If you ever had a wisdom tooth abscess, you can attest that it is one of the most painful experiences. The pain can be severe and should be addressed as soon as possible to evade further complexities. That said, this article seeks to give a comprehensive overview of what wisdom tooth abscess entails, how it occurs, its signs, and perhaps how to address the condition.
What is a wisdom tooth abscess?
A dental abscess, also known as a dentoalveolar abscess, occurs when pus collects inside a tooth. Arguably, any tooth is susceptible to dental abscesses, but wisdom teeth are more prone due to their tendency to collect and retain bacteria. Wisdom teeth are located at the extremes of the jaws, making it challenging to maintain their hygiene. Ostensibly, they emerge in individuals aged 17 to 25.
Types and causes of wisdom tooth abscess
There are two main types of tooth abscess, based on where it occurs. These are periodontal and periapical tooth abscesses.
Periapical tooth abscess
When an abscess forms at the tip of the tooth root, in the pulp area, it is a periapical abscess. The most common cause of this type of abscess is a bacterial infection in the pulp. The bacteria inhabit the soft tissue, and as it grows, pus is produced.
Bacteria may enter the tooth as a result of one or more of these factors;
- An open tooth cavity from tooth decay
- An injury to the tooth
- Exposure following a dental work
- Extensive periodontal disease
- A combination of the above factors
Children with inadequate dental hygiene are more susceptible to this condition than adults of similar hygiene standards. Poor dental hygiene leads to cavities that allow the bacteria in. If the nerves die, as a result, it accelerates the whole process of abscess formation.
Periodontal tooth abscess
A tooth abscess can also occur in the gums adjacent to a tooth root. This is the periodontal type. This abscess is distinguishable as a small red ball. A bacterial infection mainly causes the abscess in the gum, which causes the gum tissue to pull away from the tooth. An ’empty space’ is formed as a result, which in turn can harbor bacteria.
Bacterial, dead white blood cells and dead tissue make up pus in the red protruding ball. Excessive buildup of tartar and prolonged presence of food particles accelerate the formation of this type of abscess.
There are other minor types of tooth abscesses. These are rare but could occur to anyone. They are:
- Gingival abscesses
- Pericoronal abscess, and,
- Combined periodontic-endodontic abscess
A gingival abscess is localized to the gum tissue only. It does not spread to the teeth or the periodontal membrane. Pericoronal abscess, on the other hand, involves soft tissues adjacent to the tooth crown. If the two major abscess types occur at the same time, it is described as a combined periodontic-endodontic abscess.
Signs and symptoms of a wisdom tooth abscess
If you know how an abscess feels and looks, then you have a prime chance of distinguishing it from a related dental problem. Below are the signs to watch for if you suspect you could have a wisdom tooth abscess;
Swelling is a general sign of illness, but if it occurs in the gums, face, jaw area, and lymph nodes, it could mean an infection in your teeth. Swelling around the apex of the tooth root is a sign of a periapical abscess, but if it is by the gingival margin, it is likely a periodontal tooth abscess.
- Difficulty in swallowing
Due to swelling in the neck region and the lymph nodes, swallowing can become strenuous. Breathing also becomes difficult as the swelling may hamper the opening and closing of the pharynx.
Unlike any other toothache, a dental abscess causes throbbing pain, localized to the point of infection. The pain may also spread to the ear and neck region.
A distinguishing characteristic of the two types of abscesses is when the pain begins. If it begins before swelling, there’s a high chance that it is a periapical abscess. If you notice the swelling at first, it is likely a periodontal abscess.
- Bad taste and breath
As you’d expect, Pus tastes nasty. A bad taste in the mouth could indicate an underlying abscess, whose pus has begun leaking into the buccal cavity (mouth).
Pus also has a bad odor, responsible for bad breath in people having dental abscesses.
- Red gums
Shiny red gums are a warning sign of a dental condition, especially if bleeding follows, one of which might be a wisdom tooth abscess.
Teeth sensitivity is a sign of poor dental health. When your previously healthy teeth become suddenly sensitive to both hot and cold substances, it might be a precursor to a periapical abscess. The affected tooth or teeth may also become sensitive to pressure when chewing.
- Headache and fever
Headache alone can point to many health problems. However, when it occurs together with the above signs, it can be a pointer to an abscess or some other dental condition. Fever occurs alongside such a headache.
Other signs and symptoms are:
- Loss of appetite
- Malaise, and
Wisdom tooth abscess risk factors
Certain factors initiate the development of dental abscesses. These factors can also speed up the progress of an existing condition or increase the chances of developing a dental problem. These are:
- Poor oral hygiene
Failing to brush and floss one’s teeth adequately causes the buildup of plaque on the teeth. The bacteria harbored in the plaque release acids, which in turn cause tooth decay. This creates an entry point to the core of the tooth, where periapical abscess begins.
- Sugary food
Consuming sugary and starchy food promotes the growth of bacterial in the mouth and teeth. These bacteria become both, directly and indirectly, responsible for the resultant abscesses.
- Dry mouth
Dry mouth promotes bacterial growth in the teeth and can increase the risk of tooth decay. Dryness is mostly a result of aging or intake of certain medications.
An injury to the tooth, either accidentally or from a surgical operation, can provide an entry point to bacteria, ruining the tooth.
- Weak immune system
Certain people with compromised immune systems are at a higher risk of dental conditions. Diabetes, chemotherapy, and other immune-degrading conditions expose the body to bacteria attacks. It primarily affects teeth due to frequent exposure to food that feeds the bacteria.
- Impacted tooth
An impacted wisdom tooth is that which does not emerge from the gum properly. Impacted teeth may, in turn, lead to complications such as;
• Damage to adjacent teeth due to pushing. The increased pressure also increases the chances of infection around that area.
• Cysts if the sac from which they form on the jawbone is filled with fluid.
• Difficulty in cleaning it, increasing the chances of infection.
Consequences of wisdom tooth abscess
If left untreated, a tooth abscess can lead to a series of problems. Basically, a tooth abscess that is not treated timely can sometimes spread to soft tissues nearby, after gapping through the bone. The resultant conditions include cellulitis and osteomyelitis. At this point, the next dental complication mostly depends on the tooth location and nearby structures.
The internal abscess can start draining through a boil on the gum. The boil raptures to release pus. One way of telling if this has happened is if there is a sudden relief of pain, a foul smell in the mouth, and a bad taste. External drainage is not a concern as the internal drainage.
If the abscess drains internally, it could lead to serious problems in nearby tissues by spreading infection. Among the serious problems associated with internal drainage are Ludwig’s angina and septicemia. In the former case, cellulitis spreads under the tongue and jaws. An example of an extreme case is the cavernous sinus thrombosis, which happens when infection penetrates the bone tissue into the blood vessels of the head’s sinuses.
All of these conditions necessitate immediate medical care and, at times, can be life-threatening. It is thus always advisable to seek immediate medical attention instead of self-diagnosing and relying on painkillers.
Treatment for wisdom teeth abscess
Prompt treatment of a dental abscess is recommended whenever you have unmistakable signs and symptoms. If this is not possible, taking some pain relievers can help control the pain as you wait to see a dentist. Effective painkillers to consider taking can be paracetamol, aspirin, and ibuprofen. The essential oil from cloves is also good with pains associated with a dental abscess.
There is a safe limit for each of these OTC drugs; for example, children below 16 years should not take aspirin. Two painkillers can also be taken together if one doesn’t seem to work. In addition to pain relievers, practicing the following can go a long way in easing the ordeal;
- Avoid flossing the area where the abscess is.
- Using a soft-bristle toothbrush.
- If the abscess is on one side, avoid using that side to chew food.
- Don’t consume very hot or cold foods, as this may rouse the pain and sensitivity.
Treatment of an abscess usually involves draining the pus and removing the infection source. The path followed depends on the severity of the infection. The three most probable options are:
1. Root canal treatment
2. Extraction, and
Root Canal Treatment (RCT)
Root canal treatment involves removing the abscess through the tooth and then filling the tooth and sealing it. This method is used in most cases where the pulp of the tooth is infected. During the process, the cavity left is carefully cleaned, disinfected, and the canals inside appropriately shaped. It is then sealed.
Extraction of the affected tooth is recommended whenever RTI is impossible, primarily due to extensive tooth damage. This method alters the dental formula, but the tooth can be replaced with an artificial one.
The incision is done mostly on abscesses that appear on the side of the gum. A small cut is made on the abscess, and the pus drained. This operation is mainly to alleviate pain emanating from pressure built up in the abscess. Further treatment is recommended.
All three procedures require the administration of local anesthesia. If the surgical operation is more extensive, general anesthesia is used.
After the procedures, antibiotics are prescribed to kill off any new infection of the tooth.
Prevention of tooth abscess
Although impossible to guarantee that an abscess won’t form, there are a couple of things you can do to reduce the chances of ending up with one. Do these things and your trips to the dentist might never be due to pain;
1. Use dental floss at least once daily. You can also use an interdental brush to exfoliate plaque under the gum line.
2. Use a fluoride-based toothpaste to brush the teeth, at least twice daily. Brush for no less than two minutes for every instance.
3. Change your toothbrush for a new one every three months or when the bristles seem to bend outwards. Using a toothbrush for too long exposes you to bacteria.
4. To increase the paste’s effectiveness after brushing, do not rinse your mouth with water immediately after brushing. Instead, spit the excess paste.
5. A fluoride mouth rinse provides an extra protective layer after brushing. If need be, use once daily.
6. Reduce the frequency and amount of sugary food intake. The most dangerous period to take a sugary drink or a sweet is immediately after a meal or before going to bed.
7. A regular check-up by a qualified dentist can go a long way in identifying and thwarting even other dental problems.
8. Eat a healthy and balanced diet. Diet rich in calcium is good for your teeth. Milk is an excellent source of this calcium. A healthy diet is also key to a strong immune system.
Dental abscesses are very common with the wisdom teeth. As we have seen, these teeth have a high probability of being impacted and have a higher chance of bacteria growing nearby. Even though the practice is uncommon, some people prefer their wisdom teeth removed before problems set in.
This guide provides you with all you need to know about tooth abscesses and how to relieve pain. Following the given guidelines on prevention will also reduce your chances of a future dental condition or slow down one that is already present.