Dental infections can be VERY SERIOUS! If left untreated, believe it or not, they can cause HOSPITALIZATIONS and CAN BE LIFE THREATENING!!!
They are usually caused by either the TOOTH (DENTAL ORIGIN) or the surrounding tissues and gums (PERIODONTAL ORIGIN).
When it comes to TOOTH infections, usually the NERVE is involved. The NERVE is in the geometric center of the tooth, and feeds out through the end of the root. Because of this pathway, when the nerve dies or gets infected, it provides an easy route for the bacteria to infect the surrounding structures.
Once the bacteria get out of the tooth, they eat away the bone supporting both that tooth and any adjacent teeth. Eventually this can cause the loss of one or more teeth, but it may also cause SWELLING into the surrounding structures or spaces.
This SWELLING is what can become VERY SERIOUS. Dental infections can cause extensive swelling which may swell EYES SHUT, or even worse, may proceed under the jaw/mandible, which can in turn prevent SWALLOWING or CLOSE OFF a person’s AIRWAY.
Below is a dental xray, or dental radiograph of an abscessed tooth. The tooth has had a root canal, which actually looks good, but the abscess is not healing. This tooth will likely need endodontic surgery. The swelling was evident in the mouth, and could be felt by the patient and dentist.
As for DENTAL INFECTIONS,
At the top of the list has to be CAVITIES. When cavities are left untreated, the bacteria causing the cavity will continue to eat into the tooth until it gets to the nerve. When that happens, the tooth will get infected, and if left untreated even further, can proceed as mentioned above.
This includes cavities as well as deep or LARGE FILLINGS. If you have a large or deep filling, there is not much tooth between it and the nerve. Without much protection, the nerve is likely to get stimulated more, and can eventually die.
Next, any sort of TRAUMA to the teeth can damage the nerve, causing it to die. If this happens, it needs to be removed or else it will eventually cause a dental infection. This trauma includes external forces such as a punch, but can also be caused by extensive ORAL forces on a particular tooth. For example, if you have one tooth that shoulders much of the biting forces, it can eventually cause the nerve to die off.
As for PERIODONTAL INFECTIONS,
Anyone with SEVERE gum disease can get a dental infection. If you’ve lost bone surrounding the tooth, that provides the bacteria a tract to get to the root of the tooth. When this happens, the bacteria kill off the nerve of the tooth, and start eating away the surrounding bone and can progress into the surrounding spaces and structures.
These can also progress around IMPACTED WISDOM or other teeth. Whenever a tooth is exposed to the oral cavity, it is susceptible to infection. When a tooth is not completely erupted, it is very difficult to clean. This combination provides the bacteria a PERFECT situation. A tooth to infect, and a difficult spot to clean. This is ONE REASON why it is often recommended to EXTRACT IMPACTED WISDOM TEETH.
WHEN IS THAT INFECTION SERIOUS?
When it HURTS, often times the PAIN WILL BE UNBEARABLE!
If you can deal with the pain, you need to be aware of SWELLING.
If the swelling cause difficulty swallowing, breathing, or you have a temperature over 100 degrees, you definitely need to get treated as soon as possible.
HOW ARE INFECTIONS TREATED?
In order to treat dental infections, the source of the infection needs to be addressed, as well as the bacteria present that are causing the swelling. This often involves BOTH TEETH AND GUMS.
The tooth will likely either need to be ROOT CANALED or EXTRACTED, and the infection may need to be INCISED AND DRAINED (I&D). As discussed above, if the nerve is involved, it needs to be cleaned out. If there are compounding problems, it may need to be extracted. Some teeth have no choice but to be extracted.
I&D: This is basically like popping a pimple. This is done to relieve the swelling, and if often an uncomfortable procedure, but if it is done, it is VERY necessary. Often times there is a DRAIN that is placed in the infection. This provides the bacteria an easy tract to exit, rather than to cause more SWELLING. If a drain is placed, it will need to be removed in 2-3 days.
It is important to keep in mind that after an I&D is performed, the swelling may INCREASE over the course of the next day, due to the TRAUMA caused to the area. This is NOT NECESSARILY a bad outcome however, so be patient. INFECTIONS DO NOT CLEAR UP OVERNIGHT!!Also, ANTIBIOTICS will likely be involved in some aspect.
Antibiotics take a couple of days to get into your system, but they are an important part of treatment in that they help to fight off the infection. The ROOT CANAL or EXTRACTION helps to elimiate the SOURCE of infection, while the I&D and ANTIBIOTICS help to manage the swelling and kill off the bacteria causing the infection.
You will usually have the antibiotics for 7-10 days. Once you start taking them, always take them until they are gone regardless of if the swelling has gone away.
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