Diagnosis and Treatment of Periapical Tooth Abscess

Diagnosis of tooth abscess is not difficult and your dentist can easily diagnose it by examination, taping and with help of X-ray of the affected tooth. Once you visit your dentists with toothache (for periapical tooth abscess), your dentist will first examination (inspect the tooth properly) and next he will tap the affected tooth and other teeth close to the affected tooth.

Tap on your teeth: your dentist will tap on your teeth, where you are complaining of pain. He/she will also tap nearby teeth to check if they are all right. Your affected tooth is sensitive to touch and pressure. There will be sharp pain on the affected tooth on tapping with an instrument and no pain in the unaffected teeth nearby. Which can help distinguish the affected tooth/teeth.

X-ray: X-ray of the tooth can find out if there is any abscess in the tooth/teeth. X-ray can also find out if the infection has spread to nearby teeth or nearby areas. X-ray of the affected tooth can show the extent of the abscess and help in planning the treatment.

Treatment of periapical tooth abscess:

The aim of treatment if to eliminate the bacterial infection and prevent further infection of the affected tooth/teeth. This aim can be achieved by following:

  • Incision and drainage of the abscess: your dentist will make small cut in the abscess and drain the pus which is filled with bacteria and white blood cells. This is then washed with normal saline.
  • Perform root canal treatment: after draining the abscess of pus, your dentist will than perform root canal treatment (also known as RCT). RCT can help eliminate infection as well as save the tooth (from extraction) and prevent further infection. To perform root canal your will drill the affected tooth and remove the pulp and fill the gap with appropriate material and seal it. Which can help prevent further infection and also retain the actual functional capacity of the tooth.
  • Extract the tooth: Sometimes the tooth may be beyond the scope of root canal and may have to be extracted, to prevent complications of periapical tooth abscess.
  • Prescribe appropriate antibiotic: if your periapical tooth abscess is limited to the particular tooth only, you may not need any antibiotic therapy. However, if infection spreads to nearby areas such as nearby teeth or jaws, your dentist will prescribe appropriate antibiotics for elimination of the infection.

Majority of periapical tooth abscess usually need incision and drainage with root canal and some also need antibiotics. In some cases, if the affected tooth cannot be saved, it may have to be extracted to save nearby teeth and prevent tooth abscess in them.

How to prevent tooth abscess?

Maintenance of good dental hygiene is essential to prevent tooth abscess. Take good care of your teeth to avoid dental cavity, which is one of the most common cause of tooth abscess:

  • Use fluoridated drinking water but also avoid excess fluorine in water.
  • Brush your teeth at least twice a day or after every meal.
  • Use dental floss or an interdental cleaner to clean between your teeth daily.
  • Replace your toothbrush frequently (every three or four months, or whenever the bristles are frayed) and do not use tooth brush with soft or hard bristles, use medium hard bristles.
  • Eat healthy food, containing lots of fresh fruits and vegetables and limit sugary items and between-meal snacks.
  • Visit your dentist for regular checkups and professional cleanings, preferably every 6 months.
  • Use an antiseptic or a fluoride mouth rinse which can be an added extra layer of protection against tooth decay.

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