[Tooth extraction] Dental abscesses: stop the infection without waiting

Tooth extraction

Often a painful bacterial infection, the dental abscess is characterized by swelling of the gums and is accompanied by a feverish state and difficulty in chewing. Untreated, it can lead to serious complications.

What is it ?

Dental abscess is a bacterial infection of which two types can be distinguished:

Periodontal abscess, which comes from the gum and most often concerns patients with tooth loosening. Involved also, the clinical evolution of wisdom teeth before or after extraction.

Apical abscess, which is systematically associated with chewing pains, is caused by the fracture of a tooth, deep caries or a tooth that has not been treated for a long time. The bacteria will then proliferate in the nerves of the tooth.

Symptoms of the dental abscess

The dental abscess is manifested by a swollen gum that becomes red, a feeling of heat, bleeding, all leading to chewing problems accompanied by fever and fatigue. Three or four days later, pus is formed in response to the infection. Not to be confused with a strictly inflammatory reaction caused for example by a food stuck between the teeth (septum syndrome) or post-operative edema after extraction of wisdom teeth, warns Dr. Baranes.

Check at the first symptoms and do not hesitate to go to the emergency room in case of high fever or if you have great difficulty feeding you.

Dental abscess: treatments

"You have to continue brushing your teeth in spite of the bleeding and the pain, take paracetamol and consult a dentist quickly," says the dentist, "and especially do not puncture or incise the abscess with a needle or a blade, and avoid taking anti-inflammatories like Voltarene or ibuprofen that will increase the spread of the infection by masking its evolution, acting only on the pain ". In children, the spread of infection is much faster. As soon as there is swelling of the cheek, it is necessary to go to the emergencies, advises the specialist.

Two types of treatments are possible, says Dr. Baranes:

- "A local treatment, essential, carried out by the dentist, which consists in carrying out the drainage of the infection: either by the opening of the tooth to reach the end of the roots, or by the extraction of the A prescription of antibiotics and analgesics is associated, "says Dr. Baranes.

-If the abscess comes from the gums, drainage or curettage helps to clean the infection. "If the abscess is externalized to the gum and a collection of pus has formed, we will open this pocket and drain the pus, this will reduce the pressure and relieve the patient."

Serious complications, sometimes fatal ...
Untreated, a dental abscess can lead to serious complications. In a more advanced stage, the swelling will be seen externally, ganglions can appear under the jaw: the infection then spreads to the level of the soft tissues like the cheek, the skin, the muscles. We talk about infectious cellulitis. The pus wends its way through the tissues and pierces an exit orifice (the fistula), which will end on the gum or sometimes on the outside, on the skin of the face (cheek, chin).

Among the complications of the dental abscess:

-A loss of the tooth can occur: the abscess can infect the bone that holds the tooth and destroy it (periodontitis). In 90% of advanced cases, the infected tooth will be removed.
- A unilateral infection of the sinuses: the roots of the upper molars are located near the sinuses. If the tooth abscess generates pus, the sinuses can then be filled with this pus, which will cause a pain in support on the cheekbones or when the head is projected forward, a purulent flow unilateral and a feeling of bad smell in the nose.
-Bacterial endocarditis: bacteria from the dental abscess reach the heart through the blood vessels. These bacteria reaching the heart can infect the valves and lead to sometimes fatal consequences.
-More than exceptional, the abscess of the brain: the infection could spread from the teeth to the brain through the veins. An infection of the brain can lead to a coma.
- In immunocompromised patients (unbalanced diabetes for example), cellulitis spreads from the cheek neck to the chest, then causes necrosis of all tissues with the consequence of sepsis. Despite the medical care, the vital prognosis is engaged.
-Ludwig's anguish: this serious, sometimes fatal infection affects the parts under the tongue and on the side. It may block the airways and cause death by suffocation. A tracheotomy must then be performed urgently.

According to Dr. Banares, to stop the infection and avoid serious complications, you should consult at the first symptoms, and go to the emergency if the fever exceeds 38 ° C and it becomes difficult to swallow and eat .

Prevention

Certain gestures can be adopted to prevent dental abscesses.

Adopt good oral hygiene: brush your teeth two to three times a day;
Make regular visits to the dentist for a descaling and a complete examination of the dentition;
Decrease or stop smoking;
Avoid acidic foods and drinks;
Avoid foods that are too sweet.