A dental abscess, also called a phlegmon, is one of the most frequent dental problems And, at the same time, one of the most dangerous if not treated in time.The causes of this oral discomfort are varied, but they are usually caused by cavities, trauma, or gum disease. Often, behind the intense pain and swelling lies a serious underlying condition bacterial infection which requires the immediate intervention of a specialist.Correctly determining the origin of toothache is fundamental to its treatment.
A dental abscess, also called a phlegmon, is one of the most frequent dental problems And, at the same time, one of the most dangerous if not treated in time.The causes of this oral discomfort are varied, but they are usually caused by cavities, trauma, or gum disease.Often, behind the intense pain and swelling lies a serious underlying condition bacterial infection which requires the immediate intervention of a specialist.Correctly determining the origin of toothache is fundamental to its treatment.
1) What is a dental abscess or phlegmon?
1A) What is a dental abscess:
And dental abscess It is an accumulation of put (a mixture of bacteria, dead cells, and white blood cells) that forms inside oral tissues in response to a bacterial infection. This infection causes inflammation of the surrounding tissues.
1B) What is a phlegmon?
The term phlegmon It is often used interchangeably with dental abscess, although technically phlegmon describes the diffuse inflammation and the swelling of the soft tissues of the face or neck that results from the spread of that infection. In other words, an abscess is the collection of pus, and a phlegmon is the external manifestation of the infection that caused it.
2) Types of dental abscesses
The classification of the abscess is based on its location within the dental structure and surrounding tissues:
2A) Absceso periapical (o dental):
It is the most common type. It occurs at the tip of the tooth root (apex). It occurs when bacteria invade the dental pulp (the “nerve”) through a deep cavity, crack, or fracture. The infection travels down the root canal to the root tip, where it accumulates in the alveolar bone.
2B) Periodontal (or gum) abscess:
This abscess forms in the gums or in the bone around the root, but outside the tooth It is associated with the periodontal disease (periodontitis). It forms when a deep periodontal pocket (space between the tooth and the gum) becomes infected due to the accumulation of tartar and bacteria, blocking natural drainage.
3) Causes of dental phlegmon or abscess:
These are the most frequent causes of a dental abscess or phlegmon:
3A) Caries dental:
It is the most frequent cause. If dental cavities are left untreated, it progresses through the enamel and dentin until it reaches the dental pulp, causing pulpitis (inflammation of the pulp) and, finally, the necrosis (death) of the nerve, which facilitates bacterial proliferation and the formation of the abscess at the root apex.
3B) Periodontal disease:
Gingivitis and periodontitis at advanced stages destroy the tissues that support the tooth, forming pockets that become reservoirs of bacteria, which can lead to a periodontal abscess.
3C) Dental trauma:
A blow or a fracture can open an entry point for bacteria, or damage the blood vessels that nourish the pulp, leading to pulp necrosis even without visible decay.
3D) Previous dental treatments:
In rare cases, an infection can develop after a failed root canal treatment (when not all canals have been completely cleaned) or an incomplete extraction.
Any of these problems can cause bacteria to penetrate the tissues of the tooth, bone, and gums. When Pus from an infection accumulates in the area around the root of a tooth within the bone, forming what is known as an abscess or phlegmon. If the abscess is not treated, it can cause a serious infection in the bone, teeth and surrounding tissues, or a fistula can form where the pus eventually drains to the outside through the gum.
4) Risk factors for dental abscess or phlegmon:
4A) Poor oral hygiene:
Irregular brushing and lack of flossing are the main promoters of tooth decay and gum disease.
4B) High sugar diet:
Frequent consumption of sugars and carbohydrates contributes to the formation of cavities.
4C) Dry mouth or xerostomia:
Dry mouth and lack of saliva It hinders the neutralization of acids and the cleaning of food particles, increasing the risk of cavities.
5) Symptoms of a dental abscess or phlegmon:
These are the symptoms that usually accompany a dental abscess:
5A) Throbbing and intense toothache:
It is the key symptom. The pain is constant, sharp, and throbbing, and often radiates to the jaw, ear, or neck.
5B) Tooth sensitivity:
Extreme pain or discomfort when consuming hot or cold foods or drinks.
5C) Facial swelling and/or redness of the gums:
Inflammation may be localized to the gum next to the affected tooth or extend to the cheek (phlegmon).
5D) Fistula:
Sometimes, the abscess drains pus through a small channel in the gum, which may temporarily relieve the pain, but it does not mean that the infection has disappeared.
5E) Bad taste in the mouth and/or halitosis:
This occurs when the pus begins to drain.
5F) Difficulty chewing or swallowing (dysphagia):
A sign that the infection is spreading through the mouth or into the throat.
5G) General symptoms of a dental abscess or phlegmon:
Fever, general malaise, and swollen lymph nodes in the neck or jaw.
Any of these symptoms may indicate the presence of a dental abscess. Detect it early and go to the dentist as soon as possible. It can help control its progression and, thereby, minimize the pain and tissue destruction that a dental abscess can cause in patients.
6) Risks and complications if a dental abscess is not treated
A dental abscess or phlegmon It should never be ignored. Unlike other health problems that may resolve on their own, an abscess infection will not go away without professional treatment and can lead to serious complications:
6A) Osteomyelitis:
Spread of infection to the jawbone.
6B) Facial cellulite:
Severe infection of the soft tissues of the face and neck that can endanger the airways.
6C) Ludwig’s Angina:
A severe form of cellulitis that affects the floor of the mouth, with a risk of throat obstruction.
6D) Sepsis:
The bacterial infection spreads through the bloodstream to distant organs (systemic infection), which is a life-threatening complication and requires urgent hospital admission.
7) Treatments for dental abscess or phlegmon:
A dental abscess has different treatments depending on the severity of the infection.
The treatment of a dental abscess has two main objectives: eliminate the infection and save the tooth whenever possible.
These are some of the methods a dentist may consider:
7A) Phase 1: Infection control (emergency)
7Aa) Abscess drainage:
The dentist makes a small incision in the abscess to allow the pus to drain. This relieves pressure and pain immediately.
7Ab) Antibiotic prescription:
Broad-spectrum antibiotics (such as amoxicillin) are prescribed to fight the bacteria, especially if the infection has spread or the patient has systemic symptoms (fever, severe swelling, etc.).
7Ac) Pain relief:
Analgesics and anti-inflammatories (ibuprofen or paracetamol) are indicated to manage pain and inflammation.
7B) Phase 2: Treatment to eliminate the cause
Once the infection is under control, it is vital to treat the underlying cause of the abscess:
7Ba) Endodontics (root canal treatment):
If the abscess is periapical (caused by caries), a endodontics to remove the infected pulp, disinfect the root canals and seal them, allowing the tooth to be preserved.
7Bb) Periodontal treatment:
If the abscesshas been caused by agum disease, it is cleaned the space between the tooth and the gum and root planing is performed to remove tartar and infected tissue, or, if necessary a curettage treatment or gum surgery.
7Bc) Filling or reconstruction:
If the origin of the abscess is a fractured tooth, then the following procedure will be performed a filling or reconstruction, provided the tooth can be saved.
7Bd) Apicoectomy:
If root canal treatment has already been performed and the infection persists at the apex, a microsurgery called apicoectomy to remove the root tip and seal it.
7Be) Tooth extraction:
If the tooth is too damaged (vertical fracture or severe bone destruction), tooth extraction It is the only viable option to eliminate the infection. In these cases, replacement with a dental implant or bridge can be planned.
8) Home remedies to relieve a Dental abscess or phlegmon:
As we mentioned, it’s essential to see your dentist as soon as you notice any of the symptoms mentioned above. However, there are several home remedies that can help relieve the most acute symptoms:
- Keep the affected area as sanitized as possible.
- Rinses with warm salt water: Dissolve half a teaspoon of salt in a glass of warm water and rinse your mouth. This helps cleanse the area and can encourage surface drainage, temporarily relieving pain.
- Rinses with antiseptics: to eliminate as many bacteria as possible.
- Over-the-counter pain relievers: Use paracetamol or ibuprofen always following the dosage and instructions in the package leaflet.
- If the area has a fistula and is draining pus, try massage it to drain the pus from the interior.
- Cold compresses: Applying a cold compress to the affected cheek for 20 minutes can help reduce swelling.
Warning: Never self-medicate with antibiotics without a dentist’s prescription. Improper use can not only mask infection but also contribute to global bacterial resistance.
9) Prevention is the Best Treatment
A dental abscess is almost always preventable. Follow a strict hygiene protocol And reviews are the best defense:
- Brush your teeth a minimum of twice a day with fluoridated toothpaste.
- Use dental floss or interproximal brushes daily.
- Maintain a balanced diet and reduce your sugar intake.
- Get regular dental checkups and professional cleanings (every 6-12 months), since early detection of tooth decay or periodontal disease is key to preventing progression to an abscess.
A dental abscess is a common problem with various causes, but treatment is generally simple. In any case, following certain guidelines is advisable. Good oral hygiene practices and routine dental examinations will significantly reduce the risk of developing abscesses.
If you suspect you have a dental abscess or are experiencing severe toothache, contact Clínica Pardiñas as soon as possible. Prompt diagnosis and treatment are crucial for your dental and overall health.
