Tooth Grinding Causing Root Inflammation and Gum Abscess: What to Do?

Suspected bruxism causing root inflammation and periodontal abscess?

Dear Dr.
Tseng,
I am currently studying in Europe.
Last month, I visited a dentist due to pain in my lower right molar and discomfort in my jaw muscles.
This tooth had previously been filled, but the decay was not deep.
The dentist diagnosed it as root inflammation caused by bruxism and recommended starting antibiotics and monitoring the situation.
If the root inflammation persisted, a root canal treatment would be necessary.
The dentist prescribed a week’s worth of antibiotics, and after a week, the tooth pain and facial muscle discomfort improved.
I also started using a night guard for bruxism.
However, in the past week, I have noticed a worsening condition with the night guard.
The affected tooth has become very sensitive when chewing, and yesterday, I noticed a pus-filled bump on the gum around that tooth (the color of the gum).
It is not extremely painful, and I have avoided chewing on the right side all day.
Today, I observed that the top of the bump has developed a white spot resembling a pimple.
The tooth itself is not very painful, but the gum is tender.
I have not touched it, so it is not too uncomfortable.
I am currently traveling in another country and have scheduled an appointment with a dentist for a week from now when I return to my study location.
However, I am uncertain about the severity and urgency of the situation.
I am concerned that the inflammation may worsen to the point where a root canal treatment becomes necessary.
Therefore, I would like to ask you, Dr.
Tseng, whether I should seek immediate dental care locally and possibly use antibiotics, or if I can manage with saltwater or edible baking soda rinses and wait for a week before seeing the dentist.

Thank you, and I wish you well.

Niming, 20~29 year old female. Ask Date: 2018/01/04

Dr. Zeng Guanghui reply Dentistry

If there are painful swelling and abscesses around the teeth, making it difficult to bite down, it indicates acute inflammation of the periodontal tissues, and it is advisable to seek dental treatment immediately.
If you can tolerate it, try to avoid chewing hard foods temporarily, and make sure to maintain oral hygiene or use mouthwash to help disinfect the mouth.
Of course, if possible, it is recommended to seek medical treatment as soon as possible.

Reply Date: 2018/01/04

More Info

Tooth grinding, also known as bruxism, can lead to a variety of dental issues, including root inflammation and gum abscesses. Your situation, where you are experiencing sensitivity in a previously treated tooth, along with the development of a gum abscess, indicates that there may be an underlying infection or inflammation that needs to be addressed promptly.

Firstly, it is essential to understand that the presence of a gum abscess, characterized by a pus-filled bump on the gum, is a sign of infection. While the pain may not be severe at the moment, the infection can worsen if not treated, potentially leading to more serious complications, including the need for root canal therapy. The fact that you have already been prescribed antibiotics suggests that your dentist is concerned about the infection and its potential to spread.

Given that you are currently traveling and have a dental appointment scheduled for a week later, it is crucial to assess the urgency of your situation. Here are some recommendations:
1. Immediate Care: If you notice any increase in pain, swelling, or if the abscess begins to drain pus, it is advisable to seek dental care as soon as possible. An untreated abscess can lead to systemic issues, including fever and more severe infections that could require more intensive treatment.

2. Antibiotics: If your dentist prescribed antibiotics, it is important to complete the course as directed, even if you start to feel better. Antibiotics help control the infection, but they do not address the underlying issue, which may require further dental intervention.

3. Home Remedies: While waiting for your appointment, you can use warm saltwater rinses to help reduce inflammation and promote healing. Mix about half a teaspoon of salt in a glass of warm water and rinse your mouth several times a day. This can help soothe the gums and may assist in reducing discomfort.

4. Avoid Irritants: Try to avoid chewing on the affected side and refrain from consuming very hot, cold, or spicy foods that could exacerbate the sensitivity or irritation in the area.

5. Monitor Symptoms: Keep a close eye on your symptoms. If you experience any worsening of the condition, such as increased swelling, pain, or fever, seek local dental care immediately.
6. Follow-Up Care: Once you return to your school location, ensure that you follow up with your dentist. They may need to perform further evaluations, such as X-rays, to determine the extent of the inflammation and whether root canal treatment is necessary.

In summary, while you may be able to wait a week for your scheduled appointment, it is essential to monitor your symptoms closely. If there is any sign of worsening infection or increased discomfort, do not hesitate to seek immediate dental care. Your oral health is paramount, and addressing these issues promptly can prevent more severe complications down the line.

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