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Dental abscess; Other names: Dentoalveolar abscess, Periapical abscess, tooth abscess, root abscess: A decayed, broken down tooth, which has undergone pulpal necrosis. A periapical abscess (i.e. around the apex of the tooth root) has then formed and pus is draining into the mouth via an intraoral sinus . Specialty: Dentistry
Green arrows indicate tooth decay. Blue arrows indicate abscess at root of tooth. The infection at the root of the tooth can travel through bone and infect surrounding soft tissue. Mouth infections are usually diagnosed on history and physical exam in the dental office or at a clinic visit with an otolaryngologist. [1]
Periapical periodontitis of some form is a very common condition. The prevalence of periapical periodontitis is generally reported to vary according to age group, e.g. 33% in those aged 20–30, 40% in 30- to 40-year-olds, 48% in 40- to 50-year-olds, 57% in 50- to 60-year-olds and 62% in those over the age of 60. [13]
The tooth may be mobile, and the lesion may contribute to destruction of the periodontal ligament and alveolar bone. [4] The pain is deep and throbbing. The oral mucosa covering an early periodontal abscess appears erythematous (red), swollen and painful to touch. [3] The surface may be shiny due to stretching of the mucosa over the abscess.
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An abscess is a localized collection of pus which forms during an acute infection. The important difference between a periapical abscess and abscesses of the periodontium are that the latter do not arise from pulp necrosis. [12] Abscesses of the periodontium are categorized as gingival abscess, periodontal abscess and pericoronal abscess.
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The bacteria gains access to the periapical region of the tooth through deeper infection of the pulp, traveling through the roots. The resulting pulpal necrosis causes proliferation of epithelial rests of Malassez which release toxins at the apex of the tooth. The body's inflammatory response will attack the source of the toxins, leading to ...