Oral abscess - symptoms and treatment

Symptoms of a tooth abscess

The inflammatory process in the tissues of the tooth and gums occurs in stages and is accompanied by different symptoms:

• At the beginning of development, discomfort appears, slight swelling, gum bleeding is possible when brushing teeth, and pain is sensitive when pressed.
• In later stages, swelling increases, and a reaction to hot and cold foods appears. There is prolonged pain and an unpleasant odor. In addition to local changes, the abscess is accompanied by enlarged lymph nodes in the neck, increased body temperature, and general malaise.

A bitter aftertaste is noticeable in the mouth, and a change in the shade of the tooth body is possible. It is important to remember: the symptoms of gum abscess can manifest themselves in different ways - everyone has their own pain sensitivity threshold and perceives signals subjectively. Therefore, you should not wait for acute conditions; a reasonable step is to visit a dental clinic at the first incomprehensible sensation.

Treatment of maxillary abscess

The main goal of treatment of perimandibular abscesses is the complete elimination of the infectious process and the subsequent restoration of body functions. The main activities aimed at achieving this goal include:

• following a diet with a predominance of purees and pureed soups;
• opening the abscess and draining the resulting cavity;
• antibacterial therapy;
• vitamin therapy;
• taking immunostimulants;
• detoxification therapy;
• taking analgesics;
• rinsing the mouth with solutions of furatsilin and soda.

With timely and professional treatment, the prognosis of the disease is almost always favorable. Full recovery of the patient occurs after 1.5 - 2 weeks from the date of the start of treatment in the department of dental surgery at Adent.

What complications can there be?

Even if the pain has dulled, the symptoms have become less pronounced, you should not postpone your visit to the dentist. This situation may be a signal indicating the death of the root and the further spread of infection to the organs of the head or neck.

The area cannot be heated. This approach will bring short-term relief, but will accelerate the formation of the fistula and stimulate the release of pus.

Possible serious complications: brain inflammation, pneumonia. There is a risk of sepsis, development of osteomyelitis, damage to the nasal sinuses or meninges.

Causes of dental inflammation

The main causes of tooth gum abscess and pulp infection:

• Advanced caries affecting the root apex. Suppuration develops against the background of periodontitis.
• Untreated gingivitis and periodontitis (gum disease). They often develop as post-traumatic complications: pathogenic microflora accumulates in periodontal pockets.
• Weakening of the immune system after illness (flu, sore throat, etc.).
• Iatrogenic factors - bacteria entered after the use of unsterile instruments during treatment, injections, or incorrect tooth extraction.

The development of the inflammatory process may be preceded by damage to the oral mucosa and the formation of boils.

Flux and abscess: causes, diagnosis, treatment methods

Flux and abscess: causes, diagnosis, treatment methods

In modern medicine, the term “flux” as such no longer exists. The once popular word has now been replaced by “odontogenic periostitis.” However, for many, the words “tooth flux” is a more understandable term and means severe pain, swelling and something serious that urgently needs to be addressed to a doctor, and rightly so.

There are different degrees of purulent inflammatory diseases of the maxillofacial area - periostitis (flux), abscess, phlegmon.

Most often they appear against the background of advanced caries.

The first stage of inflammation is periostitis (flux) of the jaw - this is an acute inflammation of the periosteum. The cause of flux is the activation of pathogenic flora: streptococci, staphylococci and other pathogenic, often putrefactive bacteria, which were in a dormant state, under certain factors begin to actively multiply and spread, triggering an acute reaction of the body aimed at eliminating the source of inflammation.

Periostitis occurs as a complication of acute or chronic, but aggravated periodontitis, which in turn appears as a result of advanced caries. Previously treated pulpitis may also be a prerequisite. Much less often, the inflammatory process can develop with difficulty in teething, injuries, as well as periodontal diseases in the presence of periodontal pockets.

Flux can also occur after tooth extraction, due to traumatic removal or incomplete extraction of roots. Sensitization and general factors play a certain role in the development of the disease: cold, overwork, stressful situations that reduce the body’s defense reactions.

Regardless of the cause, the clinical picture develops the same

Flux and its symptoms:

• constant toothache, aggravated by pressing or tapping on the tooth;
• redness and hyperemia of the gum mucosa in the area of ​​the causative tooth
• the formation of a significant tumor in the area of ​​the tooth, upper or lower jaw, depending on its location.
• severe pain that can only go away after taking a painkiller;
• limited mouth opening;
• signs of intoxication of the body in the form of a sharp rise in body temperature, headaches, general malaise and a feeling of chronic fatigue

Abscess – second stage of inflammation

An abscess is a purulent inflammation of tissues with their melting and the formation of a purulent cavity; functionally it is practically no different from periostitis; it forms within a day or two from the onset of the disease. The symptoms in this case are the same, but at the same time more intense. Pus, as with flux, is limited to the periosteum, but can penetrate deeper into the tissue.

Sometimes during the disease a fistulous tract may appear, through which pus will come out. An effect of imaginary well-being is created, because along with the outflow, the signs of inflammation subside. However, with this type of development, the disease becomes chronic; if the infection is not stopped, it can spread to neighboring tissues and cause a complication in the form of osteomyelitis (necrotizing inflammation of the bone).

If the abscess was not drained and the fistula never formed, purulent inflammation begins to spread to the surrounding tissues - phlegmon appears.

Phlegmon is a dangerous omission

Cellulitis is the third, most severe stage of purulent inflammation in the tissues around the tooth. In this case, the pus is not limited to the periosteum alone, but wanders freely through the tissues.

Further spread of the infectious-inflammatory process in the perimaxillary soft tissues usually occurs along the fiber of the interfascial and intermuscular spaces, the fiber surrounding the vessels, nerves, and salivary glands. In this case, tissue compaction occurs, often accompanied by the appearance of asymmetry of the face and neck in the form of swelling. The pain moves beyond the jaw and becomes less localized. Chewing function may be impaired due to pain and limited mouth opening. External breathing may be impaired, and signs of intoxication may increase.

Purulent lesions of the head and neck carry the risk of further spread of purulent infection into the facial muscles, cervical regions, and beyond them into the trachea and chest cavity, into the esophagus, into the heart, and can penetrate into the lymphatic system and brain tissue.

IMPORTANT! If phlegmon is not treated in time, it can be fatal!

Treatment of periostitis, abscess

The first and most important step in treating flux is visiting a doctor.

Treatment is complex: surgical - opening and draining the inflammation, and conservative drug therapy.

Stages of treatment:

• Examination, examination, including x-ray diagnostics, determination of indications for surgical treatment.
• Local anesthesia.
• An incision is made in the gums next to the gumboil so that the purulent contents come out, observing all the rules of asepsis and antiseptics.
• Installation of drainage for further outflow of pus - otherwise the exit from the periostitis site will close faster than it will be completely cleared.
• Removal of the affected tooth, if it is not possible to cure it, or removal of the root remaining in the hole, if we are talking about flux after removal.
• Prescription of antibiotics, anti-inflammatory, painkillers.
• Control inspection and removal of drainage.
• Recommendations for home oral care.

All procedures are performed on an outpatient basis under local anesthesia. After the examination has been carried out and the cause of inflammation has been established, an incision is first made in the area of ​​the flux to release the accumulated pus, after which a so-called drainage - a rubber strip - is inserted into the wound. Treatment of an abscess differs from the elimination of periostitis only in the duration of wearing the drainage.

Next, the indications for tooth extraction or preservation are determined. If the tooth that was the source of infection is destroyed and has no functional or aesthetic value, then it is removed simultaneously with the opening of the abscess. This will improve the emptying of the purulent focus and will contribute to a faster elimination of inflammatory phenomena.

Tooth extraction is sometimes postponed due to perceived technical difficulties or the unsatisfactory condition of the patient.

In other cases, the tooth is preserved: its cavity is opened, the root canal is freed from decay products, and then conservative treatment of chronic periodontitis is carried out. All this is determined by the doctor and depends on the specific situation in the oral cavity. Treatment does not end there, but continues at home with the help of prescribed antibacterial and anti-inflammatory drugs. A repeat examination is scheduled on the 2nd day after surgery, the degree of subsidence of inflammatory phenomena is determined and, depending on this, additional treatment is prescribed. During dressing, local wound treatment is carried out. Around day 3-4, the drainage is removed, but conservative treatment continues.

Treatment of phlegmon is carried out in a hospital setting.

What happens after treatment?

After opening the abscess, if no complications arise, the disease enters the subacute stage. In most cases, inflammatory phenomena quickly (after 2-3 days) subside. There is a subsidence of the local inflammatory process: tissue infiltration decreases, the amount of purulent discharge from the wound decreases. As the wound is cleansed, granulation tissue appears, scarring and epithelization occur. At the same time, the severity of the general reactions of the body weakens, and health improves.

Usually, discomfort persists for the first 2 days, although the body temperature gradually begins to decrease, and the pain is no longer so obvious. A sharp improvement in condition and appearance occurs on the third day. Infiltration—tissue compaction at the site of inflammation—can persist for quite a long time. Gradually the “bump” should resolve.

The drainage - a rubber strip - should remain in the wound for some time after the procedure. It prevents the incision from closing prematurely, leaving an open path for pus to escape. It is strictly forbidden to loosen, push out, or adjust the drainage in any way. If a strip falls out, consult a doctor immediately. You should also contact your doctor if you do not feel better 12 hours after opening the flux.

The prognosis of periostitis with timely radical intervention is predominantly positive. Isolated deaths are associated with late seeking of dental care.

Self-medication of flux can lead to further spread of purulent inflammation in the tissues and such serious complications as osteomyelitis of the jaw or phlegmon of the soft tissues of the face and neck.

Prohibited for inflammation:

• try to open the abscess yourself;
• apply warm compresses and dressings;
• independently prescribe antibiotics and other medications;
• take painkillers before visiting a doctor;
• drink aspirin (before and after opening).

Finally, I would like to say one thing: please do not be afraid to consult a doctor for help in a timely manner. The sooner treatment is started, the better the outcome. Take care of yourself!