Upper Jaw Abscesses: Causes, Treatments, and Concerns

Maxillary abscess

Hello, doctor.
I’m not sure if you misunderstood my previous question, so I would like to ask again.
Thank you.
I have two abscesses: one is located on the gum next to my molar, and the other is on the upper gum next to my incisor.
After the root canal treatment on the molar, the abscess on the gum next to it disappeared, and the abscess on the upper gum next to the incisor also went away.
However, it wasn’t because of the root canal treatment on the incisor; later, the doctor took a full mouth X-ray and mentioned that the tooth next to my incisor also had a periapical abscess and inflammation.
He suggested that the previous upper abscess might have been caused by this tooth.
Although the abscess has now disappeared, I need to undergo root canal treatment on the tooth next to the incisor for it to heal completely.

During my first root canal treatment, I didn’t experience much pain because the nerve was already necrotic.
On my second visit, the doctor injected medication into that tooth, stating that it was necessary for the bone to regenerate.
The procedure was very painful, even with anesthesia, and once the anesthesia wore off, the tooth hurt significantly.
The next day, the previously disappeared upper abscess reappeared.
I later visited the dentist again, and he explained that there were bacteria causing inflammation inside the tooth, and he injected medication into it.
The root was inflamed, and there was a possible canal outlet, similar to the previous molar situation.
He assured me that once this tooth is treated, the upper abscess will disappear.
I would like to ask if the reappearance of the upper abscess is related to the medication injected into the tooth.
Since the medication was injected on May 3rd, the upper abscess has been fluctuating in size.
Is this normal, or should I consider seeing an ENT specialist again?

Wenwen, 40~49 year old female. Ask Date: 2022/05/27

Dr. Zeng Guanghui reply Dentistry

If during root canal treatment, after the injection of medication intended to promote bone regeneration, pain is felt and a previously resolved abscess reappears, it is possible that the medication was injected into the area surrounding the apex of the tooth root where the abscess is located.
Generally, the injected medication is expected to be gradually absorbed, leading to the slow resolution of the abscess.
However, if the abscess persists, it is advisable to return for a follow-up appointment for evaluation and examination by a dentist.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/05/27

More Info

Upper jaw abscesses, particularly those associated with dental issues, can be quite complex and often arise from infections related to the teeth or gums. Based on your description, it seems you have experienced multiple abscesses, one near your molar and another near your incisor, which can be indicative of underlying dental problems.

Causes of Upper Jaw Abscesses
1. Dental Infections: The most common cause of abscesses in the upper jaw is dental infections, often stemming from untreated cavities, gum disease, or previous dental procedures like root canals. When bacteria invade the dental pulp or surrounding tissues, they can lead to localized infections, resulting in abscess formation.

2. Root Canal Issues: As you mentioned, you had root canal treatment on your molar. If the treatment was not entirely successful or if there is residual infection, it can lead to the formation of an abscess. The same applies to your incisor; if there is an infection in the root canal system, it can cause an abscess to develop.

3. Periodontal Disease: Infections related to the gums can also contribute to abscess formation. If the gum tissue around the teeth is inflamed or infected, it can lead to the development of an abscess.

Treatments for Upper Jaw Abscesses
1. Root Canal Treatment: This is often the first line of treatment for abscesses caused by dental infections. The procedure involves removing the infected pulp, cleaning the root canals, and sealing them to prevent future infections.

2. Antibiotics: If there is a significant infection, your dentist may prescribe antibiotics to help control the infection. This is particularly important if the infection has spread or if you have systemic symptoms like fever.

3. Drainage: In some cases, if the abscess is large, it may need to be drained. This can be done in the dental office, where the dentist will make an incision to allow the pus to escape.

4. Surgical Intervention: If the abscess does not respond to conservative treatments, surgical intervention may be necessary to remove the infected tissue or to perform additional procedures on the affected tooth.

Concerns and Follow-Up
Given your situation, it is crucial to monitor the abscess closely. The fact that the abscess has reappeared after treatment could indicate that the underlying issue has not been fully resolved. Fluctuations in the size of the abscess can occur, especially if there is ongoing infection or if the treatment has not completely eradicated the bacteria.

1. Pain Management: If you are experiencing significant pain, it is essential to communicate this with your dentist. They may need to adjust your treatment plan or provide additional pain relief.

2. Follow-Up Care: Since you have had multiple treatments and the abscess has recurred, it would be wise to schedule a follow-up appointment with your dentist. They may want to take additional imaging, such as X-rays, to assess the status of the tooth and surrounding bone.

3. Referral to a Specialist: If the issue persists, your dentist may refer you to an endodontist (a specialist in root canal treatment) or an oral surgeon for further evaluation and treatment.

4. ENT Consultation: If you notice any symptoms beyond dental pain, such as swelling in the face, fever, or difficulty swallowing, it may be prudent to consult an ear, nose, and throat (ENT) specialist to rule out any complications related to the infection.

In summary, while it is not uncommon for abscesses to fluctuate in size, persistent or recurrent abscesses warrant further investigation and treatment. It is essential to maintain open communication with your dental care provider to ensure that the underlying issues are adequately addressed.

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