WHEN the inside of your mouth gets hurt or irritated, bacteria may enter and cause an infection. Sometimes you will see a painful swelling filled with pus (a thick, yellowish fluid). If the pus is unable to drain out, the area will get more swollen and painful — this is known as an abscess.

The abscess forms a barrier around the infection. This is one way that your body tries to keep a bacterial infection from spreading.

If the infection is not treated, it can damage the surrounding bone and teeth. A hollow tunnel sometimes forms through the bone and skin to allow pus to drain. This tunnel is called a fistula or “sinus tract”. You might see or feel this opening inside your mouth. It looks like a pimple. If you have pus draining through a fistula, you might notice a strange taste in your mouth.

The build-up of pressure causes the pain of an abscess. Draining the abscess through a fistula reduces the pressure. The pain will disappear, however, the infection still needs to be treated.

There are two types of abscesses and causes:

• A gum abscess, (also called a periodontal abscess), is usually caused by an infection in the space between the tooth and gum. The infection may occur after food gets trapped between the gum and tooth. In people with severe periodontal disease, bacteria can build up under the gum and in the bone.

• A tooth-related abscess, (also called a periapical abscess), occurs inside the tooth when bacteria invade the dental pulp — the innermost part of the tooth that contains blood vessels, nerves and connective tissue. This happens when the tooth’s nerve is dead or dying. This type of abscess shows up at the tip of the tooth’s root. Then it spreads to the surrounding bone.

Symptoms of dental abscess

The main symptom of a dental abscess is pain. This may be a throbbing pain, and is often intense. The pain usually starts suddenly, and becomes more intense over the subsequent hours or days. In some cases, the pain may radiate to the ear, jawbone and neck.

Signs and symptoms of a dental abscess include:

• Pain in the affected area when biting;

• Touching the affected area may be painful;

• Sensitivity to cold or hot food and liquids;

• A foul taste in the patient’s mouth;

• Fever;

• General malaise (the patient feels generally unwell);

• Trismus — the patient finds it harder to open his/her mouth;

• Dysphagia — swallowing difficulties;

• Insomnia.

These factors may increase your risk of a tooth abscess:

• Poor dental hygiene: Not taking proper care of your teeth and gums, such as not brushing your teeth twice a day and not flossing, can increase your risk of tooth decay, gum disease, tooth abscess, and other dental and mouth complications.

• A diet high in sugar: Frequently eating and drinking foods rich in sugar, such as sweets and sodas, can contribute to dental cavities and turn into a tooth abscess.

What you can do

Abscesses are always serious because the infection may spread to other parts of the body. Call your dentist for an appointment.

If you can see or feel a pimple-like swelling on your gum, rinse your mouth several times a day with a mild salt-water solution. Use 1/2 teaspoon of salt in eight ounces of water. This may help draw the pus out and relieve pressure. Even if the rinse seems to help, you still need to see your dentist as soon as possible.

What your dentist will do

Most gum abscesses will heal quickly after three things happen:

• The area is cleaned thoroughly.

• The trapped pus is allowed to escape.

• The infection is treated.

Incision: The abscess needs to be cut out (incised) and the pus, which contains bacteria, drained away. The patient will be given a local anaesthetic.

Treating a periapical abscess: Root canal treatment will be used to remove the abscess. A drill is used to bore a hole into the dead tooth so that the pus can be drained out.

Any damaged tissue will be removed from the pulp. A root filling is then inserted into the space to prevent subsequent infections.

Treating a periodontal abscess: The abscess will be drained and the periodontal pocket cleaned. The surfaces of the root of the tooth will then be smoothed out by scaling and smoothing (planning) below the gum line. This helps the tooth heal and prevents further infections from occurring.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710 or visit the website www.dentalplace4u.com