It's hard to imagine how a toothache could turn deadly - but it can. Even mild or moderate discomfort (for example, pain while chewing... sensitivity to hot and cold... and/or redness and swelling of the gums) can quickly turn into a potentially serious condition, known as abscess, a pus-filled infection inside the tooth or between the tooth and the gum. Though the pain may be merely a day or so, it can turn into the intense, throbbing pain or sharp, shooting pain that is the telltale sign of an abscess.
Dangerous Trend: The number of Americans hospitalized for dental abscesses is on the rise. Over a recent eight-year-period, hospitalizations for periapical abscesses (infections at the tip of the tooth root) increased by more than 40%.
No one has a precise explanation for the trend, but some experts speculate that the high cost of dental insurance is preventing many people from seeking routine dental care and perhaps delaying treatment when a problem occurs.
WHAT GOES WRONG
If there's a breach in a tooth's protective enamel - from tooth decay, a chip pr even gum disease, for example - you're at risk for an abscess. Some cracks can be taken care of with bonding or a crown.
Other Signs To Watch For: In addition to the symptoms described earlier, other red flags of a dental abscess may include persistent foul breath, a swollen face, jaw and/ neck glands and a fever.
Once the pain kicks in, people who have dental abscesses will often describe it as the worst they've ever experienced.
Get Help immediately: An abscess will not go away on its own. Worse, the infection can spread as quickly as overnight. An abscess can cause death when the infection spreads to the brain or heart or when swelling cuts off the airway.
When To Be Especially Suspicious: If you have pain in one of your back teeth. They're the ones that do most of the chewing, and they're also the ones that are harder to reach with dental floss and a toothbrush. If you crunch something hard, such as a popcorn kernel, piece of ice or even an almond, a back tooth is the one most likely to be cracked.
GETTING PROMPT TREATMENT
Your dentist can diagnose an abscess in just a few minutes. All he/she has to do is gently tap on the suspected tooth with a small metal device and see if you wince. A tooth abscess will be very sensitive to pressure. An X-ray will confirm is there's pus-filled pocket near the tooth root.
You might be given penicillin or another antibiotic if the infection has spread beyond the tooth. In addition, your dentist will treat the abscess in one of three ways...
Incision and draining: If the abscess is between the tooth and the gun, your dentist will make a small incision, drain out the pus and clean the area with saline. The pain will start to diminish almost immediately. Your dentist also can drain an abscess that occurs inside a tooth, but this won't cure it - the infection will probably come back.
Root canal: This is the most widely used treatment for an abscess near the tooth root. Your dentist will drill into the infected area, scrape away damaged tissue and drain the pus. After that, the canal will be filled with sealant, and the tooth will be crowned (a porcelain or metal cap is put over the tooth). If you get a root canal there's a good chance that the tooth will survive.
Extraction: This is the most permanent treatment for a deep abscess - and once the tooth is gone, the abscess goes with it.
If you can't see a dentist immediately: Consider going to an ER if you have severe pain and/or swelling. If you are having trouble breathing, go to an ER right away.
PREVENTING AN ABSCESS
If you take care of your teeth, there's a good chance that you'll never have an abscess.
Use fluoride toothpaste: It remineralizes tooth enamel and makes it stronger. This is particularly important for older adults, whose receding gums can expose parts of the tooth and leave it vulnerable to decay.
Also helpful: A fluoride mouth rinse. There are many brands in drugstores that strengthen the enamel and reduce tooth decay.
Don't slack off dental visits: Most people should have dental checkups and cleanings every six months. If you smoke or have gum disease, diabetes or an other condition that increases your risk for dental problems, it's usually a good idea to schedule even more frequent dental visits.