Dental abscess is a serious condition that affects approximately 200,000 people in the U.S. every year, resulting in a large portion of the estimated 850,000 dental emergency room visits annually. For some lucky people, a dental abscess may resolve itself with at-home treatments, but for others, dental incision and drainage is the best treatment option.
When do you need dental incision and drainage?
Caused by an infection in a portion of the mouth, a dental abscess can occur in any patient. There are three main types of dental abscesses, all of which might require dental incision and drainage.
- Gingival abscess: This type of abscess involves the gingival (gum) tissue only. It can be located very close to the tooth but does not occur as a result of tooth infection.
- Periapical abscess: A periapical abscess begins in the soft pulp inside the tooth with an infection of the dentin.
- Periodontal abscess: A periodontal abscess (also called a lateral abscess) is one that affects the teeth and other bone structures in the mouth.
Periapical and periodontal abscesses may not be visible to the naked eye, but gingival abscess appears first as a white or yellow spot on the gum. Over time, the spot may appear to get larger and become swollen as the pocket fills with bacteria and pus. It resembles a pimple on the gum.
While pain is the main symptom that sends patients to the emergency dentist (AZ Dentist is your Scottsdale emergency dentist if you’re near Phoenix!), some dismiss this early symptom. Pain may be infrequent and episodic, relieved for a time when the abscess bursts.
Abscess symptoms
Regardless of the type of abscess, each has similar symptoms that include:
- Pain and pressure that increases when you lay down
- Increased sensitivity to hot and cold food and drink
- A rush of foul-tasting liquid when you bite down, with a corresponding temporary decrease in pain
- Bad breath
- Difficulty swallowing
- Feeling “off” or unwell
- Fever
- Radiating pain that spreads to the ear, jaw, or neck
Dental incision and drainage can help relieve the pain and pressure that comes from a dental abscess.
What can I expect during and after incision and drainage?
Left untreated, there are a number of serious medical issues that can be caused by an untreated abscessed tooth. A sinus infection is one of the least serious. An untreated gingival abscess will eventually try to treat itself. The bacteria will eat away the gum and bone, boring a tunnel to create gingival abscess drainage. This tunnel is called a fistula and is visible as a small hole in the gums.
Periodontal and periapical abscess can also create infection in the bone that travels to other areas in the body, including soft tissues of the face and skull.
Once you experience symptoms of abscess and receive a diagnosis, your dentist may recommend surgical incision and drainage. Dental abscess drainage is a common treatment for dental abscess. It removes the infected material and allows the abscess to be thoroughly cleaned and treated. There are three steps to dental incision and drainage.
Step 1: Preparation
Often the anticipation of the procedure is more anxiety-producing than the procedure itself.
If this is the case for you, your dentist may prescribe a mild sedative to take before they perform the dental incision and drainage. If the area is painful, they may also use a local anesthetic to ensure your comfort.
Step 2: The incision
Using a surgical scalpel, your dentist will make an incision at the most prominent part of the abscess. The incision is deep enough to open the abscess but avoids going any deeper.
It is important that the incision follow the natural lines of the gum to prevent visible scars. This part of the procedure may result in a foul taste in the mouth. This is normal and temporary as the infected fluid drains. A dental assistant will help to suction the fluid away as well to reduce any unpleasant taste.
Step 3: Probing
Using a gloved finger or cotton swab, your dentist will probe the incision to make sure that all pockets of pus are broken up and drained.
The initial incision will open the largest body of the abscess, but it is important to make sure all smaller interior abscesses are broken up and drained.
Step 4: Abscess flush and drainage
Thoroughly flushing the incision is an important part of the process. Your dentist will use a saline solution and irrigate the incision until all pus, blood, and debris is removed.
The incision is packed with gauze to stop bleeding. In cases of excessive bleeding, your dentist may choose to cauterize the wound. Otherwise, bleeding will generally stop on its own and be minor. Most dentists will also not pack the incision, choosing to let it heal without packing material.
Your dentist may take a sample of the drained fluid and send it for testing if they feel further analysis is needed. More often, the fluid is simply drained and flushed.
In some cases, your dentist may also install a small drainage tube to assist with further drainage. If this is the case, the tube will stay in place until the abscess is fully drained and then be removed at a follow-up visit.
How do I take care of my dental abscess after drainage?
Dental incision aftercare is important to keep the incision clean and prevent further infection. Your dentist will provide you with follow-up instructions and aftercare. Always follow all the directions they give you.
Generally, flushing several times a day with warm salt water can keep your wound clean and prevent further infection. Antibiotics may also be prescribed. If this is the case, it is important to take the full course as directed.
Warm compresses on the outside of your face can also be soothing and help with pain. Over-the-counter anti-inflammatory medications should be sufficient to manage pain, but talk to your doctor if you are experiencing severe pain that is unrelieved by any medications or at-home therapies.
Dental abscess can be serious if left untreated. A dental incision and drainage can help your relieve pain and pressure, and prevent infection. Don’t put off treatment any longer. Give us a call today at AZ Dentist.