Abscessed Tooth - New York, NY

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Abscesses Start With A Dental Infection​

Dental infections are commonly caused by bacteria that invade dental pulp and spread to surrounding tissues. If dental infections aren’t treated and continue to spread, a pus-filled abscess can form. A tooth abscess can affect different parts of a tooth, as well as gum tissue and bone. Pus in a dental abscess is made of dead tissue, white blood cells and bacteria. Typically, the onset of a dental abscess is slow and may take several months to produce obvious symptoms. But when an acute periapical abscess (one that forms in the tissues surrounding the apex of the root of a tooth) develops, it’s common to experience a more rapid onset of well-localized pain.

Typically, the onset of a dental abscess is slow and may take several months to produce obvious symptoms.

Intermittent episodes of severe pain are a warning sign that something is wrong. The prognosis for uncomplicated dental infections is good, but dental infections that spread to deeper neck structures have a worse prognosis and significant mortality rate. If you have signs of an abscessed tooth in New York, NY, call Advanced Endodontics of New York right away for immediate treatment.
Woman with abscessed tooth having pain while eating

Symptoms of an Abscessed Tooth

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Why do Abscesses Occur?

Any situation that creates an opening for bacteria to infiltrate the tooth or surrounding tissues can lead to infection and an abscess. Severe tooth decay causes a breakdown in the protective enamel of teeth, allowing bacteria to spread to the pulp chamber. If you have broken, chipped or cracked teeth, bacteria can seep into any opening in a tooth and spread to the pulp. For example, microcracks from grinding your teeth can increase the risk of infection. Trauma to a tooth can injure the inner pulp without a visible crack. Last, serious gum disease (periodontitis) causes the gums to pull away from your teeth, leaving deep pockets where bacteria can grow.
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Dental Abscess Risk Factors

Types of Dental Abscesses

Periodontal and gingival

A periodontal abscess causes localized accumulation of pus within the gingival wall of a periodontal pocket. A periodontal abscess looks like a small red ball pushing out of the swollen gum tissue. This type of abscess, which can occur during gum disease treatment or as a result of untreated periodontal disease, is more common in patients with previous periodontal pockets. Abscesses unrelated to gum disease are caused by the impaction of foreign objects (e.g., a piece of dental floss) or abnormalities of your root anatomy.

Periapical

Periapical abscesses are the most frequent infectious lesions of the alveolar bone (tooth socket). A periapical abscess can affect the area in and around the root apex (end), the periodontal membrane of a tooth and the adjacent alveolar bone. They’re usually caused by bacteria that spread to the inside of the tooth to the pulp through a fracture or cavity. The pulp is the soft, innermost part of your tooth that contains nerves and blood vessels. Although this type of abscess is more common in children, it can occur at any age, especially in people with poor oral hygiene habits.

Pericoronitis

Pericoronitis is inflammation of soft tissues surrounding a partially erupted tooth that leads to infection. This rare type of abscess most frequently impacts lower third molars (wisdom teeth) that haven’t fully erupted. As such, vulnerability to this condition is substantial in people aged 16-30, with the greatest incidence in individuals aged 21-25. A partially erupted wisdom tooth can leave a flap of gum tissue that collects food particles and other debris, resulting in an ideal breeding ground for bacteria.
dental patient with tooth pain

Why Should I See an Endodontist for an Abscessed Tooth?

Although a dentist can help diagnose an abscess, endodontists specialize in treating infected teeth and pulp, and they have advanced training and technology to ensure accurate diagnosis and treatment. At Advanced Endodontics of New York, our endodontists have extensive expertise in treating abscessed teeth in New York, NY. Prompt intervention for a dental abscess is essential and our practice is equipped to deal with endodontic emergencies.

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How We Diagnose a Tooth Abscess

While most patients present with characteristic symptoms, we’ll visually inspect your tooth, then tap on it to see how you react. Teeth with an abscess are normally sensitive to pressure or touch. We’ll also take digital X-rays and a CBCT scan to pinpoint the site of infection and confirm a diagnosis. Imaging studies play an essential role in recognizing the source of infection and the extent of the spread of the disease, and they can also detect any complications.

Abscessed Tooth Treatment

Management of dental abscesses includes incision and drainage, root canal therapy, apicoectomy and tooth extraction. In some patients, antibiotics may be prescribed.

During an incision and drainage, the area around the abscess is numbed with local anesthesia. Then your gums are carefully incised and we drill into your tooth using specialized tools. Once the abscess is accessed, the infected matter is removed and the pus is drained. Next, the area is irrigated with a sterile saline solution to remove any residual bacteria or debris. After we’re certain all the infected matter and pus have been removed, we close the incision with a few sutures and/or fill the infected tooth. In some cases, a small rubber drain is placed in the abscess site to drain any pus that the body may continue to produce. The drain is typically removed within three days, after which we apply sutures or fill the impacted tooth.

During a root canal, the infected tooth roots are accessed through the crown of your tooth, then the canal is thoroughly cleaned, shaped, filled and sealed. A restorative crown is required to protect the weakened tooth and fully restore its function.

An apicoectomy involves making an incision in the gum tissue to expose the bone and surrounding inflamed tissue. Then the damaged tissue is removed along with the end of the apex. A root-end filling is placed to prevent reinfection of the root, and the gum tissue is sutured. The bone naturally heals around the root over a period of months, thereby restoring full function to the tooth.

While our goal is to always perform the most conservative method to treat a dental abscess, a tooth that is severely damaged may require extraction. If the abscess is not treated in a timely manner, this increases the risk of losing the tooth.
If the infection is limited to the abscessed area, antibiotics aren’t required. If the infection has spread to nearby teeth, the jaw or other areas, we’ll prescribe antibiotics to prevent further spread, as well as serious repercussions to your general health. We also recommend antibiotics in patients with weakened immune systems.

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