Abscess Tooth Pain

Developing a tooth abscess is considered as one of the most serious and painful dental problems. Tooth abscess pain is usually very intense, and in most cases almost impossible to relieve until you get professional treatment from a dentist. Additionally to the extreme pain associated with dental abscesses, they can become a serious risk for the general health of the patient if not treated on time.

A dental abscess is formed by the accumulation of pus, dead tissue and other fluids as a result of a bacterial infection. It may develop either inside the pulp chamber (tooth abscess) or around the root tips (periapical abscess) or inside the gums (gum abscess).

Tooth abscess pain is the result of the pressure applied to tooth nerves or other tissues when an abscess is developed in such a constrained space. The increased pressure irritates the nerves of the mouth sending pain signals to the brain.

Tooth abscesses are caused by advanced tooth decay. When a dental cavity remains undetected or untreated, it progresses through the enamel into the inner softer layer of the tooth, the dentin. Finally the tooth decay reaches the pulp chamber in the center of the tooth and the bacteria infect the pulp tissues. The infection causes inflammation of the pulp and severe toothache, a condition referred as pulpitis.

The body’s immune system sends white blood cells to the infected area to fight the bacteria. The process leads to the accumulation of pus forming a tooth abscess, which consists of live and dead blood cells, bacteria, and liquefied dead tissue cells. The decomposition of dead cells causes the production of gases which further increase the pressure inside the dental tissues, and intensify the tooth abscess pain.

Soon, the infection leads to the death of the pulp tissues and nerves inside the tooth, which offers a temporary relief from tooth abscess pain. Unfortunately the lack of intense pain does not mean that the problem is solved. The infection will continue to spread through the root canals to the root tips and the periodontal tissues. A periapical abscess will form and the toothache will start again. The elimination of tooth abscess pain requires always the intervention of a dentist.

A gum abscess is formed inside the gingival tissues that surround the teeth, as result of severe periodontal disease. If the infection reaches around the root tips, a periapical abscess is formed and a tooth may get infected through the root canals.

An abscess is usually the cause of a severe throbbing pain. The tooth abscess pain is intense, constant and may last for hours, making it difficult to sleep. Swelling may further increase the discomfort. Bad breath, sour taste and pus drainage in the mouth are also common symptoms.

At the initial stages before the development of an abscess, the tooth infection causes inflammation of the pulp tissues making the tooth extremely sensitive especially to cold. When the infection has progressed the pulp tissues begin to die, and the tooth becomes more sensitive to hot instead of cold. The disintegration of the dead tissue is the start of the abscess formation. At this phase when the nerve endings die, it is usually a period that the pain subsides temporarily. Unfortunately, as soon as the abscess is formed, the patient starts to suffer from what is actually the abscess tooth pain.

Hot foods increase the tooth abscess pain because heat causes the expansion of gases trapped at the abscess area. (formed by the dead tissue disintegration). Biting and chewing may become so uncomfortable that the patient may prefer to avoid eating.

Abscess drainage: The best way for immediate tooth abscess pain relief is the drainage of the abscess. Sometimes in case of periapical or gum abscesses, a fistula – a channel from the sac of pus to the mouth – may form which allows the pus to drain into the mouth, reducing the pressure and providing instant pain relief. But in most tooth abscesses, the dentist has to either drill a hole from the tooth surface to the pulp chamber or to make an incision to the gums, in order to provide an exit way for the concentrated fluids. However pus drainage is only a temporary way to help reduce the pain and not a treatment.

Unfortunately a dentist is not always available when you may desperately seek some tooth abscess pain relief. In this case the following can help ease some of the discomfort:

• Pain medicines – Over the counter toothache medicines can provide tooth abscess pain relief until you visit your dentist for treatment. Anti-inflammatory toothache medications help to suppress both pain and swelling.
• Antibiotics – Your dentist may prescribe antibiotics for some days before starting the treatment, especially if there is significant swelling. Antibiotics do not provide direct pain relief but they can prevent the abscess tooth pain from worsening, by fighting the infection and inhibiting the further growth of bacteria.
• Ice packs – Placing an ice pack outside the cheek at the area of the infected tooth can offer some pain relief and reduce the inflammation.
• Saltwater rinse– Rinsing the mouth with warm saltwater can ease some of the pain and help clean the mouth. If there is pus in the mouth, mouth rinses are necessary to remove the pus and bacteria and help to clean the mouth.

Abscess tooth pain is an alert that there is a serious infection in your mouth. Ignoring this warning may prove threatening not only for your tooth but for your overall health. However, the severity of the pain rarely will allow someone to ignore it and not seek treatment.

How soon you will get treatment can be very important in determining if the tooth will be saved or not. There are only 2 options to be considered for the treatment of abscess tooth pain, depending on the severity and extent of the infection. The first one is a root canal treatment and the other is the tooth extraction.

Root canal treatment – Root canal therapy, also known as endodontic treatment, is the only way to save a severely infected abscessed tooth. The treatment includes the drainage of the abscess, the removal of the dead tissue from the pulp chamber and root canals, the elimination of the infection and finally the filling and restoration of the tooth. Although the treatment may need several appointments, the drainage of the pus which is the first step of the therapy can provide significant relief from the tooth abscess pain.

Tooth extraction – Dentists consider removing the tooth only as a last option. It is necessary only if the infection can not be eliminated, after a failed root canal, or when the tooth is so extensively damaged that it can not be restored.