Upper Jaw Abscess: Causes, Treatments, and Recovery

Maxillary abscess

Hello Doctor, I have a question.
On March 3rd, I developed a pus-filled bump next to my upper left molar.
I visited an ENT specialist who said it was a dental issue.
Later, I saw a dentist who informed me that the bump was caused by inflammation at the apex of the molar's root due to a previous dental crown that had not undergone root canal treatment.
I was advised to undergo root canal therapy, and the bump would heal on its own.
I scheduled the root canal treatment for next week.

A few days later, I noticed a similar bump on my upper palate and went back to the ENT clinic, where they said it was also due to inflammation.
During my root canal treatment, I mentioned the bump on the upper palate to the dentist, who suggested it might be related to a tooth issue, possibly caused by food irritation.
Concerned, I went to the ENT department at National Taiwan University Hospital, where they suspected a blocked salivary gland, stating that it was unlikely to be caused by the molar since it was too far away.
They scheduled me for an outpatient procedure on April 22nd.
I underwent root canal treatment three times because the tooth continued to hurt and required microscopic treatment.
Eventually, I decided to have the tooth extracted.
During the root canal treatment, the pus next to the tooth disappeared, and shortly after, the bump on my upper palate also resolved, so I canceled the ENT outpatient procedure on April 22nd.

Since the dentist who performed the extraction was different from the one who did the root canal, I returned a week later for a follow-up.
I asked the dentist about the bump on my upper palate, and they took full-mouth X-rays.
They pointed out that a tooth next to my front tooth had been filled before and showed signs of inflammation at the root, with a white area indicating bacteria had entered.
The previous inflammation on my upper palate was likely caused by this tooth.
I asked the dentist why the bump had disappeared on its own, and they explained that when the immune system is stronger, the bump might resolve, but it could reappear when the immune system is weaker.
This tooth also requires root canal treatment, which I scheduled for April 23rd.
On May 3rd, the doctor at the hospital said they needed to inject medication into the tooth to see if the bone could regenerate enough to support a dental implant; otherwise, a minor surgical procedure might be necessary.
After the injection, the tooth was very painful, and I took a painkiller.
The next morning, May 4th, I woke up with less pain, but I noticed that the spot where the previous upper palate bump had disappeared now had a new, larger bump in the exact same location.
Is this normal?

Wenwen, 40~49 year old female. Ask Date: 2022/05/07

Dr. Zeng Guanghui reply Dentistry

The apex of the upper tooth had inflammation and developed a pus-filled abscess.
After undergoing root canal treatment, the abscess disappeared.
However, due to the resorption of the surrounding bone at the apex, a type of material was placed into the root canal to promote healing of the adjacent bone.
If a new abscess develops after the placement of the material, a follow-up visit is necessary for the dentist to provide further treatment.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/05/07

More Info

An upper jaw abscess, particularly one associated with dental issues, can be a complex condition that requires careful evaluation and management. Based on your description, it appears that you have been experiencing a series of dental complications, including the development of abscesses related to your upper molars, which may be linked to untreated root canal issues and possibly other dental infections.

Causes of Upper Jaw Abscess
1. Dental Infections: The most common cause of an abscess in the jaw is an infection stemming from a tooth that has undergone decay or trauma. When the pulp of the tooth becomes infected, it can lead to the formation of pus, resulting in an abscess.

2. Periodontal Disease: Infections can also arise from the gums surrounding the teeth. If gum disease is present, it can lead to pockets of infection that may develop into abscesses.

3. Complications from Dental Procedures: As you mentioned, previous dental work, such as crowns or fillings, can sometimes lead to complications if not properly managed. If bacteria enter through these areas, they can cause infections.

4. Salivary Gland Issues: Your consultation with the ENT specialist suggested that the abscess might also be related to a blocked salivary gland, which can occur due to various reasons, including dehydration or the presence of stones.

Treatments for Upper Jaw Abscess
1. Root Canal Treatment: This is often the first line of treatment for abscesses caused by infected teeth. The procedure involves removing the infected pulp, cleaning the canal, and sealing it to prevent further infection.

2. Antibiotics: If there is a significant infection, antibiotics may be prescribed to help control the infection and reduce inflammation.

3. Drainage: In some cases, if the abscess is large, it may need to be drained to relieve pressure and remove pus.

4. Surgical Intervention: If there is significant bone loss or if the abscess is recurrent, surgical options may be considered to remove the affected tissue or tooth.

5. Pain Management: Over-the-counter pain relievers or prescribed medications can help manage pain associated with the abscess.

Recovery and Monitoring
Recovery from a dental abscess can vary based on the severity of the infection and the treatment provided. It is essential to monitor the area for any signs of recurring infection, such as swelling, pain, or the reappearance of abscesses.

Your Current Situation
Regarding your concern about the new abscess appearing after treatment, it is not uncommon for abscesses to recur or for new ones to develop, especially if there are underlying issues that have not been fully addressed. Factors such as your immune response, the presence of bacteria, and the effectiveness of the initial treatment can all play a role in this.

It is crucial to follow up with your dentist or oral surgeon regarding the new abscess. They may need to reassess the situation, possibly perform imaging studies, and determine if further intervention is necessary. If the abscess is larger or accompanied by significant pain, it may require immediate attention.

Conclusion
In summary, while it is not unusual for abscesses to recur, especially in the context of dental infections, it is essential to address the underlying causes effectively. Regular dental check-ups, proper oral hygiene, and prompt treatment of any dental issues can help prevent future occurrences. If you have any concerns about your treatment or the recurrence of the abscess, do not hesitate to reach out to your dental care provider for further evaluation and management.

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