammation characterized by limited size and the formation of a cavity filled with pus. Contributing factors to the development of an abscess are the general health of the patient, the type and virulence of microorganisms, anatomical and structural features in the areas where the abscess is localized. The most common microbial pathogens are streptococci and staphylococci. The infection can spread through the ducts of the diseased teeth, the naturally occurring passages in the bone or the gradual melting of the bone. It may also be transferred in the lymph or blood in the presence of purulent inflammation elsewhere in the body.
Abscesses that develop as a complication of dental disease – periodontitis, cysts, and untreated pulpitis – are called endodontic abscesses and the infection has entered through the root canal of the tooth.
Typical of this type of abscess is severe pain in the affected tooth or the surrounding tissues. Swelling occurs and in the initial stage it is hard, then softens (as it fills with pus). The mucosal lining is red and painful, it can thin and spontaneously break releasing purulent secretions.
Patients presents with malaise, fever, fatigue, difficulty eating, bad breath. Usually the tooth is dark with a large hole or after root canal treatment. The treatment is performed depending on the stage of the endodontic abscess, which may be the opening of the tooth, incision and drainage or even its removal.
Abscesses that develop as a complication of diseases of the supporting apparatus of the teeth (periodontium) – periodontitis, difficult breakthrough of wisdom teeth, osteomyelitis – are called periodontal abscesses. In this case the infection passes around the tooth root through the available bone pocket and inflamed gums.
They are characterized by the same symptoms as endodontic abscesses with the difference that the tooth, around which the abscess develops, is alive, it is not so painful and has a normal colour. Often the swelling in these abscesses is located between two teeth and under pressure or opening of the gum, it releases pus. In milder forms of periodontal abscesses cleaning and drainage of the periodontal pocket is enough to control the inflammatory process. In more advanced stages the treatment is conducted according to the symptoms experienced by patients and the severity of the periodontal abscess.