Each tooth is made up three distinct layers: an inner pulp layer that is made up of nerves, blood vessels and cells; a layer of calcified tissue called dentin; and an outer layer of enamel, an extremely hard tissue that protects the tooth. Tooth decay caused by bacteria leads to the breakdown of enamel and eventually breaks down dentin. In severe cases of tooth decay, the bacterial infect the pulp of the tooth, eventually leading to tooth abscess. Tooth abscesses require immediate medical attention and can be treated by a number of methods.
Antibiotics and Painkillers
Since a tooth abscess is caused by a bacterial infection, an abscessed tooth can be partially treated with antibiotics, although they are not an appropriate long-term treatment. Antibiotics may help stop the spread of the infection, since bacteria from an infected tooth can spread to the jawbone, gums, and other organs if left untreated, reports the University of Maryland Medical Center.
Patients with a severe abscess may also be prescribed a course of antibiotics to treat the infection before or after dental procedures. Patients may also take analgesic medication to relieve pain until the tooth abscess can be removed with further treatment.
Root Canal
An abscessed tooth caused by tooth decay or fracture may be treated with root canal therapy, a dental procedure that removes the infected material at the pulp of the tooth. NYU Langone Medical Center reports that a root canal procedure for an abscessed tooth may involve drilling to expose the pulp and relieve pressure from pus on the tooth. Once the pulp is exposed, pus and infectious material can drain out of the tooth.
After the abscess has been drained, the dentist will use a file to remove pulp from each root of the tooth to scrape away any potentially infectious material. The roots and the center of the tooth are sealed with filling material. Crown is placed over the tooth for structural support, since a tooth that has undergone a root canal is considered "dead", and it is much weaker than living teeth.
Tooth Removal
If left to progress, tooth abscess can lead to the development of a fistula, which results from a collection of pus that connects sites of infection within the teeth and jaw around the infected tooth. The collection of pus puts pressure on the teeth and damages the bone around the abscessed tooth. If the bone becomes damaged, the tooth may require an extraction, since there is no structural support for the tooth after root canal therapy. The dentist or oral surgeon may drain the pus and infected tissue by cutting the gums and then remove the affected tooth. After extraction, the patient may have the tooth replaced with a prosthetic.
