Abscess

An abscess is a swelling filled with pus. There are three types of dental abscesses that resemble each other; it is their point of origin that differentiates them. A gum or gingiva! abscess is the result of injury to or infection of the surface of the gum tissue. If an infection moves deep into gum pockets, drainage of pus is blocked and a periodontal abscess results. A periapical abscess refers to a tooth in which the pulp is infected, usually secondary to tooth decay (see figure on following page).

A gum abscess is the result of irritation caused by toothpicks or other objects, from food being forced into the gums, or by aggressive brushing. If the trauma causes a break in the gum surface, bacteria invade the area, causing a local infection. Initially, the area appears red, smooth, and shiny. As the infection progresses, the area becomes pointed and pus is released.

A periodontal abscess involves the deeper structures surrounding the tooth. This kind of abscess develops when the gum pocket becomes blocked by plaque, tartar, and/or food. Because these foreign substances are not removed daily, harmful bacteria proliferate, resulting in a series of reactions. In response to the presence of these substances, the body’s immune system sends particular cells to fight the foreign substances and the harmful bacteria contained in the plaque. Studies have shown that more than one type of harmful bacteria cause gum disease and the resulting abscess. Some types of bacteria found at various stages of gum disease, including abscesses, are Bacteroides, Actinobacillus, Actinomyces, Capnocytophaga, and Treponema. The resulting infections are caused by the reaction between the toxins of these bacteria and the immune cells present to destroy the bacteria.

A tooth-related or periapical abscess is usually a result of damage to the nerve of the tooth, and is present along with swelling, pain, reddening of the gums, and sensitivity to chewing and/or hot or cold. The tooth related to the abscess usually has a deep cavity or filling. Pus is caused by destruction of tissue by toxins and interruption of the blood supply. The center of the abscess absorbs fluid from surrounding tissue, causing the abscess to become larger. Fever, malaise (feeling tired, no energy), and swelling in the neck area may be present with the abscess. The infection may stay localized or spread. If an abscess is deep, a fistula (a tubelike passage from the abscess to the surface of the gums) forms where the fluids are released. However, if the fluids in the abscess are released into the surrounding tissues instead of being discharged on the surface, the infection spreads and is called cellulitis. Fever, chills, and lack of appetite increase as the infection worsens.

A condition called cementoma, in which excess bone forms around the root of a tooth or teeth, looks like an abscess during its beginning stage, but it is not. Cementoma, often caused by trauma, is usually seen on lower front teeth. No treatment is required.

An abscess may have a sudden appearance (acute) or it may have been present for a long period of time (chronic) without any signs or symptoms. In the acute stage, the gums around the abscess become enlarged, red, tender, and painful. The tooth may be loose and sensitive to chewing. Pressing on the area where the gums and teeth meet may release pus. A dull pain that throbs and radiates maybe present. Periodontal abscess may produce a feeling of sickness, fever, and swelling in the lymph glands in the neck. If the infection has been present for a long time (chronic), there may be no symptoms. Treating the acute abscess is more successful than treating the chronic, which has caused more extensive damage over time.

Conventional Treatment


It is important to determine which type of abscess is present so that the appropriate treatment may be rendered. In all three types of abscess, the pus must be drained. Antibiotics may be prescribed if systemic symptoms such as fever and swelling in the lymph glands are present. (Mouth infections often affect the lymph glands in the neck region.) Deep cleaning will be suggested for gum pocket (periodontal) abscesses. If too much bone has been lost and the tooth is too loose, it may have to be pulled. In the case of a periapical abscess, root canal therapy (see Endodontic Techniques, Root Canal Therapy, in Part Three) or tooth extraction is indicated.

Homepathic Treatment


When using tablets, dissolve them under your tongue. When using liquids, place the drops directly on your tongue. (Because of their alcohol base, liquids should not be used by children or recovering alcoholics.) Do not eat or drink for fifteen minutes prior to or after taking medication. (See Part One, Homeopathy, for further information.)

Hebal Treatment

Recommendations

• As diabetics are prone to the spread of infections, they should notify their dentist and physician at the first sign of an abscess.

• Avoid alcohol and sugar, but drink large amounts of water, grape juice, and grapefruit juice, and maintain a low-fat diet.

• Decrease iron intake. As reported in the American Journal of Nutrition in 1982, excessive iron supplementation can release toxins that hasten bacterial growth.
  

From The Complete Book of Dental Remedies by Flora Parsa Stay, DDS , ©1996. Published by Avery Publishing, New York. For personal use only; neither the digital nor printed copy may be copied or sold. Reproduced by permission.