periapical abscess symptoms causes and treatments

A periapical abscess is essentially a collection of pus that forms at the tip of the tooth’s root.

It is often the result of a dental infection- when bacteria invade your tooth pulp, usually through a crack or cavity- that has spread to the bone at the tooth’s root.

While it may sound scary, it is essential to remember that periapical abscesses are treatable and their management can prevent more severe complications.

A periapical abscess can develop major, potentially fatal problems if left untreated, spreading to other parts of your body.

You should get medical attention right away if you suspect you have an abscess.

What are the Causes of Periapical Abscess?

1Untreated Dental Infections  

The primary cause of periapical abscesses is untreated dental infections. These infections can result from cavities, cracked teeth or gum diseases.

When left untreated, they can lead to the accumulation of bacteria in the pulp chamber of the tooth, which can eventually cause an abscess to form. 

2. Poor Oral Hygiene

Neglecting your oral hygiene can contribute to the development of dental infections. Regular brushing, flossing and dental check-ups are necessary to prevent these issues.

3. Dental Trauma

Sometimes, a sudden blow or injury to a tooth can disrupt the protective enamel, allowing bacteria to infiltrate and lead to an abscess.

How Do you Know if You Have a Periapical Abscess?

Identifying these can be crucial for seeking prompt treatment.

Here are some common symptoms to watch for:

1. Severe Toothache

The most noticeable symptom is an excruciating toothache, often localized to a specific tooth. 

2. Swelling of the Face or Gums

The area around the affected tooth may become swollen and painful to touch.

3. Fever

An oral infection can cause your body to react with a fever as it tries to fight off the infection.

4. Bad Taste or Odour

Sometimes, the abscess can rupture, leading to a bad taste in your mouth and a foul odour.

5. Pus Drainage

In some cases, you may notice pus draining from the infected tooth.

Sensitivity to heat and cold- increased sensitivity to temperature changes is also a common sign.

Diagnosis for Periapical Tooth Abscess

To identify periapical tooth abscesses, dentists use radiographic (X-ray) imaging in addition to visual examinations.

Examination of Teeth

A dentist will check your gums and teeth. Additionally, they could lightly tap the impacted tooth to check if it responds to pressure.

Dental X-rays

An X-ray of your abscessed tooth will be taken by your dentist. These pictures can show them the extent of the infection's spread.

CT Scan of Teeth

If your dentist believes the infection may have progressed to your neck, they may occasionally ask for a CT (computed tomography) scan.

Your dentist can see your mouth in three dimensions thanks to a dental CT scan.

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Periapical Abscess Treatment Options 

The degree of infection spread determines the course of treatment for periapical abscesses.

Treatment Options include medications and treatments like:

  • Antibiotics.

  • Incision and drainage.

  • Root canal therapy.

  • Tooth extraction.

1. Antibiotics

Antibiotics are frequently prescribed by dentists to stop the spread of abscesses. Antibiotics won't prevent the infection from returning, which is crucial to realise. The tooth will still require treatment.

2. Incision and Drainage

A little incision (cut) will be made into the abscess by your dentist during this process. This permits infection (pus) to go away. A sterile saline solution will then be used to flush the region.

Your dentist could occasionally make a small incision and insert a rubber drain. This gives the residual infection time to dissipate over the next days. (While the drain is installed, you can have an odd taste in your mouth.)

3. Root Canal Treatment

To save your tooth, your dentist might suggest a root canal. A tiny hole is made in the apex of your tooth by an endodontist or dentist during this process.

They will drain the infection and remove the affected tooth pulp using microscopic devices.

The inside of your tooth will next be cleaned and disinfected, and a rubbery dental filling called gutta-percha will be inserted. By sealing your teeth, you lower your chance of getting an infection again.

For your tooth that has had a root canal treatment, you will frequently also require a dental crown.

4. Tooth Removal Procedure

An abscessed tooth may not always be salvaged. Your dentist might advise tooth extraction if the infection is extremely bad.

During this process, your tooth will be softly removed from its socket once the surrounding tissues have been properly released.

To lessen the possibility of bone loss in your jaw, they could potentially implant a dental bone graft.

Your dentist will discuss your possibilities for a new tooth with you before extracting it. Dental implants and bridges are common forms of treatment.

Prevention and Oral Health Practices for Periapical Abscess

The best way to deal with a periapical abscess is to prevent it from occurring in the first place.

Here are some prevention tips and good oral health practices to follow:

  1. Brush and Floss Regularly: Brush your teeth at least twice a day and floss every day to maintain a regular oral hygiene regimen.
  2. Regular Dental Check-ups: For early detection and treatment of dental disorders, schedule routine examinations and cleanings with your dentist.
  3. Dietary Choices: Limit sugary and acidic foods, as they can contribute to tooth decay. Opt for a balanced diet that promotes oral health.
  4. Protect Your Teeth: If you engage in contact sports or activities that carry a risk of dental injury, consider using a mouthguard to protect your teeth.
  5. Prompt Treatment: If you notice any dental pain or unusual symptoms, don't delay seeking professional dental care.


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What Is Periapical Abscess?

It is a dental condition where pus accumulates at the tip of the tooth’s root due to an untreated infection, causing pain, swelling, and discomfort.

Is Periapical Abscess Acute?

Yes, they can be acute as it often manifests with sudden and severe symptoms like intense toothache, facial swelling and fever.

Can Periapical Abscess Go Away on its Own?

No, it does not typically go away on its own. Professional dental treatment is usually required to address the infection and prevent complications.

What Does A Periapical Abscess Look Like?

It may appear as a swollen, painful bump near an infected tooth, often with redness, tenderness and sometimes pus drainage.

Is Periapical Abscess Normal?

No, it isn’t normal and indicates an underlying dental problem. It should be treated by a dentist to prevent further complications.

Do Periapical Abscess Hurt?

Yes, they can be extremely painful due to the pressure and inflammation caused by the infection. It often results in severe toothache.

Can You Pop A Periapical Abscess?

No, never attempt to pop a periapical abscess. This can worsen the infection, spread bacteria and lead to a more significant health issue.

How To Treat Periapical Abscess?

It may involve antibiotics, drainage, root canal therapy or even tooth extraction- depending on the severity. Consulting a dentist is crucial.

What is the Difference Between Periapical Abscess And Periodontal Abscess?

The key difference is the location of the abscess. A periapical abscess is at the tooth’s root tip, while a periodontal abscess occurs in the supporting gum and bone tissue around the tooth. Both require professional treatment.