July 03, 2021
An abscess is a collection of infection fluid that can arise due to the ingress of microbes following an insult to a tissue complex. A dental abscess is found in relation to the roots of the tooth. In order to understand the formation of dental abscess, it is important to know what triggered it in the first place.
How does a tooth abscess occur?
Microorganisms can find their way on the surface of the tooth if oral hygiene measures are not taken care of. These microbes have the ability to secrete acids that can degrade the hard tissue layers of the tooth (enamel and dentin). Once the rotting of the tooth starts, the deeper the decay goes, the more it becomes painful. The pulp, located at the core of the tooth is protected by the enamel and dentin. When the decay reaches the pulp, the pain increases as it is sensed by the nerves and blood vessels present in the pulp. The entire pulpal chamber is invaded by the microbes and the part of the pulp present in the roots soon becomes infected.
The microbes that are routinely found in abscessed teeth are such that can survive both in the presence and the absence of oxygen. Apart from a decay, a tooth that has had previous treatment but not properly sealed or a tooth that has been fractured are also some of the common routes through which the microbes can cause an abscess. It thus becomes important to eliminate these microbes. This is done primarily through surgical interventions in which a dentist carries out the root canal treatment.
Antibiotic therapy in combination with dental treatment
An abscess needs to be drained, as a patient shows up with a swelling, pain and redness associated with the tooth. This drainage is done by drilling the tooth a opening it for the abscess to drain. The canals of the root are irrigated with certain liquid medicaments that remove all the debris and biofilms caused by the microbes. An appropriate medicament is placed within the canals that prevents re-infection of the tooth. In the process of this treatment which can be completed in a single-sitting or can go up to three sessions, the dentist will advice the patient to take antibiotics whose course lasts for 2 to 3 days.
Antibiotics chosen for dental abscesses are such that they target a wider range of microorganisms and do not cause any adverse reactions upon consumption. Amoxicillin, Metronidazole, Cephalosporins, Clindamycin are some of the most commonly used treatment options for stopping the spread and eliminating the microorganisms. Dosing for each of them vary based on their pharmacological effects on the body. The patient should be asked about a history of allergy to any of the drugs. Based on their age and the presence or absence of a systemic condition, the patient is prescribed the antibiotics.
Can antibiotics only treat dental abscess?
If a patient visits a dentist and presents with an abscess, simply a prescription of antibiotics will not act as a permanent solution. Temporarily, the swelling might regress and the patient might feel that his or her condition is bettered. However, the root cause of the abscess has not been eliminated yet and hence a re-infection can occur when he microbes once again accumulate at the decayed, fractured or open surfaces of the teeth.
Antibiotics have been prescribed for dental abscesses for a long time. We are now starting to observe that certain species of microbes have developed a resistance to some commonly prescribed antibiotics. In such cases, the dentist is likely to switch to an alternative antibiotic or might give another antibiotic in conjunction. The prescription of antibiotics mentions the dosage that the patient is supposed to take. If consumed more than prescribed, the patient is likely to develop side-effects and hypersensitive reactions. Patients with a previous history of implants, cardiac, nephritic or lung surgeries should specifically keep in mind about the dosing prescribed by their dentist.
Does antibiotic therapy help with tooth abscess pain?
The dental abscess had very good prognosis when an intervention is done upon its diagnosis. However, if ignored, this abscess can invade the adjacent regions of the teeth, and lead to septicaemia. Certain spaces in the face might become infected, swollen and ultimately, surgeries need to be scheduled for their drainage. Antibiotics are helpful in limiting the spread of microorganisms. But they should never be the sole reason of eliminating an abscess. Thus, a visit to the dentist upon the fret observation of a dental abscess should be mandatory.