Dental Abscess: Symptoms, Treatment, and When to Seek Help

Dental abscess issue

Hello Doctor: I have a dental abscess near the gum of my upper right first molar.
I discovered it at the end of February, and I have not experienced any significant discomfort since then.
Around the end of March, I visited a dental clinic where the abscess was incised, and I completed a course of antibiotics.
Later, I went to a hospital dental department for a diagnosis, and the dentist suspected it to be an apical abscess, recommending root canal treatment.
However, due to the outbreak of the pandemic, outpatient services at major hospitals have been reduced, and I have been participating in a government-subsidized vocational training program with strict attendance requirements, which has delayed my treatment plan.
I expect to start the treatment plan by the end of June.
Recently, my abscess has started to become red, and my temperature has been around 37.0 to 37.4 degrees Celsius.
I am a bit worried that it might be cellulitis.
What should I do in this situation? Can I visit a clinic to ask the doctor for antibiotics?

tom, 20~29 year old female. Ask Date: 2022/05/14

Dr. Zeng Guanghui reply Dentistry

If there is no obvious swelling or pain on the buccal side of the gums, and no fever is present, it is likely not cellulitis.
However, a localized abscess should be treated promptly to prevent it from progressing to cellulitis.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/05/14

More Info

Dental abscesses are localized infections that can occur in the tooth, gums, or surrounding tissues, often resulting from untreated dental decay, gum disease, or trauma. They can manifest as a painful swelling or a "gum boil" filled with pus, and they may cause discomfort, fever, and swelling in the face or jaw. Understanding the symptoms, treatment options, and when to seek help is crucial for managing this condition effectively.

Symptoms of a Dental Abscess
1. Pain: This is often the most prominent symptom. The pain can be sharp, throbbing, or constant and may radiate to the jaw, neck, or ear.

2. Swelling: You may notice swelling in the gums, face, or jaw. The area around the abscess may feel warm to the touch.

3. Redness: The gums around the affected tooth may appear red and inflamed.

4. Fever: A mild fever (as you mentioned, around 37.0 to 37.4 degrees Celsius) can occur as the body fights the infection.

5. Bad Breath or Unpleasant Taste: This can result from the pus draining into the mouth.

6. Difficulty Opening the Mouth: In some cases, the swelling can restrict jaw movement.

Treatment Options
1. Antibiotics: If you suspect an infection, especially if the abscess is becoming red and you have a fever, it is advisable to consult a dentist. Antibiotics can help control the infection, especially if it has spread or if there are systemic symptoms like fever.

2. Drainage: The dentist may need to drain the abscess to remove the pus and relieve pressure. This is often done in conjunction with antibiotic therapy.

3. Root Canal Treatment: If the abscess is due to an infected tooth, a root canal may be necessary to remove the infected pulp and seal the tooth.

4. Extraction: In some cases, if the tooth is severely damaged or if the infection is extensive, extraction may be the best option.

5. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain and reduce inflammation.

When to Seek Help
You should seek dental care immediately if you experience:
- Increasing pain or swelling
- Difficulty swallowing or breathing
- Fever that persists or worsens
- Swelling that spreads to other areas of the face or neck
Given your situation, where the abscess has become red and you have a slight fever, it is essential to consult a dentist as soon as possible. While you can request antibiotics from a dental clinic, it is crucial to have a professional evaluation to determine the extent of the infection and the appropriate treatment plan.

Conclusion
In summary, dental abscesses require prompt attention to prevent complications such as the spread of infection or the development of more severe conditions like cellulitis or osteomyelitis. Given your current symptoms and the history of the abscess, it would be prudent to seek dental care sooner rather than later. A dentist can provide a thorough examination, possibly perform drainage, and prescribe the necessary antibiotics to manage the infection effectively. Delaying treatment could lead to more significant health issues, so prioritizing your dental health is essential.

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