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).
If an abscess has a pimple-like swelling at the tip, rinsing with warm salt water will cause it to form a head, which will eventually release pus. Over-the-counter ointments may help relieve symptoms such as pain, and burning. Do not use over-the-counter steroid ointments since these may cause infections to spread.
Aloe vera gel, Belladonna 30x, and Silicea 6x applied directly to abscessed area, and mouthwashes made of dandelion or a combination of echinacea, myrrh, and licorice may provide temporary relief.
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.